Knowledge, Attitudes, Practices, and Associated Factors Regarding Malaria Prevention among Undergraduate Regular Students at Debre Markos University, Ethiopia: A Cross-Sectional Study, 2026

Malaria is a disease that thrives in warm, wet places, carried by mosquitoes that breed in standing water. It remains a persistent threat across much of Africa, where the climate allows the insects to survive year-round. While the disease is preventable, stopping it requires more than just medical supplies; it depends on what people know, how they feel about the risk, and the specific actions they take to protect themselves. This gap between knowing a disease is dangerous and actually changing one's daily habits to avoid it is a central challenge in public health. Understanding this gap is crucial because even in places with high education levels, knowledge does not always translate into the behaviors that keep people safe.

In 2026, researchers at Debre Markos University in Ethiopia set out to examine this exact disconnect among university students. These students represent a unique group: they are educated and have access to information, yet they travel frequently between their rural homes and the university, moving between areas where malaria is common and areas where it is not. The team surveyed 374 regular undergraduate students to see what they knew about malaria, how they felt about preventing it, and what they actually did to stay safe. They asked questions about the causes of the disease, the symptoms, and the methods used to stop it, such as sleeping under treated nets or clearing away stagnant water. They also looked at whether factors like gender, religion, or past infections influenced these habits.

The results revealed a clear divide between what the students knew and what they did. More than half of the students demonstrated a solid understanding of how malaria spreads and how to prevent it. They could correctly identify the mosquito as the carrier and knew that standing water is a breeding ground. Similarly, a majority held positive attitudes toward prevention, agreeing that it was important to take steps to avoid the disease. However, when it came to actual behavior, the numbers dropped significantly. Less than half of the students reported consistently using good preventive practices. This suggests that knowing the facts and believing in the importance of safety measures is not enough to guarantee that people will act on that knowledge.

The study found that certain factors were linked to better knowledge. Male students were more likely to have good knowledge than female students, and those who identified with the Orthodox Christian faith also showed higher levels of understanding compared to other groups. Interestingly, the act of draining stagnant water around one's living area was strongly linked to having good knowledge, suggesting that people who engage in this practical task tend to understand the science behind it better. When it came to attitude, the only factor that stood out was the practice of draining stagnant water; those who did this were more likely to have a positive outlook on malaria prevention.

When the researchers looked at what actually drove good preventive practices, the picture became more specific. Students who participated in malaria awareness campaigns, used insecticide-treated bed nets, drained stagnant water, supported community control efforts, used mosquito repellents, and kept their windows closed at night were the ones most likely to have good habits. Surprisingly, simply having access to information about malaria did not guarantee good practices once other factors were taken into account. This implies that hearing about the disease is not the same as being equipped to fight it. The study also found that a student's age, their field of study, or their history of having malaria in the past did not independently predict whether they would take effective precautions.

Despite the high level of education among the participants, the study concluded that the university environment was not enough to ensure consistent protection against malaria. While most students knew the risks and believed in the solutions, fewer than half were consistently applying those solutions in their daily lives. The researchers noted that the study had limitations, such as relying on students to report their own behaviors, which can sometimes be inaccurate, and that the findings might not apply to every university in the country. Nevertheless, the work highlights a critical need: health education for students must go beyond just sharing facts. To truly reduce the risk of malaria, institutions must help students overcome the practical and behavioral barriers that stop them from turning their knowledge into action.