Abstract
Indoor Residual Spraying (IRS) is the application of a residual insecticide to Malaria vector resting surfaces of all houses or structures where such vectors might come into contact with the insecticide. The success of IRS relies on how the communities view and embrace it. Individual factors like socio-demography, knowledge, attitude and practices of heads of households are associated with a willingness to accept/not accept IRS. The aim of the study was to determine the knowledge, attitudes and practices of the residents of Shakawe and Xakao (Botswana) associated with the uptake of IRS. The study was conducted in Xakao and Shakawe, villages located in the Okavango district, which has the highest Malaria prevalence in Botswana while continuously record incompatible IRS uptake levels. A cross-sectional survey design was chosen with sample size of 395 households determined, using EPINFO version 7.10. SPSS statistical software, version 28, was used to capture and analyse the data. Descriptive data was presented in graphs, charts and tables. Correlation and regression analyses were conducted to determine the association between the dependent and independent variables. Adjusted odds ratios were used to draw inferences from the findings. A 96% response rate was obtained for the study, with more female respondents (67.1%) than male respondents (32.9%). Respondents in Shakawe (66.2%) and Xakao (66.4%) fell mostly between 20 and 50 years of age. 89.76% of the respondents earned less than P2000.00 per month, with 53.1% of the them not formally employed. 96% of Shakawe respondents, compared to Xakao (63%), were knowledgeable about IRS. 38% of Shakawe respondents demonstrated positive IRS associated attitudes, compared to Xakao with 56%. 91.4% of the respondents demonstrated good IRS associated practices, 7.8% satisfactory practices and 0.8% poor practices. The results also indicated that there were 1.816 odds of residents with good practices (OR 1.816, 95% CI (0.58 – 3.74)), 2.797 odds of knowledgeable residents (OR 2.797, 95% CI (0.634 – 12.344)) and 2.514 odds of residents with good attitude (OR 2.514, 95% CI (1.143 – 5.53)) accepting IRS. Of the three variables, attitude had a significant association (p=0.001) with the uptake of IRS. Confounding variables, including age and socio-economic status, had an insignificant association with the respondents’ IRS uptake decisions. The study communities were shown to be homogenous despite their uptake differences. Regular and meaningful assessment of the knowledge, attitudes and practices of the target communities must
be conducted so as to promptly identify and respond to intervention fatigue, ambiguities in understanding the intervention brought about by poor communication and alternative media and general misconceptions about the intervention.