Abstract

BackgroundIn Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana.MethodsThis cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15–59 years for men and 15–49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria.ResultsOverall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment.ConclusionsThe findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty.

Highlights

  • In Ghana, about 3.5 million cases of malaria are recorded each year

  • In relation to locality of residence, the findings show that compared to Ussher Town, individuals living in Agbogbloshie and James Town were more likely to use herbal/traditional treatment as the first response to malaria relative to orthodox treatment (OR = 7.47, p < 0.01 and 2.33, p < 0.001, respectively)

  • In relation to the socio-ecological model adopted for this study, the findings show the specific individual, interpersonal and structural factors that are associated with the use of alternative treatment for malaria relative to the use of orthodox treatment

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Summary

Introduction

In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. There is evidence to show that there is a reduction of mosquitobreeding sites with increasing proximity to the centre of urban areas [7], there are many recorded cases of malaria transmission in urban areas [8]. Low socio-economic status and poor sanitation (leading to the development of breeding sites) in urban poor communities substantially increase the risk of malaria. This presents a challenge to the control of malaria in such settings

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