Knowledge, attitudes and practices (KAP) about malaria among people visiting referral hospitals of Eritrea in 2008

Background: Knowledge, attitudes, awareness, practices and beliefs of communities contribute immensely to sustainable control of endemic diseases such as malaria. Strategic malaria control involves primary prevention which focuses on vector elimination and personal behavior change specifically through the consistent use of insecticide-treated nets (ITNs) and prompt and effective case management. This health facility based study was conducted to investigate the knowledge, attitudes and practices toward malaria among people visiting referral Hospitals of Eritrea, so as to develop a cost effective behavioral change communication strategy for community based malaria control. Methods: The study was conducted in the Referral Hospitals of the four Zobas as well as Teseney Hospital where there was the highest malaria morbidity and mortality. A total of 250 people with 50 people from each hospital were randomly selected. A structured questionnaire covering information on respondent demographics, knowledge, attitudes and practices was administered upon receipt of an informed consent for participation. Results: All the study subjects knew at least one of the symptoms of malaria with nearly three quarters mentioning three or more of the classical symptoms including fever. More than 80% knew that mosquitoes were the vector for the disease with a similar proportion having participated in environmental preventive control measures. Nearly half (44.6%) of the respondents gave priority for usage of ITNs to children under 5 years, to both children and pregnant mother and 11.2% to pregnant mothers. Conclusion: The majority of the respondents in this study knew enough information about malaria, and had participated in environmental preventive measures. The primary prevention of malaria through uninterrupted use of ITNs and transformation of knowledge into practices requires emphasis on the development of a community based behavioral change communication strategy. Key words: KAP, malaria, Behavioral change communication strategy, Eritrea, ITN

Vaginal bleeding in 6 years old young female: diagnostic challenge

A 6 year old young girl was referred to Mendefera (Zoba Debub Referral) Hospital with vaginal bleeding of 4 days duration. She had a history of swimming in a river prior to the incident. An aquatic leech bloated with blood detached from the vagina after 100 milliliters of normal saline flushing into the vagina. The patient was discharged on the second day postremoval of the leech, on amoxicillin for 7 days and follow up. Health professionals must be aware of the possibility of leech bites in the vagina as the differential diagnosis for abnormal vaginal bleeding, especially in places where leech infestation is common, a high index of suspicion is of great help to make an early diagnosis and treatment. Key words: KAP, malaria, Behavioral change communication strategy, Eritrea, ITN