Perceptions of causes of and health seeking behaviour for severe complicated malaria in under five in Mkuranga district, Tanzania

Abstract

To determine the extent of management of childhood febrile illness and health care seeking behavior for under five, a cross sectional descriptive study was conducted in Mkuranga district in June 2003. The study involved 155 community members, 37 mothers/guardians of ill under fives admitted in heath facilities and 48 health workers. Structured and semi-structured schedules were used for data collection. The results showed that 25% of community respondents and 97% of mothers/guardians were aware of severe malaria and used some local terms to describe the disease. Some beliefs related to the causes of life threatening signs of severe malaria were explored; some respondents associated such signs with spiritual causes. Thirty three percent (33%) of community respondents and 3.§-%- of mothers/guardians reported witchcraft as a-cause of convulsions. Treatment of under fives was found to be delayed and in some cases inappropriate for a child presenting with signs of severe malaria. Forty eight percent (48%) of children who were reported to be sick two weeks prior to the interview started treatment after one to two weeks of the onset of the illness, while 24% started after 4 to 6 days. Twenty one percent (21 %) of community respondents and 11 % of mothers/guardians preferred traditional healers for management of convulsions, while 6% and 3% of community and mothers/guardians respectively, preferred traditional healers for management of coma. About 92% and 65% of the community and mothers/guardians

ix respondents reported that they preferred to take their children with coma to a health center/dispensary, respectively. About 75% and 51 % of community and mothers/guardians reported that they would take a child with convulsions to a health center/dispensary. Likewise 88% and 57% of community and mother/guardians of under fives reported to prefer to take their children with anaemia to health centers/dispensary. Furthemore, the results showed that about 96% and 62% of community and mother/guardians reported that they would take a child to the health center/dispensary if she/he would present with inability to eat and suck, respectively. Home management of the mentioned childhood problems was reported only by about 26% of the community respondents. From the study it is concluded that there are some beliefs related to the causes of life threatening signs of severe malaria. These may lead to delay of timely health care seeking and inappropriate treatment of malaria. Failure to recognize danger signs of severe malaria and misinterpretation of these danger signs ends up into fatal condition. The study recommends that more effort should be taken to increase awareness of the community on danger signs and symptoms of severe and complicated malaria in under-fives. Health education may change the misconception of the causes of signs and symptoms of severe malaria and lead to positive change of health seeking behaviour. Correct interpretation of signs may influence

x treatment seeking behavior towards modern treatment. Home care may prevent simple malaria from progressing to complicated and life threatening conditions