Assessment of Home Management of Fever/ Malaria in Under-Five Children in Dembia District, Northwest Ethiopia
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Date
2005-04
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Addis Ababa University
Abstract
Background: Malaria kills more than 1 million people every year in the world, 90% of
them in Sub-Saharan Africa; the majority of them are children under five years old.
Early diagnosis and prompt access to treatment is the main strategy to reduce
morbidity and mortality due to malaria. In Africa, evidences indicate that 70% of
malaria cases in rural areas and about 50% of the cases in urban areas treat malaria
first at home. Though prompt access to treatment within 24 hrs of onset of fever is
appropriate, studies indicate that there is a poor, inadequate and inappropriate
practice of treating fever/malaria in many developing countries.
Objective: The purpose of this study was to assess knowledge, attitudes, practices,
and beliefs (KAPB) about a home management of malaria in under five children.
Methods: A cross-sectional study using qualitative and quantitative data collection
methods were conducted in rural area of Dembia District, North Gondar, Amhara,
Northwest Ethiopia. Multistage sampling technique was used to select randomly 517
households/ mothers (caregivers) of under-five children from 4 randomly selected
Peasant Associations. Data were collected from 515 subjects using structured
questionnaire. Focus Group Discussions and Key informants' interviews were
conducted. The data were analyzed using EPI INFO version 6.04 and SPSS version
11 statistical packages.
Results: The study subjects had a better knowledge about
symptoms of mild malaria, such as fever (99.4%), head ache
(97.6%), chills and shivering (99.6%), poor appetite (95.1%),
vomiting (98.2%) and joint and body pain (94.9%), but could
association of the mosquitoes with malaria to lesser extent
(69.9%), while majority of them attributed its cause to cold or
changed weather (83.7%) and to stagnant water (77.1%). Most
respondents believed malaria is preventable (85.8%). They
practiced preventive methods such as Environmental
management (74.4%), DDT spray of households (53.8%), and
bed net use (3.4%) to prevent malaria. Home Management of
malaria/fever is practiced in the area in a high proportion of the
under 5 children (45.2%) with modern anti-malarial drugs.
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Reasons mentioned for delayed health care seeking of
caregivers for fever or malaria were hoping the child will be well
or taken to traditional healer (50.8%), far distance (27%), and
shortage of money (7.7%).
Conclusion: The knowledge of caregivers about symptom of malaria and their
practice to prevent the disease was very high. However, they could associate
mosquitoes with malaria to a lesser extent, and most of them had also
misconceptions about its causation. Home treatment of fever/ malaria was found to
share a major part in the health service provision in under-five children in the area.
Recommendations: Thus, design of effective malaria communication strategy;
training and motivation of community health agents and mothers to treat cases
promptly and properly; and strengthening the link between private-public health
sector partnerships with the community were recommended.
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Keywords
Malaria, Fever/ Malaria