Knowledge, attitudes and practices on malaria and mosquitoes in the Far-North region of Cameroon

BACKGROUND: Malaria remains a significant public health burden in Cameroon, with the Far-North region experiencing high transmission rates. Despite the widespread distribution of Long-Lasting Insecticidal Nets (LLINs) and other control measures, the disease persists. Understanding the community's knowledge, attitudes and practices (KAP) is crucial for developing effective and targeted interventions. This study aimed to assess the KAP regarding malaria and its mosquito vectors among households in the Far-North region of Cameroon. METHODS: A community-based cross-sectional survey was conducted in 50 randomly selected villages across the region from August to September 2020. A total of 500 households were interviewed using a structured questionnaire translated into local languages. Data were analyzed using descriptive statistics and Pearson correlation to identify factors associated with key knowledge and practice outcomes. RESULTS: General knowledge about malaria was high: all respondents had heard of malaria, 88.2% correctly identified mosquito bites as the primary cause and 98.8% were aware it could be fatal. However, a critical lack of knowledge was identified, with 67.2% of respondents unaware that mosquito larvae develop in stagnant water. Ownership and reported use of LLINs were near-universal (98.8% and 96%, respectively), yet malaria prevalence in households was 91.6% (self-reported malaria incidence within the last year). Sub-optimal net maintenance practices were common, including washing with detergent and drying in the sunlight. A heavy reliance on self-medication (39.0%) and traditional plant-based remedies (72.4%) for treatment was reported, primarily driven by the perceived high cost of hospital care. Correlation analysis revealed that higher education levels were significantly associated with better knowledge of malaria cause (r = 0.101, p = 0.024) and mosquito larval habitats (r = 0.124, p = 0.006). CONCLUSION: The population of the Far-North region exhibits high awareness of malaria but critical gaps in understanding mosquito breeding sites. The paradox of high LLIN coverage coupled with high malaria prevalence suggests issues with net maintenance and proper use. Economic barriers and cultural preferences drive the use of self-treatment and traditional remedies.