Socio-demographic and environmental characteristics
A total of 1,464 respondents were involved in the study. Of these, the majority (60.7%) were females. About 52.5% of respondents were above 33 years of age and 43.2 % had higher levels of education. Almost half of respondents were married (Table 1). Approximately half of respondents (47.8%) were owners of the houses. About half (48.2%) of the households had at least six to 10 members. Children under five years were present in 52.7% of the households. Most participants (94.6%) were living in houses built with cement bricks and metal roofs (93.6%), but only 36.4% of houses had insect window screens. About 70% of households were supplied with tap water in their home premises. Majority of the houses (61.2%) had open garbage cans and 38.7% had vegetation in their surroundings. One-third (33.4%) of the houses had storage water units set outdoors, 25.1% had stagnant water collections, 22.5% had potential artificial or natural water containers outdoor (tires, flower pot, small can, box, coconut shell, plastic plate). Domestic animals were found in approximately one third of the respondents’ homes (Table 2).
The majority of respondents stated that stagnant and draining polluted water (80.3%) and garbage (35%) were the major mosquito breeding sites. As regards to mosquito biting time, 39% considered mosquitoes to bite during the night, 31% during sundown while 30.5% anytime of the day (Table 3). Yellow fever was the most frequent (86.6%) MBVD that respondents had heard prior to our study. Others included Chikungunya (13.9%), Zika (7.5%) and Dengue (3.7%). Only a few respondents knew that YFV (12.2%), CHIKV (5.4%), ZIKV (1.8%), DENV (1.5%) and RVFV (0.6%) were transmitted by mosquitoes. Almost all respondents (97.2%) identified malaria as a disease that is spread by mosquitoes. A fewer respondents inappropriately mentioned typhoid fever, HIV/AIDS, Ebola virus disease (EVD) and trypanosomiasis as mosquito-borne diseases (Table 4). Regarding knowledge on the role of mosquito in spreading zoonoses, only 23.7% (348/1,464) were aware that mosquito can transmit pathogens to animals or exchange pathogens between animals and humans. Of these, 348 respondents, 39.0% were not able to mention any zoonosis while about 14% mentioned zoonosis not vectored by mosquito (trypanosomiasis, rabies), 5% stated EVD and 34% answered malaria (Table 4).
The majority (70.1%) of respondents who knew about any MBVD, stated fever as the most common symptom, followed headache (52.4%), general body pain (21.2%) and joints pain (18.7%). Only a few respondents mentioned jaundice (9.9%), back pain (4.2%), haemorrhage (2.2%), skin rashes (1.8%), other (5.7%).
Of the 1,464 respondents, the majority mentioned environmental measures such as cleaning and removal of garbage (64.2%), draining of standing water (24.8%) and proper disposal of empty containers (10.1%) as the most effective mosquito control measures. Other measures included use insecticide-treated mosquito nets (41.0%) and spraying of insecticide (22.2%). Covering of the water storage containers (10%), mosquito screens on house window (8.8%) and wearing of long clothes were mentioned by only a few (1.7%) respondents (Table 3).
A total of 1,346 (91.9%) had lower overall score of knowledge related to mosquito and MBVD (Table 5). Knowledge scores related to mosquito breeding places were significantly associated to the respondent’s age, marital status, education level and sex. Respondents above 33 years of age (OR: 2.4; 95%CI: 1.4-4.2; p=0.0002), married (OR: 2.2; 95%CI: 1.3-3.7; p=0.0016), high education level (OR: 2.0; 95%CI: 1.2-3.2; p=0.002) had higher knowledge on mosquito breeding places. The female respondents had low knowledge scores regarding to mosquito breeding places (OR: 0.3; 95%CI: 0.2-0.6; p=0.0001) and regarding times of mosquito biting activity (OR: 0.8; 95%CI: 0.6-1; p=0.03) compared to males. The non Christians (OR: 1.3; 95%CI: 0.9-1.7; p=0.03) had high score than Christians about times of mosquito of activity. The age, sex, occupation, religion, marital status, education of respondents were not significantly associated with the knowledge about the role of mosquito in zoonosis and arboviruses transmission, arboviral disease, preventions and control measures as well as to the overall knowledge (Table 6).
