Table 1.
Questionnaire description
| Block | Information |
|---|---|
| (A) Interviewee demographic data | Name |
| Address | |
| Birth date and age | |
| Gender | |
| Race/color | |
| Birth place | |
| Residence time in the current address | |
| (B) Dwellers demographic data | Name |
| Age | |
| Gender | |
| Relationship with the interviewee | |
| Residence time > 12 months in the address | |
| Schooling | |
| School’s name and location | |
| (C) Malaria episodes reported by the interviewee | If remembers the 1st malaria |
| Self-reported malaria in the last 12 months | |
| Inactivity and days lost due to malaria | |
| If needed health care in the last 12 months | |
| Places sought for health care | |
| Hospitalization due to malaria | |
| (D) Interviewee’s last episode of malaria | How he/she discovered he/she had malaria |
| Date of the last malaria episode (self-report) | |
| If he/she had malaria symptoms | |
| Type of malaria (falc, vivax) | |
| Access and adherence to treatment | |
| (E) Malaria information for each dweller | If they had malaria in the last 12 months (as reported by the interviewee) |
| Hospitalization to treat malaria | |
| (F) Household goods | Ownership of goods and animals |
| (G) Occupation and income of the household | Types of occupation of the householders |
| Number of dwellers contributing for the household income | |
| If the income received is considered sufficient | |
| (H) Characteristics of household | Material used for the wall, roof, ceiling and floor |
| Presence of crevices in the walls | |
| Number of rooms | |
| (I) Household access | Type of access to the household (river, road, trail) |
| If household is accessible by vehicle on a rainy day | |
| If access is paved | |
| If you would like the street, road or trail to be paved | |
| If the access to the house floods | |
| If flooding reaches the door of the house | |
| Presence of natural or artificial water bodies in the vicinity of the house and the neighborhood | |
| (J) Water supply | Type of access to water |
| Source of water used in the kitchen and for drinking | |
| How water is stored | |
| If water is treated before consumption | |
| Frequency at which water is missing at home | |
| Place where the households shower | |
| Place where the households wash dishes and clothes | |
| Place where the households go to tend to their physiological needs | |
| (L) Garbage disposal | How waste is disposed |
| Frequency of garbage collection by public service, if available | |
| (M) Access to electricity | If there is electricity in the household |
| If available: its source, installation date, if time-restricted or fails, cost | |
| If not available: source of energy used | |
| (N) Mobility and potential exposure to malaria | Routine activities from 6 p.m. to 9 p.m. |
| Frequency and motivation to go close to water bodies and the forest | |
| Frequency of sleeping in the wild | |
| Frequency, motivation, and length of stay in farms | |
| If needs to travel to receive social benefits, frequency and length of stay | |
| If needs to travel for working, frequency and length of stay | |
| If traveled for any other reason in the last 12 months, frequency and length of stay | |
| (O) Use of bednet and other protections | Ownership of impregnated and standard bednets and quantity |
| General usage, usage in the last night | |
| Problems with bednet usage | |
| If the households use other methods for mosquito protection | |
| Recommendations or suggestions for improving the health of the family and community |