Self-treatment of malaria in a rural area of western Kenya

Abstract

Reported are the results of a study of residents' knowledge about malaria and antimalarial drugs and of their treatment-seeking behaviour in a rural area of western Kenya. The study subjects were generally well-informed about the symptoms of the disease. Malaria was perceived as a relatively mild illness, much less severe than acquired immunodeficiency syndrome (AIDS), measles, difficulty in breathing, and diarrhoea. Self-treatment was extremely common: of 138 episodes of febrile illness, 60% were treated at home with herbal remedies or medicines purchased at local shops, and only 18% received treatment at a health centre or hospital; no treatment was sought by the remainder. Commercially available chloroquine preparations were perceived as more effective than either antipyretics or herbal remedies for the treatment of malaria, and injections were regarded as more effective than oral medications. 4-Amino-quinolines were used to treat 58% of febrile illnesses but in only 12% of the cases was a curative dose of > or = 25 mg/kg body weight employed. Even attendance at a health centre did not ensure adequate treatment because of the common practice of sharing medication among family members. Greatly increased attention should be paid to the role of home treatment of malaria when policies are being developed for the management of febrile illnesses in sub-Saharan Africa.

PIP: The results of a study of residents' knowledge about malaria and antimalarial drugs and of their treatment-seeking behavior in a rural area of western Kenya are reported. The investigation was conducted in 2 villages where malaria is holoendemic. Samples of 20-25 women were interviewed to discover their views about the main causes, symptoms, and treatments of malaria as well as measles, difficulty in breathing, and diarrhea. The study subjects were generally well-informed about the symptoms of the disease. Malaria was perceived as a relatively mild illness, much less severe than acquired immunodeficiency syndrome, measles, difficulty in breathing, and diarrhea. A total of 23 families completed an 8-week follow-up period, during which 230 separate illness episodes were reported. Only 23.1% of the patients who sought treatment did so at a health center, the remaining were treated at home. Most illnesses for which they sought treatment at a health center were self-diagnosed as malaria (82% vs. 60%; p 0.05). Self-treatment was extremely common: of 138 episodes of febrile illness, 60% were treated at home with herbal remedies or medicines purchased at local shops, and only 18% received treatment at a health center or hospital; no treatment was sought by the remainder. Commercially available chloroquine preparations were perceived as more effective than either antipyretics or herbal remedies for the treatment of malaria, and injections were regarded as more effective than oral medications. 4-aminoquinolines were used to treat 58% of febrile illnesses, but in only 12% of the cases was a curative dose of or= 25 mg/kg body weight employed. Even attendance at a health center did not ensure adequate treatment because of the common practice of sharing medication among family members. Increased attention should be paid to the role of home treatment of malaria when policies are being developed for the management of febrile illnesses in Sub-Saharan Africa.