Abstract
Untreated or poorly treated malaria case is reported to progress to the severe form over time. Studies showed a high prevalence of untimely utilization of health service in low-income countries. The objective was to identify the determinants of late use of malaria treatment in children under five years of age in Ouidah, Benin. The study was cross-sectional and carried out during June 2017. Data on sociodemographic characteristics and malaria management were collected in randomly selected 450 couple mother-child pairs using a questionnaire. A multivariate analysis using a logistic regression and the stepwise digressive method was used to identify the determinants of late use of malaria treatment in children under five years of age. The prevalence of delayed utilization of health facilities for malaria management in children under 5 years was 87.8% (95% CI: 81.6% - 92.8). Delays in health care utilization depended on whether mothers were married (OR = 4.4, 95% CI: 2.2-8.8), they used the motorcycle as a means of travel to health facilities (OR = 2.3, 95% CI: 1.1-5.2), complained about the high cost of transport (OR = 2.4, 95% CI 1.2-4.7), or believed in the possibility of preventing malaria (OR = 2.4, 95% CI: 1.2 - 4.7). When health care costs are paid by both the parents or by grandparents at the same time, then children were less likely to experience a delay (OR = 0.4, 95% CI: 0.2 - 0.7). The prevalence of delays in health care utilization for malaria treatment (HCUMT) in children under five years is high in Ouidah in Benin south setting. Organization of simple malaria management through community training, regular and continuous supply of inputs (medicines and diagnostic tests) for malaria control would reduce the delays in HCUMT in children in Ouidah, Benin.
Highlights
Malaria is still a major public health concern
More than half (52%) lived within 5 km from a local health facility, 62.0% used the motorcycle as a means of travel to the health facility, compared to 36.7% who traveled on foot
The prevalence of delayed utilization of health facilities for recourse (OR = 0.4, 95% CI: 0.2 - 0.7) compared to when malaria management in children under 5 years did the mother or only the father had paid the treatment change significantly according to the level of knowledge of fee
Summary
In Benin, 680 785 cases of malaria have been reported in children under five representing 42.5% of the burden of disease in all age groups, and 44% of malaria-related morbidity among the under-fives in 2015 [1]. Severe malaria is the main cause of death in hospitals, 20.8% of deaths in the general population and 38% in children under five [1,2,3,4]. The number of deaths caused by malaria remains high despite the efforts made in the past years. The large gap between expected (105 deaths) and the number of deaths recorded in 2015 (1747 deaths) shows that more efforts still have to be made. The proportion of timely treatment of malaria in children was 24% in Benin, while this proportion is even lower (23%) in the department of Atlantic
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