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Background <p>Malaria remains a leading cause of morbidity and mortality in rural Nigeria, where socioeconomic, educational, and informational factors critically influence prevention and treatment behaviours.</p> Methods <p>This study is a cross-sectional analysis of the 2021 Malaria Indicator Survey (MIS) to investigate the relationships between household income, education, media exposure, and key malaria control outcomes among rural populations. Three complementary analyses were conducted: household-level associations between income and insecticide-treated net (ITN) ownership and use (<i>n</i> = 5,021 households); individual-level associations of education with malaria prevention awareness and ITN use among women aged 15–49 years (<i>n</i> = 9,546); and the influence of media exposure on malaria treatment-seeking behaviour (<i>n</i> = 893).</p> Results <p>Results indicated near-universal ITN ownership across income groups, demonstrating equitable distribution (97.7%), but usage was significantly lower (70.3%). However, ITN use varied inversely with income, with low-income households having 3.6 times higher odds of ITN use (95% CI: 3.07–4.29). Among women, education was a strong predictor of malaria prevention awareness, with higher education levels associated with increased knowledge (p &lt; 0.001). Paradoxically, ITN use decreased as education increased, suggesting that behavioural or contextual factors modulate preventive practice despite greater awareness. Media exposure did not significantly influence the type of healthcare service accessed for malaria treatment, indicating that information access alone may not determine treatment-seeking patterns.</p> Conclusions <p>These findings highlight complex relationships between social determinants and malaria control behaviours. While ITN distribution efforts have achieved broad coverage, targeted behavioural interventions may be needed to improve ITN utilisation, particularly among higher-income groups who may underestimate their risk. Education is associated with increased awareness, but this does not necessarily lead to net use, highlighting the need for strategies that address barriers beyond knowledge. The limited impact of media exposure on treatment choices calls for comprehensive approaches that go beyond simply disseminating information, addressing structural and cultural factors in healthcare utilisation. Policymakers, including the Nigerian Ministry of Health (MOH) and the National Malaria Elimination Programme (NMEP), should design interventions that combine education, community engagement, and practical support to ensure sustained behaviour change. This study provides information to help optimise malaria control strategies and reduce the malaria burden in rural Nigeria by addressing both knowledge gaps and real-world barriers to prevention and treatment.</p>

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Socioeconomic and educational influences on malaria prevention and treatment behaviours in rural Nigeria

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月24日

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  • Jude Oluwapelumi Alao,
  • Oluwadamilare Peter Olowoshile,
  • Timothy Adetayo James,
  • Chinonso Chinaza Okezie,
  • Zainab Pamilerin Adebayo,
  • Success Chimbuchi Ogbonna,
  • Emmanuel Adedeji Oyelayo

摘要

Background

Malaria remains a leading cause of morbidity and mortality in rural Nigeria, where socioeconomic, educational, and informational factors critically influence prevention and treatment behaviours.

Methods

This study is a cross-sectional analysis of the 2021 Malaria Indicator Survey (MIS) to investigate the relationships between household income, education, media exposure, and key malaria control outcomes among rural populations. Three complementary analyses were conducted: household-level associations between income and insecticide-treated net (ITN) ownership and use (n = 5,021 households); individual-level associations of education with malaria prevention awareness and ITN use among women aged 15–49 years (n = 9,546); and the influence of media exposure on malaria treatment-seeking behaviour (n = 893).

Results

Results indicated near-universal ITN ownership across income groups, demonstrating equitable distribution (97.7%), but usage was significantly lower (70.3%). However, ITN use varied inversely with income, with low-income households having 3.6 times higher odds of ITN use (95% CI: 3.07–4.29). Among women, education was a strong predictor of malaria prevention awareness, with higher education levels associated with increased knowledge (p < 0.001). Paradoxically, ITN use decreased as education increased, suggesting that behavioural or contextual factors modulate preventive practice despite greater awareness. Media exposure did not significantly influence the type of healthcare service accessed for malaria treatment, indicating that information access alone may not determine treatment-seeking patterns.

Conclusions

These findings highlight complex relationships between social determinants and malaria control behaviours. While ITN distribution efforts have achieved broad coverage, targeted behavioural interventions may be needed to improve ITN utilisation, particularly among higher-income groups who may underestimate their risk. Education is associated with increased awareness, but this does not necessarily lead to net use, highlighting the need for strategies that address barriers beyond knowledge. The limited impact of media exposure on treatment choices calls for comprehensive approaches that go beyond simply disseminating information, addressing structural and cultural factors in healthcare utilisation. Policymakers, including the Nigerian Ministry of Health (MOH) and the National Malaria Elimination Programme (NMEP), should design interventions that combine education, community engagement, and practical support to ensure sustained behaviour change. This study provides information to help optimise malaria control strategies and reduce the malaria burden in rural Nigeria by addressing both knowledge gaps and real-world barriers to prevention and treatment.