Effective control of malaria in Sub-saharan Africa has always been slowed down by lack of adequate knowledge on transmission, modes of prevention and control. Ten years after commencement of a renewed malaria control initiative- 'roll back malaria' (RBM) on the continent, this study was set up to assess the impact of the programme in an endemic city through knowledge and practices of malaria control. The study was carried out between October and December 2009 and was cross-sectional in nature involving 3171 adult women who were selected from households using systematic sampling methods. Quantitative information such as age, educational level, marital status, occupation number of children, and knowledge of malaria prevention and practices were obtained using structured and semi structured questionnaires, while qualitative information was obtained using focussed and in-depth group discussions to complement quantitative data. Over 99% of the respondents were aware of malaria as a disease popularly called Osuala but only 63.3% considered it a serious disease of public importance. At least 16.5% of the respondents had no clear knowledge about malaria prevention. Factors affecting knowledge about malaria prevention in the community were illiteracy, poverty and unemployment, and cultural beliefs. Health education should be strengthened on malaria prevention while efforts to intensify on formal and informal adult education strengthened in order to realise the objectives of RBM initiative in the community and hence that of Africa at large
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