Knowledge, attitudes, practices and determinants of mosquito repellent use for malaria prevention in Nangabo Ward,...

Despite their potential to complement and enhance malaria prevention, mosquito repellents remain underutilized in endemic regions like Uganda, where outdoor transmission and insecticide resistance threaten current interventions. This study assessed the Knowledge, Attitudes, Practices (KAP), and determinants of mosquito repellent use for malaria prevention in Nangabo Ward, Wakiso district, Uganda.

A cross-sectional mixed-methods study was used among 185 household heads or their adult representatives, selected through simple random sampling. A pretested semi-structured questionnaire gathered quantitative data, alongside in-depth interviews from 15 purposively selected participants. Quantitative analysis was conducted using Stata MP V14, while qualitative content analysis utilized Atlas.ti 14. Both descriptive and inferential statistics were used to evaluate the associations between variables.

The study found that while 63.8% of the participants were aware of repellents, and 59.5% had Positive attitudes towards them, there was low consistent use of only 8.2%. Although over 77.3% reported ever using mosquito repellents, occasional use was reported to be at 44.9%. Additionally, significant knowledge gaps existed, with only 38.4% of respondents understanding that repellents were safe for children under 5 years old, and 35.7% for pregnant women. Key barriers included cost (36.8%, affordability, and policy gaps (91.9% unaware of regulations). Multivariable analysis demonstrated that age 60 years and above was strongly associated with non-use (AOR = 2.50, 95% CI 1.43-4.38, P = 0.001), while heads of households with tertiary education 58% were more likely to use (AOR = 0.42, 95% CI 0.22-0.79, P = 0.007). Similarly, large households (8-10 members) were less likely to use mosquito repellents (AOR = 2.59, 95% CI 1.28-5.24, P = 0.008). Positive attitudes increased the likelihood of repellent use (AOR = 3.28, 95% CI 1.15-9.34, p = 0.036). Positive attitudes increased the likelihood of repellent use (AOR = 3.28, 95% CI 1.15-9.34, p = 0.036). Qualitative insights continued to emphasize the barriers to mosquito repellent use and highlighted a strong community preference for natural repellent options over synthetic ones.

While awareness and attitudes towards repellents were generally positive, usage was low due to high costs, limited availability, and inadequate government support. A significant link was found between age, education, household size, and repellent use. Qualitative data showed a preference for natural repellents, suggesting the integration of these products into the Uganda National Malaria Control Programme (NMCP) with subsidies and community education.