Malaria morbidity, treatment‐seeking behaviour, and mortality in a cohort of young children in rural Burkina Faso

Abstract

Summaryobjective To describe the pattern of fever-associated morbidity, treatment-seeking behaviour for fever episodes, and cause-specific mortality in young children of a malaria-holoendemic area in rural Burkina Faso.methods In a longitudinal community-based intervention study, 709 representative children aged 6-31 months were followed daily over 6 months (including the main malaria transmission period) through village-based field staff.results Of 1848 disease episodes, 1640 (89%) were fever episodes, and of those, 894 (55%) were attributed to malaria (fever + ‡5000 parasites/ll). Eighty-five percent of fever episodes were treated, mainly with chloroquine and paracetamol, 69% of treatments took place in households, 16% in local health centres, 13% in villages, and 1% in hospitals. Treatment-seeking in a health centre or hospital was associated with accessibility and disease severity. Cerebral malaria and malnutrition-associated diarrhoea were the most frequently diagnosed causes of death. While most children with a post-mortem diagnosis of diarrhoea had not received any treatment, children who died of malaria had often received insufficient treatment. In particular, there was a lack of an appropriate second-line treatment at formal health services after chloroquine treatment had failed to resolve symptoms.conclusions These findings call for more effective prevention and treatment of malaria, malnutrition and diarrhoea in rural African communities, as well as for better supervision of existing malaria treatment guidelines in formal health services.

A study of malaria care provider choice in Ghana

“…The majority of malaria cases identified in our sample were managed first at home with herbal preparations, left over drugs or over the counter drugs. This finding is consistent with previous studies in Ghana (11,12,41) and other parts of SSA (42)(43)(44) that establish polypharmacy as a common practice in the region. While the most desirable strategy is to encourage people to seek hospital-based treatment, the fact of the matter is that self-medication will remain a popular choice due to economic and/or structural factors such as lack of access to health care facilities.…”

Childhood malaria: mothers\' perception and treatment-seeking behaviour in a community in Ebonyi State, South East Nigeria

“…The treatment-seeking behaviour of each community is largely determined by their perception of the relative 16,18 where self medication was the most preferred first option for management of childhood malaria, this was not the case in this study. It is likely that the reported good services in the health facilities, which include efficacy of treatment given and the availability of a doctor, made it of more proven value than self medication.…”

Caretaker's perceptions, attitudes and practices regarding childhood febrile illness and diarrhoeal diseases among riparian communities of Lake Victoria, Tanzania

“…Although, the sample sizes of the two studies were different, this high prevalence suggests higher levels of transmission of malaria in areas of the Lake Victoria basin. It has been established that in endemic areas most febrile illness among under-five children is due to malaria (Muller et al, 2003). However, the possibility of the presence of other infectious diseases like Acute Respiratory Infections (ARI) cannot be ignored.…”