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      Malaria treatment health seeking behaviors among international students at the University of Ghana Legon

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          Abstract

          Introduction

          Appropriate management of malaria demands early health seeking behaviour upon suspicion of malaria-like symptoms. This study examined malaria treatment seeking behaviour and associated factors among international students at University of Ghana.

          Methods

          The study used a cross-sectional and quantitative approach. Data collection was undertaken using a structured questionnaire administered on a random sample of 264 international students. Data obtained on malaria treatment and factors influencing treatment behaviors were analyzed using IBM, SPSS Statistics version 22. Associations between individual characteristics and Malaria treatment seeking behavior was assessed by Pearson Chi-square(X 2) test of independence. Binary logistic regression model was built using a backwards Wald approach, with variables retained at Wald p-value <0.05.

          Results

          The findings show that 35% of the respondents obtained self-prescribed antimalarial at their utmost first choice of Malaria treatment. At bivariate level, a significant relationship between Malaria health-care seeking behaviour and:- Respondents continent, X 2(1, N = 264) = 7.936, p = .005; Service accessibility, X 2(1, N = 264) = 7.624, p = .006; Wait time, X 2(1, N = 264) = 22.514, p <0.001; Treatment cost, X 2(1, N = 264) = 97.160, p <0.001; Health insurance, X 2(1, N = 264) = 5.837, p = 0.016, and Perceived staff attitude, X 2(1, N = 264) = 18.557, p < 0.001. At multivariable analysis, inappropriate malaria health seeking behaviours was associated with low perceived service accessibility as (≥30mins) (aOR = 6.67; p<0.001), perceived long wait time (≥30mins), (aOR = 5.94; p = 0.015), perceived treatment cost affordability (<15 GHC) (aOR = 19.88; p<0.001) and age group: -34-41years (aOR = 8.83; p<0.001).

          Conclusion

          There were widespread inappropriate health-care seeking behavior for Malaria treatment among international students. Improving accessibility to malaria treatment services, reducing wait time at health facilities and the treatment cost will address inappropriate malaria treatment health seeking behaviours among the international students.

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          Most cited references30

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          The Dielmo project: a longitudinal study of natural malaria infection and the mechanisms of protective immunity in a community living in a holoendemic area of Senegal.

          The Dielmo project, initiated in 1990, consisted of long-term investigations on host-parasite relationships and the mechanisms of protective immunity in the 247 residents of a Senegalese village in which malaria is holoendemic. Anopheles gambiae s.l. and An. funestus constituted more than 98% of 11,685 anophelines collected and were present all year round. Inoculation rates of Plasmodium falciparum, P. malariae, and P. ovale averaged respectively 0.51, 0.10, and 0.04 infective bites per person per night. During a four-month period of intensive parasitologic and clinical monitoring, Plasmodium falciparum, P. malariae, and P. ovale were observed in 72.0%, 21.1% and 6.0%, respectively, of the 8,539 thick smears examined. Individual longitudinal data revealed that 98.6% of the villagers harbored trophozoites of P. falciparum at least once during the period of the study. Infections by P. malariae and P. ovale were both observed in individuals of all age groups and their cumulative prevalences reached 50.5% and 40.3%, respectively. Malaria was responsible for 162 (60.9%) of 266 febrile episodes; 159 of these attacks were due to P. falciparum, three to P. ovale, and none to P. malariae. The incidence of malaria attacks was 40 times higher in children 0-4 years of age than in adults more than 40 years old. Our findings suggest that sterile immunity and clinical protection are never fully achieved in humans continuously exposed since birth to intense transmission.
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            World Malaria Report 2022.

            (2022)
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              Prevention Efforts for Malaria

              Purpose of Review Malaria remains a global burden contributing to morbidity and mortality especially in children under 5 years of age. Despite the progress achieved towards malaria burden reduction, achieving elimination in more countries remains a challenge. This article aims to review the prevention and control strategies for malaria, to assess their impact towards reducing the disease burden and to highlight the best practices observed. Recent Findings Use of long-lasting insecticide-treated nets and indoor residual spraying has resulted a decline in the incidence and prevalence of malaria in Sub-Saharan Africa. Other strategies such as larval source management have been shown to reduce mosquito density but require further evaluation. New methods under development such as house improvement have demonstrated to minimize disease burden but require further evidence on efficacy. Development of the RTS,S/AS01 malaria vaccine that provides protection in under-five children has provided further progress in efforts of malaria control. Summary There has been a tremendous reduction in malaria burden in the past decade; however, more work is required to fill the necessary gaps to eliminate malaria.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: Writing – original draft
                Role: Formal analysisRole: Writing – original draft
                Role: Writing – original draftRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                26 October 2023
                2023
                : 18
                : 10
                : e0276412
                Affiliations
                [1 ] Department of Social and Behavioural Sciences, College of Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
                [2 ] Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Uganda
                [3 ] Department of Epidemiology and Disease Control, College of Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
                [4 ] Department of Government Studies, School of Management Studies, Uganda Management Institute, Kampala, Uganda
                [5 ] Department of Health Policy, College of Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
                Ensign Global College, GHANA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0001-6015-8625
                https://orcid.org/0000-0002-5074-3676
                Article
                PONE-D-22-27540
                10.1371/journal.pone.0276412
                10602253
                37883486
                2c0c0c01-3bec-42d5-a754-4d21115c526e
                © 2023 Lwenge et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 5 October 2022
                : 10 October 2023
                Page count
                Figures: 0, Tables: 2, Pages: 13
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Parasitic Diseases
                Malaria
                Medicine and Health Sciences
                Medical Conditions
                Tropical Diseases
                Malaria
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                Medicine and Health Sciences
                Public and Occupational Health
                Behavioral and Social Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Global Health
                Medicine and Health Sciences
                Pharmacology
                Drugs
                Antimalarials
                Social Sciences
                Economics
                Health Economics
                Health Insurance
                Medicine and Health Sciences
                Health Care
                Health Economics
                Health Insurance
                People and Places
                Geographical Locations
                Africa
                Ghana
                Medicine and Health Sciences
                Pharmaceutics
                Drug Therapy
                Custom metadata
                All relevant data has been provided to the editors upon and for the researchers who meet the criteria of access to confidential data. This is because the University of Ghana has put legal restrictions on sharing a de-identified data set. Please contact them on thesisoffice@ 123456ug.edu.gh to permit you have access to the data.

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