Seeking treatment for symptomatic malaria in Papua New Guinea

Abstract

BackgroundMalaria places a significant burden on the limited resources of many low income countries. Knowing more about why and where people seek treatment will enable policy makers to better allocate the limited resources. This study aims to better understand what influences treatment-seeking behaviour for malaria in one such low-income country context, Papua New Guinea (PNG).MethodsTwo culturally, linguistically and demographically different regions in PNG were selected as study sites. A cross sectional household survey was undertaken in both sites resulting in the collection of data on 928 individuals who reported suffering from malaria in the previous four weeks. A probit model was then used to identify the factors determining whether or not people sought treatment for presumptive malaria. Multinomial logit models also assisted in identifying the factors that determined where people sought treatments.ResultsResults in this study build upon findings from other studies. For example, while distance in PNG has previously been seen as the primary factor in influencing whether any sort of treatment will be sought, in this study cultural influences and whether it was the first, second or even third treatment for a particular episode of malaria were also important. In addition, although formal health care facilities were the most popular treatment sources, it was also found that traditional healers were a common choice. In turn, the reasons why participants chose a particular type of treatment differed according to the whether they were seeking an initial or subsequent treatments.ConclusionsSimply bringing health services closer to where people live may not always result in a greater use of formal health care facilities. Policy makers in PNG need to consider within-country variation in treatment-seeking behaviour, the important role of traditional healers and also ensure that the community fully understands the potential implications of not seeking treatment for illnesses such as malaria at a formal health care facility.

Factors Affecting Attendance at and Timing of Formal Antenatal Care: Results from a Qualitative Study in Madang, Papua New Guinea

“…Another study conducted in Madang also found that living closer to a health facility does not necessarily lead people to seek treatment. Furthermore, cost was not a significant factor for choosing a formal health care facility [28]. Some pregnant women included in this study went to significant lengths to attend ANC by, for example, staying with a family member who lived closer to a clinic throughout their pregnancy, sometimes taking husbands and other children with them.…”

“…Women choose health facilities based on advice from husbands or others, or because of perceptions regarding better quality and effectiveness [23], [28]. In general, women preferred health centers over the hospital in Madang [23], [28].…”

“…In general, women preferred health centers over the hospital in Madang [23], [28]. Some moved to live closer to a health facility because it meant staying with their own family, where some felt they would receive better care than if they lived with their husband’s family.…”

Predicting Antidisease Immunity Using Proteome Arrays and Sera from Children Naturally Exposed to Malaria

“…Symptomatic cases (n ϭ 108) correspond to donors Ͻ5 years of age presenting at local health clinics with positive parasitemia, defined as having over 1000 Pf and/or 250 Pv asexual blood stage parasites per l of whole blood, and fever within the last 24 h, but without any severe malaria symptoms (32). Asymptomatic cases (n ϭ 116) were selected from a wider crosssectional field study that included all age groups, and were defined as children Ͻ10 years of age with no fever or history of fever in the last 48 h, but with Pf and/or Pv parasitemia detectable by PCR or light microscopy (LM) (33). Although symptomatic and asymptomatic samples were collected in different studies, and were not matched for age or parasitemia, this data set allowed us to query the natural immune response to both Pf and Pv simultaneously.…”

Quality of Antimalarial Drugs and Antibiotics in Papua New Guinea: A Survey of the Health Facility Supply Chain

“…Two studies conducted primarily in rural settings of PNG reported that health facilities were the most common source of antimalarial treatment [24]–[26]. A national household survey carried out in 2008/09 found that 45% of recently febrile household members had attended a health facility and 74% of them had received an antimalarial medicine.…”