Abstract
BackgroundMalaria epidemics in highland areas of Kenya cause significant morbidity and mortality.MethodsTo assess treatment-seeking behaviour for malaria in these areas, a questionnaire was administered to 117 randomly selected households in the highland area of Kipsamoite, Kenya. Self-reported episodes of malaria occurred in 100 adults and 66 children.ResultsThe most frequent initial sources of treatment for malaria in adults and children were medical facilities (66.0% and 66.7%) and local shops (19.0% and 30.3%). Adults and children who initially visited a medical facility for treatment were significantly more likely to recover and require no further treatment than those who initially went to a local shop (adults, 84.9% v. 36.8%, P < 0.0001, and children, 79.6% v. 40.0%, P = 0.002, respectively). Individuals who attended medical facilities recalled receiving anti-malarial medication significantly more frequently than those who visited shops (adults, 100% vs. 29.4%, and children, 100% v. 5.0%, respectively, both P < 0.0001).ConclusionA significant proportion of this highland population chooses local shops for initial malaria treatment and receives inappropriate medication at these localshops, reslting in delay of effective treatment. Shopkeeper education has the potential to be a component of prevention or containment strategies for malaria epidemics in highland areas.
Highlights
Malaria epidemics in highland areas of Kenya cause significant morbidity and mortality
Roll-Back Malaria (RBM) focuses on intervention efforts via effective anti-malarial regimens like artemesinin-based combination therapy (ACT), pre-empting epidemics in epidemic-prone areas, and improving home management of the disease
Among adults who had malaria episodes, health care was initially sought care at a medical facility 50%, 64% and 67.9% of the time for one, two and six month periods from the malaria episode to questionnaire administration, while in children it was sought at a medical facility 66.7%, 60% and 67.2% for the same time periods
Summary
Malaria epidemics in highland areas of Kenya cause significant morbidity and mortality. RBM focuses on intervention efforts via effective anti-malarial regimens like artemesinin-based combination therapy (ACT), pre-empting epidemics in epidemic-prone areas, and improving home management of the disease. A rapid treatment response is essential for effective home management. To this end, an understanding of treatmentseeking behaviour enables communities and the formal health care system to design interventions that cater to a specific population [5]. Despite the resulting high case fatality rates characteristic of epidemics, malaria treatment-seeking patterns in epidemic-prone areas of Africa are not well studied, among adults. The present study utilizes the latter approach to study treatment-seeking behaviour among both adults and caretakers of children in a highland, epidemic region in Kenya
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