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. 2023 Aug 26;22(1):246.
doi: 10.1186/s12936-023-04680-6.

Prompt treatment-seeking behaviour varies within communities among guardians of children with malaria-related fever in Malawi

Christopher C Stanley  1   2 , James Chirombo  3 , Harrison Msuku  4 , Vincent S Phiri  5 , Noel Patson  4 , Lawrence N Kazembe  6 , Jobiba Chinkhumba  4   5 , Atupele Kapito-Tembo  4   5 , Don P Mathanga  4   5
Affiliations

Prompt treatment-seeking behaviour varies within communities among guardians of children with malaria-related fever in Malawi

Christopher C Stanley et al. Malar J. .

Abstract

Background: In Malawi, malaria is responsible for 40% of hospital deaths. Prompt diagnosis and effective treatment within 24 h of fever onset is critical to prevent progression from uncomplicated to severe disease and to reduce transmission.

Methods: As part of the large evaluation of the malaria vaccine implementation programme (MVIP), this study analysed survey data to investigate whether prompt treatment-seeking behaviour is clustered at community-level according to socio-economic demographics.

Results: From 4563 households included in the survey, 4856 children aged 5-48 months were enrolled. Out of 4732 children with documented gender, 52.2% were female and 47.8% male. Among the 4856 children, 33.8% reported fever in the two weeks prior to the survey. Fever prevalence was high in communities with low socio-economic status (SES) (38.3% [95% CI: 33.7-43.5%]) and low in areas with high SES (29.8% [95% CI: 25.6-34.2%]). Among children with fever, 648 (39.5%) sought treatment promptly i.e., within 24 h from onset of fever symptoms. Children were more likely to be taken for prompt treatment among guardians with secondary education compared to those without formal education (aOR:1.37, 95% CI: 1.11-3.03); in communities with high compared to low SES [aOR: 2.78, 95% CI: 1.27-6.07]. Children were less likely to be taken for prompt treatment if were in communities far beyond 5 km to health facility than within 5 km [aOR: 0.44, 95% CI: 0.21-0.92].

Conclusion: The high heterogeneity in prevalence of fever and levels of prompt treatment-seeking behaviour underscore the need to promote community-level malaria control interventions (such as use of long-lasting insecticide-treated nets (LLINs), indoor residual spraying (IRS), intermittent preventive therapy (IPT), presumptive treatment and education). Programmes aimed at improving treatment-seeking behaviour should consider targeting communities with low SES and those far from health facility.

Keywords: Fever; Malaria; Malawi; Prompt treatment-seeking.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Map of Malawi showing districts implementing the malaria vaccine implementation program (MVIP)
Fig. 2
Fig. 2
Map showing cluster-level socio-economic status and percentages of prompt treatment seeking behaviours among guardians of children with fever MVIP districts in Malawi
Fig. 3
Fig. 3
District maps showing smoothed prevalence estimates of prompt treatment-seeking (low in blue areas and high in yellow areas) among children under 5 years with history of fever
See this image and copyright information in PMC

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