Caregivers’ treatment-seeking behaviors and predictors of whether a child received an appropriate antimalarial treatment: a household survey in rural Uganda

BMC Infectious Diseases

Research Article

Richard Sekiwunga¹  John B. Collins²  Rosemin Kassam³  Eric Liow³  Juliet Tembe⁴ 

[1] Child Health and Development Centre, School of Medicine, Makerere University, P.O. Box 7062, Kampala, Uganda;Department of Educational Studies; Faculty of Education, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada;School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, V6T 1Z3, Vancouver, BC, Canada;The Islamic University, Mbale, Uganda;

关键词: Malaria;    Treatment-seeking;    Behavior;    Children;    Knowledge;    Management;    Access;    Predictors;    ACT;    Uganda;   

DOI  :  10.1186/s12879-016-1815-5

 received in 2016-02-26, accepted in 2016-09-01,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThis study responds to a rural community’s concern that, despite national initiatives, malaria management in young children falls short of national guidelines in their district. This study aimed to: (1) describe caregivers’ treatment-seeking behaviors in the rural district of Butaleja, (2) estimate the percentage of children who received an appropriate antimalarial, and (3) determine factors that maximized the likelihood of receiving an appropriate antimalarial. Appropriate antimalarial in this study is defined as having received only the Uganda’s age-specific first-line malaria treatment for uncomplicated and severe malaria during the course of the febrile illness.MethodsA household survey design was used in 2011 to interview 424 caregivers with a child aged five and under who had fever within the two weeks preceding the survey. The survey evaluated factors that included: knowledge about malaria and its treatment, management practices, decision-making, and access to artemisinin combination therapy (ACT) and information sources. Bivariate analysis, followed by logistic regression, was used to determine predictors of the likelihood of receiving an appropriate antimalarial.ResultsHome management was the most common first action, with most children requiring a subsequent action to manage their fever. Overall, 20.9 % of children received a blood test, 68.4 % received an antimalarial, and 41.0 % received an ACT. But closer inspection showed that only 31.6 % received an appropriate antimalarial. These results confirm that ACT usage and receipt of an appropriate antimalarial in Butaleja remain well below the 2010/2015 target of 85 %. While nine survey items differentiated significantly whether a child had or had not received an appropriate antimalarial, our logistic regression model identified four items as independent predictors of likelihood that a child would receive an appropriate antimalarial: obtaining antimalarials from regulated outlets (OR = 14.99); keeping ACT in the home for future use (OR = 6.36); reporting they would select ACT given the choice (OR = 2.31); and child’s age older than four months (OR = 5.67).ConclusionsFew children in Butaleja received malaria treatment in accordance with national guidelines. This study highlighted the importance of engaging the full spectrum of stakeholders in the management of malaria in young children - including licensed and unlicensed providers, caregivers, and family members.

【 授权许可】

CC BY   
© The Author(s). 2016