Assessing Community Knowledge and Preventative Practices for Malaria in the Vaal Triangle, Gauteng, South Africa

Abstract

Malaria remains a major public health concern in Southern Africa, necessitating robust vector control strategies and community awareness to prevent transmission. Insect repellents play a crucial role in reducing mosquito bites, but the increasing insecticide resistance and high operational costs of chemical spraying highlight the need for alternative, cost-effective repellents. In South Africa, particularly in rural communities, traditional phytomedicines derived from indigenous knowledge are widely used for mosquito repellence. However, despite general awareness of malaria, knowledge gaps and misconceptions persist, especially in non-endemic areas such as the Vaal Triangle, Gauteng. This study aimed to assess community knowledge, attitudes, and perceptions toward malaria prevention, treatment, and the use of traditional mosquito repellents. A semi-structured questionnaire was used in a descriptive cross-sectional study with 419 Vaal Triangle residents. Both in-person interviews with people (n=216) and focus group interviews with traditional healers (n=203) were used to gather data. The findings indicated a high level of malaria awareness (95%), yet significant misconceptions about transmission and treatment were prevalent. A majority (70.17%) incorrectly believed malaria could spread through contact with an infected person, while only 12.65% correctly identified the bite of an infected female Anopheles mosquito as the mode of transmission. Furthermore, 86.87% of participants believed malaria could be managed without medical treatment. Regarding prevention, 89.88% reported using mosquito repellents, though only 48.93% recognized the effectiveness of sleeping under mosquito nets. Logistic regression analysis revealed that males (adjusted OR: 0.25, p=0.001), individuals practicing Hinduism (adjusted OR: 0.20, p=0.004), and those with no formal schooling (adjusted OR: 0.18, p=0.015) were significantly less likely to be aware of malaria. Traditional medicine remained a prominent aspect of malaria prevention, with 49.40% of respondents referencing unspecified remedies, however plants species such as Nepeta cataria, Lavandula, Lippia javanica, Artemisia afra, Hypoxis hemerocallidea and Helichrysum odoratissimum amongst others were reported in the traditional profiles of malaria treatment and mosquito control. This study highlights the need for targeted, culturally sensitive educational interventions to correct misconceptions and improve malaria prevention practices. Integrating traditional knowledge with evidence-based malaria control strategies, in collaboration with community leaders and traditional healers, could enhance public health efforts. Future research should focus on scientifically validating traditional phytomedicines to assess their efficacy and potential inclusion in malaria prevention programs