Division of Parasitic Disease, National Center for Infectious Diseases, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Department of Pediatrics, University of Pennsylvania, Center for Research and Training in Tropical Diseases, Universidad del Valle de Guatemala, Atlanta, Georgia, Guatemala
Surveys of residents of the Pacific coast of Guatemala revealed a lack of knowledge and many misconceptions about the transmission and treatment of malaria, which could adversely affect malaria control measures and antimalarial therapy. Although mosquitoes are known to play an important role in malaria transmission and are thought to become infected by biting individuals with malaria, 75% of people interviewed believe that the mosquitoes can also acquire infections from contaminated water or by biting snakes and frogs. Furthermore, most residents believe that malaria can be acquired in other ways, such as by bathing too frequently or by drinking unboiled water. Although self-treatment of malaria with oral and injectable drugs purchased at stores and pharmacies is very common, less than 10% of the respondents were aware of the correct curative dose of chloroquine. Chloroquine injections are preferred to tablets and believed to be approximately three times as potent as tablets of the same concentration. Nearly two-thirds of the interviewees believed that pregnant and lactating women with malaria should avoid the use of chloroquine because it may cause a spontaneous abortion or dry up breast milk. Similar surveys of National Malaria Service workers and village malaria workers revealed higher levels of knowledge, although the village workers had many misconceptions about malaria transmission. An educational campaign directed at correcting some of these misconceptions should result in more appropriate self-treatment of malaria and greater acceptance by residents of personal protection methods and vector control and drug treatment programs.