Knowledge, attitudes and practices of malaria control and prevention in a high-exposure occupational group: A cross-sectional survey of mining workers in Haut-Katanga Province in the Democratic Republic of Congo

BACKGROUND: Mining workers represent a high-risk occupational population for malaria in the Democratic Republic of Congo. This study aimed to assess the knowledge, attitudes and practices regarding malaria control and prevention among mining workers to inform targeted interventions. METHODS: A cross-sectional survey was conducted among 606 mining workers in Haut-Katanga Province. Data on socio-demographics and KAP regarding malaria were collected using a structured questionnaire. Multivariate logistic regression was employed to explore potential independent determinants of adequate knowledge and poor practice. P values less than 0.05 were considered statistically significant. RESULTS: Totally 485 valid questionnaires were collected, and 365 mining workers (75.3%) were considered to possess adequate knowledge. Multivariate analysis revealed that middle school education level (adjusted OR = 0.37; 95% CI: 0.22-0.64; p < 0.01) and working in the early morning or evening shifts were significant barriers to achieving adequate knowledge (adjusted OR = 0.46; 95% CI: 0.24-0.90; p = 0.02). For attitudes, most workers were willing to use insecticide-treated bed nets (99.3%) and spray insecticides indoors (94.7%). Highest self-reported preventive practices were wearing long-sleeved clothing (99.3%) and the use of insecticide-treated bed nets (91.1%). CONCLUSIONS: Although majority of mining workers demonstrates adequate knowledge of malaria, a significant "knowledge-practice gap" still exists, enhancing the need to promote acceptance and sustained adoption of preventive practices. Corporate policies should move beyond general education toward visual-based training tailored for miners and subsidized preventive tools at home. The implementation of malaria-specific paid sick leave will also be essential to translate positive attitudes into prompt health-seeking behaviors by removing financial disincentives.