The influence of caregiver's malaria-related knowledge on the use of insecticide-treated net among children under-five: a cross-sectional study.

Background: Malaria remains a critical public health challenge globally, particularly in sub-Saharan Africa where it significantly contributes to morbidity and mortality among children under-five. In Ghana, efforts to promote the use of insecticide-treated nets (ITNs) as a preventive measure have been substantial but utilization rates remain suboptimal. This study examines the influence of caregivers' malaria-related knowledge on ITN use among children under the age of five years in a rural district of Ghana.

Methods: A community-based cross-sectional study was conducted in the Ahafo Ano South West District, Ghana, between June and October 2023. A total of 442 caregivers (mothers) of children under-five were selected using a two-stage sampling process. Data were collected through structured interviews and analysed using bivariate and multivariable logistic regression models to determine the association between caregivers' malaria-related knowledge and ITN use among children.

Results: Out of 442 caregivers, 436 (98.6%) completed the survey. ITN use among children under-five the night before the survey was reported by 73.8% of caregivers. Overall, 36.8% of caregivers had good malaria-related knowledge, 41.2% had satisfactory knowledge, and 21.9% had poor knowledge. Multivariable analysis showed that caregivers with good malaria-related knowledge were 12 times more likely to use ITNs for their children (AOR = 12.06, 95% CI 2.30-53.20) compared to those with poor knowledge. Other significant predictors included education on ITN use, ITN ownership, child's age, and use of alternative malaria prevention methods.

Conclusion: This study highlights the critical role of caregiver malaria-related knowledge in promoting ITN use among children under-five in rural Ghana. Caregivers with better knowledge were significantly more likely to use ITNs, emphasizing the need for targeted health education programs. Such interventions should enhance awareness of malaria risks and ITN benefits, empower caregivers to use ITNs effectively, and reduce barriers to ITN access. These findings provide valuable insights for policymakers aiming to improve ITN utilization and reduce malaria morbidity and mortality in vulnerable populations.