BACKGROUND AND OBJECTIVES:
Early recognition of symptoms of malaria and commencing appropriate home-based treatment or seeking prompt treatment in a health facility are malaria control strategies recommended under the Roll Back Malaria initiative. This initiative aims at reducing malaria morbidity and prevention of mortality in children aged <5 years. The success of this strategic plan for malaria control depends on the health-seeking behavior of caregivers of these children. The goal of this study was to document the health-seeking behavior of caregivers whose children (aged 6–60 months) presented with severe malaria in a tertiary health institution.
This descriptive cross-sectional study was conducted from July 2012 to June 2013. Appropriate health-seeking behavior included seeking prompt treatment in a health facility within 24 hours of onset of severe malaria symptoms or presentation in a health facility within 48 hours with symptoms of severe malaria while on home-based treatment. Features of severe malaria were identified by using the criteria of the World Health Organization. Data were obtained by using a researcher-administered questionnaire, and malaria was confirmed in each child by using microscopy and following a standard protocol. Analysis of data was performed by using SPSS version 16.0.
Of the 120 caregiver (31.4 ± 7.0 years)/child pairs (24 ± 14.7 months) recruited, 35 (29.2%) caregivers had appropriate health-seeking behavior. Of the 85 (70.8%) caregivers with poor health-seeking behavior, 82 (96.5%) inappropriately managed malaria at home by administering the wrong malaria medications (given, in most cases, at incorrect dosages), and 3 (3.5%) did nothing during the illness (P = .003). Appropriate health-seeking behavior did not significantly depend on level of education of the caregivers (P = .17). The most common place for home-based care was the patent medicine vendor in 65 (79.3%) of 82 cases, and 20.7% was from neighbors and traditional physicians. The mortality rate observed in this study was 150 per 1000; 94.4% were children whose caregivers had poor health-seeking behavior (P = .02).
Health education regarding appropriate malaria care should be intensified for caregivers and other community-based health care providers such as the patent medicine vendors.
- Copyright © 2015 by the American Academy of Pediatrics