Malaria is the most widespread parasitic disease in the world. It is an acute febrile illness caused by the Plasmodium parasite and transmitted to humans through the bite of infected female Anopheles mosquitoes [1] .

In 2023, the World Health Organization (WHO) estimated the number of malaria cases and 597,000 deaths worldwide to be 263 million. The WHO African Region accounted for 94% of cases and 95% of deaths, the majority of which were children under five years of age [2] .

In Niger, approximately 3 million cases of malaria were recorded in health facilities in 2019, including 4509 deaths. Children under five years of age were the most vulnerable group, with more than one million cases and approximately 3000 deaths. Infants under 2 years of age represented one of the most vulnerable groups with an increased risk of rapid disease progression, complications, and death [3] [4] . This characteristic vulnerability of infants under 2 years of age prompted this study, which aimed to assess the knowledge, attitudes, and practices of mothers regarding malaria in the Niamey V health district.

A total of 323 mother-child pairs aged 0 to 24 months were surveyed.

Study Limitations:

Factors such as education, age, access to health services, and cultural beliefs can influence mothers’ knowledge, attitudes, and practices regarding malaria. These attitudes may also vary from region to region, depending on local malaria characteristics, and may evolve over time in response to awareness campaigns, socioeconomic changes, or shifts in malaria transmission. The sample size may also limit the quality of the results, which will not be generalized to the general population. A broad and in-depth study of the population’s knowledge, attitudes, and practices will provide a better understanding of the problem and the development of effective and sustainable prevention strategies adapted to local contexts.

The average age of mothers was 28.19 years ± 6.76, this result is similar to that of Seck I et al. [5] in 2008 in Senegal who found an average of 28 years; this average age confirms the high reproductive activity at this period of life. Mothers were 34.37% not in school. Kiniffo IR et al. [6] in 2020 in Benin reported that 95% of mothers were illiterate; Gokpeya MB et al. [7] in 2013 in Côte d’Ivoire reported 30% of mothers not in school; Seck I et al. [5] reported 49.6% of mothers not in school. In these countries, the schooling of mothers, varying according to the place of residence (urban or rural), would be linked to socio-economic and cultural factors often preventing access to education. Our bivariate analysis showed that mothers’ education significantly influenced their knowledge of malaria (P < 0.05). The girl’s education could then facilitate their understanding of malaria prevention strategies and affect adherence to public health interventions, such as the use of insecticide-treated mosquito nets and attendance at health services. The children were predominantly female with 50.46% and had a mean age of 6.79 months, Chaka C et al. [8] in 2012 in Mali had also reported a female predominance with 56.5%. Differences in distribution by sex appear negligible in studies on malaria, because the disease would affect children regardless of sex. The young age of the child, on the other hand, exposes them to a risk of malaria due to a lack of acquired immunity. Indeed, prolonged exposure to mosquito bites can allow the acquisition of partial immunity to malaria. Nutritional status was normal in 88% of children. Well-nourished children develop a better immune response, thus reducing the risk of malaria severity. In contrast, malnourished children are at increased risk of serious complications, as demonstrated by a study in Uganda, which linked malnutrition to higher mortality rates in children with malaria [9] .

All mothers had already heard of malaria, community members were the main source of information with 78.33%; Drabo KM et al. [10] in 2003 in Burkina Faso reported that all mothers surveyed knew the name of malaria in the local language. Ndour CT et al. [11] in 2006 in Senegal found radio as the main source of information on malaria with 91.10%. Thus, it is important to remember the crucial role that mass media can play in understanding diseases provided that they use local languages and techniques that are simple for the population to understand. They knew at least one symptom of malaria in 95% of cases, fever was the most cited symptom with 90.40%; Abate A et al. [12] in 2019 in Ethiopia found that 91% of pregnant women were able to identify fever as a key symptom of malaria. We found that only 47.98% of mothers knew at least one sign of malaria severity. However, Seck I et al. [5] in Senegal indicated that only 7.1% of mothers knew the signs of malaria worsening. Knowledge of the mode of transmission of malaria by mosquito bites was reported by 85.13% of mothers. Léger OM et al. [13] in 2019 in Cameroon found in their study that in 78.6% of cases, the mosquito bites was known as the mode of transmission of malaria. Our bivariate analysis had indeed demonstrated that knowledge of both the mode of transmission and the signs of malaria severity was significantly associated with the mother’s education (P < 0.05). These worrying situations merit that particular emphasis be placed on the education of young girls, while integrating health promotion and prevention messages into training programs, particularly in the fight against malaria. It should also be noted that knowledge of the population on the mode of transmission of a disease is an indicator that can guide efficient strategies to combat this disease [14] . Consulting a health center was the most commonly reported response by mothers when their child showed signs of malaria, at 82.35%. Mohamed D and al. [15] reported 92.44% in Mali in 2019; Paul NM and al. [16] revealed in 2020 in Rwanda that although mothers were aware of the symptoms of malaria, barriers to accessing health services, such as long distances and costs, significantly limited access to healthcare for poor populations.

Despite the efforts made by the State of Niger and its partners in the fight against malaria, mothers’ knowledge, attitudes, and practices regarding malaria remain insufficient. The gaps in knowledge about the mode of transmission, means of prevention, and symptoms of malaria are worrying. It is important to place particular emphasis on the education of women and awareness-raising activities adapted to the local context. The results of this study provide a solid basis for better defining future strategies. Further and larger-scale research will confirm these results and refine future malaria strategies.