Estimating malaria risk behaviours and their determinants among at-risk populations in a pre-elimination setting, Sisaket Province, Thailand–Cambodia border

Abstract

Background: Human behavioural and occupational factors play a critical role in sustaining malaria transmission. This study aimed to identify factors associated with poor levels of knowledge, attitudes, and practices (KAP) and factors influencing risk behaviours among at-risk populations. Methods: A survey of 402 at-risk individuals was conducted in Sisaket Province in late 2022, where substantial progress in malaria elimination has been achieved. Data was collected using a structured questionnaire. Descriptive statistics and logistic regression models were used to identify factors associated with KAP and malaria risk behaviours. Results: Over half of the participants demonstrated good knowledge (51.5%), attitudes (64.7%), and practices (58.2%) regarding malaria transmission, treatment, and prevention. Poor attitudes were significantly more likely among individuals with lower education levels [primary or below: aOR = 2.2, 95% CI 1.2–4.0); senior primary: aOR = 2.5, 95% CI 1.4–4.8] and low socioeconomic status (aOR = 1.8, 95% CI 1.1–3.0). Poor practices were less common among individuals working in agriculture (aOR = 0.2, 95% CI 0.1–0.5). Risk behaviours were significantly more frequent among males (aOR: 2.8, 95% CI 1.2–6.8) and individuals with poor practices (aOR: 3.5, 95% CI 1.6–8.1). Conclusions: Despite overall moderate KAP levels, gaps in attitudes and risk behaviours persist. Targeted strategies, such as social and behaviour change communication, should focus on improving attitudes among individuals with low education levels and reducing risk behaviours among males and those with poor practices by promoting adherence to effective preventive measures. © The Author(s) 2025.