Attitudes and perceptions
Approximately, three quarters (72.5%) of the respondents were aware about impact of mosquitoes on their daily life. Most (60.7%) respondents reported being bitten by mosquitoes outdoor in their home places, fewer at recreational places or work places and half of respondents responded were bitten indoors. In all, 44.6% respondents were regularly bitten and 31.2% reported sometimes. Overall 90% of participants were bitten during the dark (sundown 36%, night 53%); fewer reported mentioned to be bitten during the day (7.0%). When asked about activities associated with mosquito abundance, 21% mentioned drainage and blocked draining water channels, 17.7% garbage, 14% farming activities, 10% house/road construction, 7.7% animal rearing and automobiles garage (Table 7).
Most respondents (72.9%) perceived that they were responsible for the prevention and protecting themselves and their households against mosquitoes and MBVD. However, only 37.3% were aware about their responsibilities at community level. They perceived that mosquitoes and MBVD control and prevention to be the responsibility of the health authorities and national Government (Table 8).
The most familiar sources of information about MBVDs were health professional/hospital (40.2%). their relatives or family members (26.1%). Other important sources were the mass media such as radio or television (25.3%), schools (17.7%). Church, megaphone public announcement, Government announcement, newspapers, internet, telephone short messages were less common sources of information (Table 7). About 80% appeared to observe the correct attitude towards MBVDs. The overall attitude scores were significantly associated to the respondent’s age and occupation. Respondents aged over 33 years (OR: 0.8; 95%CI: 0.6-1.0; p=0.02) had lower attitude scores compared to those aged 18 to 33 years. Considered together students and medical personnel (OR: 0.002; 95%CI: 1.1-1.9; p=0.002) had correct attitude towards to mosquito and MBVDs. The sex, religion, marital status, education of respondents and overall knowledge were not significantly associated with the respondent’s attitude (Table 9).
Practices regarding vector control
Slightly more than a half (58.6 %) of the respondents reported cleaning environment, one quarter use of insecticides, another one quarter reported emptying garbage containers and emptying of flowers pots (11%) as the measures undertaken to reduce mosquito abundance around their homes. The draining of standing water was mentioned by 16.3% of respondents and garbage cleaning by 11.3%. Covering of water source or drinking water and/or storage containers was stated by only 10.4% of respondents.
As regards to measures undertaking to reduce or avoid mosquito bites, a large proportion of the respondents (79%) stated the use of mosquito nets, fumigation and spraying of insecticide (15.8%), mosquito screen on windows (13%), use of fan (10%), wearing long clothes (0.3%) and praying to God (1%). High proportions of residents (67.7%) confirmed that they did not have any challenge in taking action to prevent or control mosquitoes. Challenges in mosquito control and prevention included lack of money and other resources (42.9%), limited access to necessary items (19.3%), not having time (19%), disbelief in the effectiveness of these preventive measures (12.8%). Although 87.4% of the respondents had at least one mosquito net, only 67% confirmed to have slept under a mosquito net during the previous night. The source of the mosquito nets included national mass distribution campaign (68.8%), healthcare facilities (15%) and procurement from shop/market (18.8%). Almost 45% of these mosquito nets had holes (Table 10). The overall practice score was lower among 85.7% of participants. The age, sex, occupation, marital status and education of participants were not significantly associated with their practice. The other believer than Christian (OR: 0.5; 95%CI: 0.3-0.8; p=0.003) had lower practices compared to Christians believers. The high overall knowledge (OR: 1.4; 95%CI: 0.8-2.3; p=0.1) and attitude (OR: 1.22; 95%CI: 0.9-1,6; p=0.1) were not significantly associated with the respondent’s good practice.