Malaria Risk, Behavioral Gaps, and Preventive Perceptions among Military Personnel in Conflict-Affected Deployments Ecology, Ethiopia: Health Belief Model Insights, 2024.
1
School of Medical laboratory technology, Jimma University, Jimma, Ethiopia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Occupationally deployed high-risk mobile populations, including military personnel in malaria-endemic conflict zones, present major barriers to malaria elimination. Operational exposures increase vulnerability, while normalized perceptions of malaria risk and inconsistent preventive behaviors sustain hidden infection reservoirs. Applying the Health Belief Model (HBM) to understand these barriers is essential for designing adaptive, context-specific interventions.
METHODS:
An analytical cross-sectional study was conducted from August to October 2024, guided by the HBM, to assess behavioral drivers of malaria risk among 500 systematically sampled military personnel deployed in Ethiopia’s high-transmission conflict Ecology. WHO-endorsed rapid tests and microscopy were used for diagnosis. Validated and adapted tool of HBM constructs (Cronbach’s α >0.85) were applied. Predictors of infection were identified through hierarchical multivariate logistic regression, with model validity verified by testing multicollinearity (VIF <2.0) and goodness-of-fit (Hosmer-Lemeshow p >0.05).
RESULTS:
Malaria prevalence was 25.4%. Soldiers exhibited moderate-low perceived severity (mean 2.37-3.19/5), reflecting disease normalization, and moderate but externalized susceptibility (mean 3.10/5). Despite high benefit recognition (mean 3.73/5; 85% endorsed preventive efficacy), consistent ITN use dropped below 35% in low-transmission periods (mean 1.83/5), showing threat-dependent prevention. Integrated awareness of susceptibility, severity, and benefits reduced infection odds by 85.2% (AOR = 0.148, 95% CI 0.028–0.791, p = 0.025).
CONCLUSIONS:
Addressing low severity perception and externalized risk is critical for closing behavioral gaps that sustain infection reservoirs and impede malaria elimination goals. A comprehensive National Malaria Protection Protocol for Deployed Units is urgently needed to safeguard high-risk personnel. This essential protocol should standardize preventive measures, enforce evidence-based SOPs, and ensure tailored resource allocation, supported by pre-deployment education and military-civilian health coordination. Immediate implementation is vital to curtail transmission, maintain operational readiness, reduce productivity losses, and advance key sustainable development objectives particularly malaria elimination, health equity (SDG 3), economic stability (SDG 8), and partnerships (SDG 17).
Occupationally deployed high-risk mobile populations, including military personnel in malaria-endemic conflict zones, present major barriers to malaria elimination. Operational exposures increase vulnerability, while normalized perceptions of malaria risk and inconsistent preventive behaviors sustain hidden infection reservoirs. Applying the Health Belief Model (HBM) to understand these barriers is essential for designing adaptive, context-specific interventions.
METHODS:
An analytical cross-sectional study was conducted from August to October 2024, guided by the HBM, to assess behavioral drivers of malaria risk among 500 systematically sampled military personnel deployed in Ethiopia’s high-transmission conflict Ecology. WHO-endorsed rapid tests and microscopy were used for diagnosis. Validated and adapted tool of HBM constructs (Cronbach’s α >0.85) were applied. Predictors of infection were identified through hierarchical multivariate logistic regression, with model validity verified by testing multicollinearity (VIF <2.0) and goodness-of-fit (Hosmer-Lemeshow p >0.05).
RESULTS:
Malaria prevalence was 25.4%. Soldiers exhibited moderate-low perceived severity (mean 2.37-3.19/5), reflecting disease normalization, and moderate but externalized susceptibility (mean 3.10/5). Despite high benefit recognition (mean 3.73/5; 85% endorsed preventive efficacy), consistent ITN use dropped below 35% in low-transmission periods (mean 1.83/5), showing threat-dependent prevention. Integrated awareness of susceptibility, severity, and benefits reduced infection odds by 85.2% (AOR = 0.148, 95% CI 0.028–0.791, p = 0.025).
CONCLUSIONS:
Addressing low severity perception and externalized risk is critical for closing behavioral gaps that sustain infection reservoirs and impede malaria elimination goals. A comprehensive National Malaria Protection Protocol for Deployed Units is urgently needed to safeguard high-risk personnel. This essential protocol should standardize preventive measures, enforce evidence-based SOPs, and ensure tailored resource allocation, supported by pre-deployment education and military-civilian health coordination. Immediate implementation is vital to curtail transmission, maintain operational readiness, reduce productivity losses, and advance key sustainable development objectives particularly malaria elimination, health equity (SDG 3), economic stability (SDG 8), and partnerships (SDG 17).
| eISSN: | 2654-1459 |
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