Abstract
BackgroundHow people respond to febrile illness is critical to malaria prevention, control, and ultimately elimination. This article explores factors affecting treatment-seeking behaviour for febrile illnesses in a remote area of Lao PDR.MethodsHousehold heads or their representatives (n = 281) were interviewed using a structured questionnaire. A total of twelve focus group discussions (FGDs) each with eight to ten participants were conducted in four villages. In addition, observations were recorded as field notes (n = 130) and were used to collect information on the local context, including the treatment seeking behaviour and the health services.ResultsAlmost three-quarters (201/281) of respondents reported fever in past two months. Most (92%, 185/201) sought treatment of which 80% (149/185) sought treatment at a health centre. Geographic proximity to a health centre (AOR = 6.5; CI = 1.74–24.25; for those < 3.5 km versus those > 3.6 km) and previous experience of attending a health centre (AOR = 4.7; CI = 1.2–19.1) were strong predictors of visiting a health centre for febrile symptoms. During FGDs, respondents described seeking treatment from traditional healers and at health centre for mild to moderate illnesses. Respondents also explained how if symptoms, including fever, were severe or persisted after receiving treatment elsewhere, they sought assistance at health centres. Access to local health centres/hospitals was often constrained by a lack of transportation and an ability to meet the direct and indirect costs of a visit.ConclusionIn Nong District, a rural area bordering Vietnam, people seek care from health centres offering allopathic medicine and from spiritual healers. Decisions about where and when to attend health care depended on their economic status, mobility (distance to the health centre, road conditions, availability of transport), symptoms severity and illness recognition. Current and future malaria control/elimination programmes could benefit from greater collaboration with the locally accessible sources of treatments, such as health volunteers and traditional healers.
Highlights
How people respond to febrile illness is critical to malaria prevention, control, and elimination
In the villages selected for this intervention, it was critical to explore thoroughly the treatment seeking behaviour for the febrile illnesses and malaria so as to design a tailored community engagement to maximize the uptake of Mass Drug Administration (MDA) [21, 24]
Observations of behaviours and utterances in the communities where MDA was conducted were used to provide wider information on the local social and cultural context relevant to malaria, febrile illnesses, preventive measures, treatment seeking and the wider healthcare situation, which are not dictated by the themes and topics of the questionnaire survey and focus group discussions (FGDs)
Summary
How people respond to febrile illness is critical to malaria prevention, control, and elimination. As states in the GMS adopt strategies to eliminate malaria, identifying and appropriately managing the remaining cases becomes increasingly critical. In the GMS, the remaining malaria cases together with the burden of parasite reservoir are clustered in hard-to-reach populations, with high mosquito densities, abundance of larval habitats, and human-mosquito interactions, which results from time spent working in forests and the practice of swidden cultivation [2,3,4,5,6,7]. Five southern provinces (Savannakhet, Saravan, Sekong, Attapeu and Champasak) accounted for 96% of the total malaria cases in 2014 and 36% of the total national population of seven million [3, 8]. As part of the national strategic plan for malaria control and elimination, Laos aims to eliminate P. falciparum by 2030 [3, 9, 10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
