Abstract
(1) Background: The Democratic Republic of the Congo (DRC) is heavily affected by malaria despite availability of effective treatments. Ignorance and unrecommended behaviour toward a suspected malaria case in households may contribute to this problem. (2) Method: In communities of one rural and one urban Health Centres in each of the 11 previous provinces of DRC, all households with a case of malaria in the 15 days prior to the survey were selected. The patient or caregiver (responder) were interviewed. Logistic regression was used to assess predictors of knowledge of recommended antimalarials and adequate behaviour in case of suspected malaria. (3) Results: 1732 households participated; about 62% (1060/1721) of the responders were informed about antimalarials, 70.1% (742/1059) knew the recommended antimalarials and 58.6% (995/1699) resorted to self-medication. Predictors of knowledge of antimalarials were education to secondary school or university, information from media and smaller households. Predictors of good behaviour were Catholic religion and smaller households. Receiving information from Community Health Workers (CHWs) failed to be determinants of knowledge or adequate behaviour. (4) Conclusion: malaria control in DRC is hampered by ignorance and non-adherence to national recommendations. These aspects are influenced by unsuccessful communication, size of households and level of education.
Highlights
Malaria is still causing a significant health burden in the Democratic Republic of theCongo (DRC) despite the implementation of numerous disease control tools including potent drugs
Some studies, including in Democratic Republic of the Congo (DRC), have shown that larger households are at increased risk of malaria [13,14,15]; this may have resulted in overrepresentation of larger households in our sample
A study in the DRC showed that self-medication mostly concerns antimalarials, and that the users usually do not know the exact dosage of the drug used and do not check the expiry date [8]
Summary
Congo (DRC) despite the implementation of numerous disease control tools including potent drugs. Over 40,000 people of the country’s 90 million inhabitants, mainly children under five years old, still die from malaria per year [1]. Numerous parameters influence the effectiveness of drugs in everyday use. One of the under-researched factors negatively influencing effectiveness is the irrational use of drugs in health facilities and communities. Studies have estimated that children under five years of age suffer from 2 to 11 fever episodes per year [2,3], often from a fever of other origin [3,4]. Given an average household size of five to six members in the DRC [5], and the incidence of malaria and other febrile illnesses, a health seeking decision with potentially fatal consequences has on average to be made every week
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