Caretakers' perceptions of clinical manifestations of childhood malaria in holo-endemic rural communities in Tanzania

Abstract

A cross-sectional household survey was carried out in Kibaha district, Tanzania to obtain caretakers' knowledge on symptoms of childhood malaria in children under five years of age in relation to its management. A total of 1530 caretakers were interviewed, 620 (40.5%) reporting malaria attacks among their children in the last three months of which, 432 (70%) reported that the attacks were severe. Only 15.7% (68/432) of those reporting severe attacks could mention convulsions as symptoms of severe malaria, while fever and vomiting were mentioned as symptoms of severe malaria by 93.3% (403/432) and 52.3% (226/432) of the care-takers respectively. Higher level of education was significantly associated with knowledge of symptoms of severe malaria, also with promptness in taking management action. The fact that most of the caretakers reported fever and vomiting as symptoms of severe malaria, and hence the observed high proportion of reported severe malaria, implies that the communities under study do not perceive febrile convulsion as being a symptom of severe malaria. The implication of these findings on the control of malaria through treatment on demand are discussed.

PIP: 90% of the estimated 300-500 million cases of malaria which occur annually worldwide occur in Africa. Current World Health Organization strategy for controlling malaria involves preventing and reducing morbidity and mortality through early case diagnosis followed by the delivery of prompt and effective treatment. Findings are presented from a cross-sectional household survey conducted in July 1995 in Kibaha district, Tanzania, to obtain caretakers' knowledge on symptoms of childhood malaria among children under age 5 years in relation to its management. 620 (40.5%) of the 1530 households surveyed reported malaria attacks among their children in the preceding 3 months. 432 of those 620 households reported that the attacks were severe. 68 of the 432 (15.7%) which reported severe attacks could mention convulsions as symptoms of severe malaria, while fever and vomiting were mentioned as symptoms of the condition by 93.3% and 52.3% of the caretakers, respectively. Higher level of education was significantly associated with knowledge of symptoms of severe malaria, as well as with promptness in taking management action. That most caretakers reported fever and vomiting as symptoms of severe malaria suggests that the communities studied do not perceive febrile convulsion as being a symptom of severe malaria. The implication of these findings upon malaria control through treatment on demand are discussed.