title: Caregivers' Malaria Knowledge, Beliefs and Attitudes, and Related Factors in the Bata District, Equatorial Guinea.
abstract: OBJECTIVE
  Adequate community knowledge about malaria is crucial in order to improve prevention by reducing exposure to the disease. Malaria is a major cause of morbidity and mortality among children of less than five years of age in Equatorial Guinea. However, information concerning the accuracy of community knowledge is insufficient. This study aimed at assessing the depth of caregivers' knowledge of malaria, their beliefs and attitudes about this disease, and their socioeconomic determinants in the Bata district of Equatorial Guinea.
  
  
  METHODS
  A cross-sectional study was conducted in the district of Bata, involving 440 houses selected from 18 rural villages and 26 urban neighbourhoods. A combined "Malaria Knowledge Score" was generated based on caregivers' knowledge about transmission, symptoms, prevention, the treatment of children, and best place to seek treatment. Multivariate logistic regressions analyses were performed to assess those factors that are associated with knowledge about malaria.
  
  
  RESULTS
  A total of 428 caregivers were interviewed; 255 (59.6%) and 173 (40.4%) lived in urban and rural areas respectively. Significant differences between rural and urban households were observed in caregivers' malaria knowledges and beliefs. Almost 42% of urban and 65% of rural caregivers were unaware as to how malaria is transmitted (OR = 2.69; 95% CI: 1.78-4.05). Together with rurality, the factors most significantly associated with the Malaria Knowledge were the level of education of the caregiver and the socioeconomic status of the household.
  
  
  CONCLUSIONS
  Improvements in educational programs are needed to empower the most vulnerable households such that they can pro-actively implement malaria control measures. This could be achieved by a comprehensive communication strategy aimed at changing individual and community behaviours, and delivered by suitably trained community health workers and indoor residual spraying personnel.
authors.affiliation: Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.|Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain.
authors.forename: Maria
authors.identifier: http://orcid.org/0000-0002-0177-6885
authors.initials: M
authors.lastname: Romay-Barja
authors.affiliation: Centro de Referencia de Control de Endemias, Malabo, Equatorial Guinea.
authors.forename: Policarpo
authors.initials: P
authors.lastname: Ncogo
authors.affiliation: Ministerio de Salud y Bienestar Social, Malabo, Equatorial Guinea.
authors.forename: Gloria
authors.initials: G
authors.lastname: Nseng
authors.affiliation: Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain.|Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Santana-Morales
authors.affiliation: Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.|Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain.
authors.forename: Zaida
authors.initials: Z
authors.lastname: Herrador
authors.affiliation: Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.|Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Berzosa
authors.affiliation: Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain.|Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Basilio
authors.initials: B
authors.lastname: Valladares
authors.affiliation: Ministerio de Salud y Bienestar Social, Malabo, Equatorial Guinea.
authors.forename: Matilde
authors.initials: M
authors.lastname: Riloha
authors.affiliation: Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.|Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain.
authors.forename: Agustin
authors.initials: A
authors.lastname: Benito
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D003150:Community Health Workers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003469:Culture; D016703:Equatorial Guinea; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008288:Malaria / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012424:Rural Population; D012959:Socioeconomic Factors; D055815:Young Adult