Low Coverage, Moderate Knowledge, And Limited Trust: An Assessment of Knowledge, Attitudes, And Perceptions Towards Indoor Residual Spraying in Masala, Ndola, Zambia
- 1Chreso University
Abstract
BackgroundIndoor Residual Spraying (IRS) is a proven vector control intervention for malaria prevention, yet community acceptance remains suboptimal in many settings. This study assessed the knowledge, attitudes, and perceptions towards IRS among residents of Masala Township in Ndola, Copperbelt Province, Zambia.
MethodsA community-based cross-sectional study was conducted among 282 systematically selected adult residents of Masala Township using a structured questionnaire administered through face-to-face interviews (response rate: 89.5%). Knowledge scores (range 0-6) were categorized as poor, moderate, or good. Attitudes were measured using Likert scale items (range 1-5) and categorized as positive, neutral, or negative. Data were analysed using descriptive statistics, chisquare tests, and binary logistic regression (p<0.05).
ResultsIRS coverage in the last 12 months was low at 24.8% (70/282). Knowledge levels were moderate in 43.6%, with only 24.8% demonstrating good knowledge. Attitudes were neutral overall (mean score 3.2{+/-}0.8), with 29.8% positive, 43.6% neutral, and 26.6% negative. Perceptions of chemical safety were poor, with only 39.7% believing IRS chemicals are safe. Fear of side effects (46.2%) and limited of trust in the spraying process (31.6%) were the most commonly reported barriers to acceptance. Associated factors with positive attitudes included: past spraying experience (AOR=4.56, p<0.001), tertiary education (AOR=3.45, p=0.002), higher income (AOR=2.89, p=0.007), plastered walls (AOR=2.12, p=0.029), and better knowledge (AOR=1.42, p=0.003).
ConclusionIRS coverage in Masala (24.8%) is substantially below the WHOrecommended 80% threshold. Fear of side effects and lack of trust were the main barriers to acceptance. Factors associated with positive attitudes included education, income, knowledge, wall type, past spraying experience, and trust in health workers. Given the cross-sectional design, these findings represent associations, not causal relationships. Urgent interventions addressing safety concerns through enhanced community sensitization and trust-building are needed to improve IRS uptake and progress towards Zambias malaria elimination goals.
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BibTeX
@misc{mabaso2026coverage,
title = {{Low Coverage, Moderate Knowledge, And Limited Trust: An Assessment of Knowledge, Attitudes, And Perceptions Towards Indoor Residual Spraying in Masala, Ndola, Zambia}},
author = {F. Mabaso and H. Mwelwa and E. Mapiki and C. Mapiki},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.04.26362228},
url = {https://www.medrxiv.org/content/10.64898/2026.09.04.26362228v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Low Coverage, Moderate Knowledge, And Limited Trust: An Assessment of Knowledge, Attitudes, And Perceptions Towards Indoor Residual Spraying in Masala, Ndola, Zambia
AU - F. Mabaso
AU - H. Mwelwa
AU - E. Mapiki
AU - C. Mapiki
PY - 2026
DA - 2026/09/04
PB - medRxiv
DO - 10.64898/2026.09.04.26362228
UR - https://www.medrxiv.org/content/10.64898/2026.09.04.26362228v1
AB - BackgroundIndoor Residual Spraying (IRS) is a proven vector control intervention for malaria prevention, yet community acceptance remains suboptimal in many settings. This study assessed the knowledge, attitudes, and perceptions towards IRS among residents of Masala Township in Ndola, Copperbelt Province, Zambia. MethodsA community-based cross-sectional study was conducted among 282 systematically selected adult residents of Masala Township using a structured questionnaire administered through face-to-face interviews (response rate: 89.5%). Knowledge scores (range 0-6) were categorized as poor, moderate, or good. Attitudes were measured using Likert scale items (range 1-5) and categorized as positive, neutral, or negative. Data were analysed using descriptive statistics, chisquare tests, and binary logistic regression (p<0.05). ResultsIRS coverage in the last 12 months was low at 24.8% (70/282). Knowledge levels were moderate in 43.6%, with only 24.8% demonstrating good knowledge. Attitudes were neutral overall (mean score 3.2{+/-}0.8), with 29.8% positive, 43.6% neutral, and 26.6% negative. Perceptions of chemical safety were poor, with only 39.7% believing IRS chemicals are safe. Fear of side effects (46.2%) and limited of trust in the spraying process (31.6%) were the most commonly reported barriers to acceptance. Associated factors with positive attitudes included: past spraying experience (AOR=4.56, p<0.001), tertiary education (AOR=3.45, p=0.002), higher income (AOR=2.89, p=0.007), plastered walls (AOR=2.12, p=0.029), and better knowledge (AOR=1.42, p=0.003). ConclusionIRS coverage in Masala (24.8%) is substantially below the WHOrecommended 80% threshold. Fear of side effects and lack of trust were the main barriers to acceptance. Factors associated with positive attitudes included education, income, knowledge, wall type, past spraying experience, and trust in health workers. Given the cross-sectional design, these findings represent associations, not causal relationships. Urgent interventions addressing safety concerns through enhanced community sensitization and trust-building are needed to improve IRS uptake and progress towards Zambias malaria elimination goals.
ER -