The study took place in elementary schools in the city center (with relatively low endemicity) and in the Niayes area (at high risk of anopheline and malaria) in Dakar region of Senegal. These schools belong to the academic inspectorates (AI) of Grand Dakar and Thiaroye in the suburb.
Type and period of study
The Knowledge, attitudes and practices (KAP) study was carried out in two phases over a period of 13 months between December 2018 and January 2019. We conducted a cohort study in the intervention group in which three KAP surveys were carried out before, one week and one year after awareness raising with the MOSKI-KIT®. We also compared this cohort to control group during the third test.
Sampling and sample size calculation
The Dakar region had been divided into two strata according to the endemicity of malaria: downtown Dakar (with relatively low endemicity) and the Niayes area (at high risk of anopheline). In the city center (Grand Dakar), the study took place in the Imam Abdou Ndiaye 1 and Imam Abdou Ndiaye. In the Niayes area (Thiaroye), these were Martyrs A; Martyrs B; Thiaroye Gare 1 B and Mame Moussé Niang schools. The different schools of our study were divided into an intervention group (used MOSKI KIT®) and a control group (never been in contact with MOSKI KIT®).
The main target consisted of pupils from Grades 4 (G4) and 5 (G5) classes of primary / elementary schools in Dakar during 2017-2018 school year. The required sample size (n) has been calculated according to the formula below:
Concerning the household survey, we enrolled all the parents of the pupils who gave a consent for their participation in the study
The school children targeted for this study were those of the grades 4 (G4) and 5 (G5) in intervention schools the first year (2017-2018), and those of G5 and grade 6 (G6) for both types of schools the second year of our study.
A questionnaire validated by the director of each school was sent by the teachers to Parents who gave their consent participated to the household surveys
For the survey conducted before the sensitization and the one, a week later, the KAP data collection, was done on electronic tablets after downloading questionnaires from the Open Data Kit system (ODK). One year after, the survey was done on paper at the teachers request. The same questionnaire was used for each school children’s survey. For household surveys, we administered the questionnaires through phone calls.
We divided the different selected schools into two groups: an intervention group (exposed to the MOSKI KIT®) and a control group (not exposed to the MOSKI KIT®). The intervention group was also divided into two subgroups: a complete package subgroup (CPS) (which used all the tools of the MOSKI KIT®) and a partial package subgroup (PPS) (which had used only the MOSKI IMAGES®). Within these schools we carried out different KAP surveys for school children (pre and post-tests)
The scale applied to the KAP surveys consists of assigning a score of 1 (one) to each correct answer and 0 (zero) to each wrong answer. The maximum score was 32 (22 in the KNOWLEDGE section, 3 in the ATTITUDES section and 7 in the PRACTICES section). Is considered as correct answer:
- an exact answer checked
- an incorrect answer not checked for multiple response questions
- the total note for a section constitutes the score of the rubric while the total sum of the marks is a overall score of the schoolchildren
The different data collected had been analyzed with the STATA statistical software. To appreciate the impact of awareness raising through the MOSKI KIT®, we took the proportion of school-children who had at least half of the maximum score. The Chi-square and Fischer tests were used according to their applicability condition for the comparison of proportions.
Our study had obtained ethical approval from the National ethics committee for health research in Senegal under the number SEN16/71. Administrative authorization had also been requested from the Ministry of Health and the education authorities in the areas in which the selected schools were located. Parental consent for school children’s participation and interviews was secured before the start of our study.