title: Is Nigeria winning the battle against malaria? Prevalence, risk factors and KAP assessment among Hausa communities in Kano State.
abstract: Malaria is one of the most severe global public health problems worldwide, particularly in Africa, where Nigeria has the greatest number of malaria cases. This community-based study was designed to investigate the prevalence and risk factors of malaria and to evaluate the knowledge, attitudes, and practices (KAP) regarding malaria among rural Hausa communities in Kano State, Nigeria.
  
  
  
  A cross-sectional community-based study was conducted on 551 participants from five local government areas in Kano State. Blood samples were collected and examined for the presence of Plasmodium species by rapid diagnostic test (RDT), Giemsa-stained thin and thick blood films, and PCR. Moreover, demographic, socioeconomic, and environmental information as well as KAP data were collected using a pre-tested questionnaire.
  
  
  
  A total of 334 (60.6 %) participants were found positive for Plasmodium falciparum. The prevalence differed significantly by age group (p < 0.01), but not by gender or location. A multivariate analysis showed that malaria was associated significantly with being aged 12 years or older, having a low household family income, not using insecticide treated nets (ITNs), and having no toilets in the house. Overall, 95.6 % of the respondents had prior knowledge about malaria, and 79.7, 87.6 and 95.7 % of them knew about the transmission, symptoms, and prevention of malaria, respectively. The majority (93.4 %) of the respondents considered malaria a serious disease. Although 79.5 % of the respondents had at least one ITN in their household, utilization rate of ITNs was 49.5 %. Significant associations between the respondents' knowledge concerning malaria and their age, gender, education, and household monthly income were reported.
  
  
  
  Malaria is still highly prevalent among rural Hausa communities in Nigeria. Despite high levels of knowledge and attitudes in the study area, significant gaps persist in appropriate preventive practices, particularly the use of ITNs. Innovative and Integrated control measures to reduce the burden of malaria should be identified and implemented in these communities. Community mobilization and health education regarding the importance of using ITNs to prevent malaria and save lives should be considered.
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.|School of Health Technology, Club Road, Nassarawa, Kano, Kano State, Nigeria.
authors.forename: Salwa
authors.initials: S
authors.lastname: Dawaki
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. halmekhlafi@yahoo.com.|Endemic and Tropical Diseases Unit, Medical Research Center, Jazan University, Jazan, Kingdom of Saudi Arabia. halmekhlafi@yahoo.com.|Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen. halmekhlafi@yahoo.com.
authors.forename: Hesham M
authors.identifier: 0000-0003-2582-7410
authors.initials: HM
authors.lastname: Al-Mekhlafi
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. init@um.edu.my.
authors.forename: Init
authors.initials: I
authors.lastname: Ithoi
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Jamaiah
authors.initials: J
authors.lastname: Ibrahim
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Wahib M
authors.initials: WM
authors.lastname: Atroosh
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Awatif M
authors.initials: AM
authors.lastname: Abdulsalam
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Hany
authors.initials: H
authors.lastname: Sady
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Fatin Nur
authors.initials: FN
authors.lastname: Elyana
authors.affiliation: North West Zonal Tuberculosis Reference Laboratory, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.
authors.forename: Ado U
authors.initials: AU
authors.lastname: Adamu
authors.affiliation: Rabi'u Musa Kwankwaso College of Advanced and Remedial Studies, Tudun Wada, Kano State, Nigeria.
authors.forename: Saadatu I
authors.initials: SI
authors.lastname: Yelwa
authors.affiliation: Department of Biology, Faculty of Natural and Applied Sciences, Umaru Musa Yar'adua University, Katsina, Katsina State, Nigeria.
authors.forename: Abdulhamid
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Mona A
authors.initials: MA
authors.lastname: Al-Areeqi
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Lahvanya R
authors.initials: LR
authors.lastname: Subramaniam
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Nasr
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Yee-Ling
authors.initials: YL
authors.lastname: Lau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Attitude; Epidemiology; Knowledge; Malaria; Nigeria; Practice; Prevalence