Knowledge, Attitude, and Associated Factors Regarding Malaria among Caregivers of Under-Five Children in the Federal Capital Territory, Abuja, Nigeria

In the warm, humid landscapes of Nigeria, a mosquito bite is more than a nuisance; it is a potential gateway to a disease that claims more young lives than almost any other. Malaria, caused by a microscopic parasite carried by female mosquitoes, remains a relentless threat to children under five. While modern medicine offers clear paths to treatment, the success of these treatments often depends less on the availability of drugs and more on the people who care for the sick child. These caregivers—usually mothers, fathers, or guardians—must decide when to seek help, what to believe about the illness, and how to manage the fever at home. Their understanding of the disease and their trust in medical advice form the first line of defense. If a caregiver does not recognize the warning signs or believes the illness is caused by something other than a mosquito, the child may not receive the life-saving care they need in time.

A recent study set out to understand exactly what caregivers in the Federal Capital Territory, Abuja, know and believe about this deadly disease. Researchers traveled to three distinct areas within the territory, ranging from the bustling city center to more rural communities, to speak with 308 caregivers of young children. They asked detailed questions to measure two things: knowledge and attitude. Knowledge referred to what the caregivers actually knew about how malaria spreads, what symptoms to look for, and how it should be treated. Attitude measured their feelings and beliefs, such as whether they thought malaria was a serious threat, if they trusted hospitals, or if they preferred traditional remedies over modern medicine. The goal was not just to count correct answers, but to see how factors like education, income, and religion shaped these views.

The results revealed a troubling gap between what is known by health experts and what is understood by the people on the ground. While most caregivers correctly identified that mosquito bites cause malaria, a significant portion held onto dangerous misconceptions. Nearly half of those surveyed believed that a dirty environment or the heat of the sun could cause the disease. Even more concerning was the lack of awareness regarding the severity of the illness. When asked about the complications that can arise from malaria, ninety percent of the caregivers could not name a single one. This is a critical blind spot, as recognizing severe symptoms is often the difference between a child recovering at home and a child needing emergency hospital care. Furthermore, awareness of the official national treatment guidelines was extremely low; only a tiny fraction of caregivers knew that specific modern medicines were the recommended first choice or that treatment should begin within a day of a fever starting.

The study also painted a complex picture of how caregivers feel about the disease. While many expressed trust in health facilities and agreed that early treatment prevents complications, this positive outlook was mixed with hesitation. About half of the caregivers did not view malaria as a serious problem for young children, and a majority admitted they would try home treatments or traditional medicine before going to a hospital. This ambivalence suggests that even when people have good intentions, they may delay seeking professional help due to conflicting beliefs or a lack of urgency. The researchers found that while most people trusted the medical system, a significant number still relied on older, unproven methods, creating a barrier to effective care.

Perhaps the most revealing part of the study was how these knowledge gaps and attitudes were linked to a person's life circumstances. The data showed that education and money were the strongest forces shaping what a caregiver knew and how they felt. Caregivers with higher levels of education and those who worked in formal jobs consistently scored much higher on knowledge tests and held more favorable attitudes toward medical treatment. Similarly, those with higher incomes were better informed. In contrast, caregivers with no formal schooling, those who were unemployed, or those struggling with financial constraints were the least likely to know the correct facts about malaria. Financial difficulty was the single biggest factor linked to poor knowledge, suggesting that the stress of making ends meet may crowd out the ability to learn about health or access information.

Interestingly, the study found that the gender of the caregiver or their marital status did not significantly change their knowledge or attitude. This indicates that the problem is not about who is doing the caring, but rather about the resources and education available to them. The researchers concluded that the current situation in Abuja leaves many families vulnerable not because they lack love or concern for their children, but because they lack the specific information and economic stability needed to act on that concern. To protect the next generation, the study suggests that health education must be tailored to reach those with the least education and the lowest incomes, addressing their specific barriers to understanding and accessing care. Without closing these gaps, the fight against malaria will remain an uphill battle for the families who need it most.