Abstract
BACKGROUND: Despite ongoing preventive efforts, malaria remains a significant global public health agenda. While numerous studies focus on malaria prevalence, and inadequately assess community perceptions and beliefs regarding the disease. Addressing these perceptions is crucial for developing effective and sustainable interventions. This study aims to address these gaps by evaluating the perceptions and practices of household heads and representative family members concerning malaria. METHODS: A community-based cross-sectional study was conducted with a sample size of 1,883 households, calculated using the double population proportion formula via OpenEpi calculator. This calculation was based on a bed net utilization rate of 72.2% in the Ilu Galan District, Oromia Region, Ethiopia, with a 95% confidence level, 80% power, a 3% margin of error, a 10% non-response rate, and a design effect of 2. A multi-stage stratified sampling technique was employed to select administrative Woredas and towns across six zones in Southwest Ethiopia, further divided into 44 urban and rural kebeles. Kebeles and household selections were made through simple random sampling. Data were collected using a structured questionnaire and observation checklist. After ensuring data completeness and consistency, statistical analysis was performed. Predictor variables with p ≤ 0.25 during bivariable analysis were subjevted for multivariable logistic regression, and associations measured using adjusted odds ratios and 95% confidence intervals, considering statistical significance at p ≤ 0.05. RESULTS: The study achieved 82.4% response rate. Among participants, 31% from 69% of households reported that malaria they were infected in the past 28 days. Of these, 55.2% did not complete their prescribed treatments, and 61.8% believed malaria could be transmitted through contact with an infected person's sweat. Daughters and housewives showed lower knowledge of malaria transmission (p ≤ 0.01). Higher education levels among household heads were linked to better practices regarding insecticide-treated bed nets (AOR = 0.28, 95% CI 0.12-0.63, p ≤ 0.01). CONCLUSION: This study highlights a significant proportion of the population affected by malaria, alongside misconceptions that may hinder prevention efforts. Therefore, malaria prevention strategies should be comprehensive, sustainable, targeting households importantly and gender-inclusive.