Knowledge and Practice of Malaria Prevention Among Caregivers of Children Under Five in Adamawa State, North East Nigeria

Malaria remains the leading cause of under-five morbidity and mortality in Nigeria, with North East states such as Adamawa recording high transmission rates due to limited preventive coverage and insufficient health literacy. This study evaluates the knowledge and practice of malaria prevention among caregivers of children under five in selected local government areas of Adamawa State. A descriptive cross-sectional design is employed, with 305 caregivers recruited through multistage sampling. A pre-tested, semi-structured questionnaire explores awareness of malaria transmission, correct use of insecticide-treated bed nets, indoor residual spraying acceptance, and adherence to malaria prophylaxis schedules. Descriptive statistics and chi-square analysis are used to examine associations between sociodemographic characteristics and preventive practices. Evidence from the 2021 Nigeria Malaria Indicator Survey indicates that bed net ownership in North East Nigeria is below the national target, and consistent use remains a challenge due to misconceptions and warm climate perceptions. The study is grounded in the Knowledge, Attitudes, and Practices framework, which links health awareness to behaviour change. Expected findings will identify specific knowledge gaps and behavioural barriers among caregivers, offering a basis for targeted health education and community mobilisation. Policy recommendations will address distributor-level and household-level challenges in malaria prevention programming. This research supports national malaria elimination strategies and contributes evidence for strengthening the primary healthcare response. Keywords: malaria prevention, caregivers, under-five children, Adamawa State, North East Nigeria.