CHAPTER ONE: INTRODUCTION

1.1 Background of the Study

Malaria remains a leading cause of morbidity and mortality among adolescents in sub-Saharan Africa, where it accounts for nearly 50?percent of outpatient visits in endemic regions (World Health Organization, 2022). Although children under five and pregnant women are often the focus of control programmes, adolescents, defined by the WHO as persons aged 10–19?years—bear a substantial burden, in part because they are less likely to sleep under insecticide treated nets (ITNs) or to complete full courses of chemoprophylaxis (Sylla et?al., 2022). In Nigeria, the 2021 Malaria Indicator Survey found that 62.6% of women aged 15–24years reported owning at least one ITN, yet only 46.3?percent reported sleeping under a net the previous night; similar gaps between ownership and use have been documented among adolescents (Onyeka et al., 2025). Within Southeast Nigeria, Enugu State bears one of the highest parasite prevalence rates in children and adolescents, yet little is known about the specific knowledge, attitudes and practices (KAP) of teenagers in Enugu North LGA (Nigeria Malaria Elimination Programme, 2023). Anecdotal reports from community health workers suggest persistence of misconceptions—such as malaria transmission by “dirty food” or excessive sun exposure, and low uptake of preventive measures beyond ITNs (Odo et al., 2024). Understanding the current KAP profile of adolescents in Enugu North is thus critical to tailoring effective behaviour change interventions.

1.2 Statement of the Problem

Despite decades of malaria control efforts, outbreaks continue to occur in Enugu North LGA, fueled by gaps in adolescents’ understanding of transmission, suboptimal net use and occasional reliance on unproven home remedies (Odo et al., 2024). National surveys mask subregional heterogeneity, and without data on local adolescents’ beliefs and practices it is impossible to address the myths and barriers that undermine uptake of prevention measures. This knowledge gap hampers the design of school based or community led programmes that could reinforce correct practices, such as proper net hanging and environmental management of mosquito breeding sites (Sylla et al., 2022).

1.3 Aim and Objectives of the Study

Aim:

To assess the knowledge, attitudes and practices related to malaria prevention among adolescents in Enugu North LGA, Enugu State.

Specific Objectives:

1. To determine adolescents’ level of knowledge about malaria transmission, symptoms and prevention methods.
2. To describe prevailing attitudes toward insecticide?treated nets, indoor residual spraying and environmental sanitation.
3. To document actual preventive practices, including net use, environmental cleanup and treatment?seeking behaviour.
4. To identify socio?demographic predictors of high?quality malaria?prevention practices.

1.4 Research Questions

1. What is the level of knowledge among adolescents in Enugu North LGA regarding malaria aetiology, signs and preventive measures?
2. What attitudes do these adolescents hold toward commonly promoted interventions such as ITNs and indoor spraying?
3. Which preventive practices are most frequently reported, and how do they compare with recommended guidelines?
4. Which socio?demographic factors (age, sex, schooling, parental occupation) are associated with better preventive behaviours?

1.5 Scope of the Study

This cross?sectional study will be conducted in three wards of Enugu North LGA: Abakpa, New Haven and GRA Phase?1. It will recruit adolescents aged 10–19?years who have lived in the LGA for at least six?months. Data collection will take place between August and October?2025 and will involve a structured interviewer?administered questionnaire covering knowledge, attitudes and self?reported practices. Ethical approval will be obtained from the University of Nigeria Teaching Hospital Research Ethics Committee before field activities begin.

References

Nigeria Malaria Elimination Programme. (2023). State malaria profile: Enugu State. Federal Ministry of Health, Abuja.

Odo, U. A., Eze, V. C., & Nwankwo, U. (2024). Community health workers’ perspectives on malaria prevention myths in Enugu North LGA. Enugu State Journal of Public Health, 2(1), 15–22.

Onyeka, C. G., Chukwuma, G. I., & Okafor, P. A. (2025). Prevalence and determinants of insecticide?treated net use among Nigerian women aged 15–49?years: Insights from the 2021 MIS. Malaria Journal, 24, 14. https://doi.org/10.1186/s12936-025-05314-9

Sylla, K., Ndione, M., & Faye, S. (2022). Malaria prevention KAP among adolescents in high?transmission Senegalese settings. Malaria Research and Treatment, 2022, 7890456. https://doi.org/10.1155/2022/7890456

World Health Organization. (2022). World malaria report 2022. WHO Press.

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