Results from a Knowledge, Attitudes, and Practices Survey in Two Malaria Transmission Foci of Santo Domingo, Dominican Republic

Abstract

Metropolitan Santo Domingo has accounted for a majority of reported malaria cases in the Dominican Republic in recent years. To inform malaria control and elimination efforts, a cross-sectional survey of malaria knowledge, attitudes, and practices collected 489 adult household-level questionnaires across 20 neighborhoods in the city's two main transmission foci, Los Tres Brazos (n = 286) and La Ciénaga (n = 203), in December 2020. Overall, most residents (69%) were aware of the problem of malaria in Santo Domingo, but less than half knew that mosquitos transmit the disease (46%) or took any correct preventative measure (45%). More residents of Los Tres Brazos, where malaria incidence is higher than in La Ciénaga, said that they had never been visited by active surveillance teams (80% versus 66%, respectively; P = 0.001), did not link mosquitos with malaria transmission (59% versus 48%, P = 0.013), and did not know medication can cure malaria (42% versus 27%, P = 0.005). Fewer residents of Los Tres Brazos said that malaria was a problem in their neighborhoods (43% versus 49%, P = 0.021) and fewer had mosquito bed nets in their homes (42% versus 60%, P < 0.001). The majority (75%) of questionnaire respondents in both foci did not have enough mosquito nets for all household residents. These findings demonstrate gaps in malaria knowledge and community-based interventions and highlight the need to improve community engagement for malaria elimination in affected areas of Santo Domingo.

Figure 1.

Map of Santo Domingo with La Ciénaga and Los Tres Brazos malaria transmission foci indicated. Neighborhoods shaded according to malaria incidence; blue dots indicate sampled neighborhoods in knowledge, attitudes, and practices survey.

Figure 2.

Weekly malaria incidence in two main transmission foci, Santo Domingo, 2010–2021.

Figure 3.

Survey sampling process.

Figure 4.

Biggest health problem in barrio, by transmission focus, Santo Domingo, 2020.

Figure 5.

Proportions of survey participants who cited given source of information about malaria, by transmission focus and overall sample, Santo Domingo, 2020.