Determinants of delay in seeking treatment among malaria patients in Dera district, NorthWest Ethiopia: a case control study

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Abstract

Background

Prompt and effective treatment of malaria is critical because delays increase the risk for serious illness, disability and death.

Objective

To assess determinants of delay in seeking treatment among malaria patients at Dera district, NorthWest Ethiopia.

Methods

A case control study was conducted from September 01 to October 15, 2014. A total of 318 malaria patients diagnosed using microscopy or rapid diagnostic test, and who sought treatment in health centers were interviewed. Multivariable logistic regression was done to identify determinants of delay.

Results

Delay was high when a patient earned less than 25.0 USD [AOR=15.7, 95% CI: 4.8 – 51.2] and 9.6 times higher if he/she was not a member of community based health insurance [AOR= 9.6, 95% CI: 4.4 – 21.3]. Respondents who travelled for more than 30 minutes to get to a health facility [AOR= 4.4, 95% CI: 1.2 – 15.9] were more likely to be late in seeking treatment for malaria.

Conclusion

Income, community based health insurance, previous history of malaria infection, decision making and distance were determinants of delay in seeking treatment for malaria. To reduce the delay, interventions should focus on outreach malaria services and increase enrollment to community based health insurance.

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Most cited references 12

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Determinants of health care seeking for childhood illnesses in Nairobi slums.

Negussie Taffa, G Chepngeno (2005)

The practice of appropriate health seeking has a great potential to reduce the occurrence of severe and life-threatening child illnesses. We assessed the influence of socio-demographic, economic and disease-related factors in health care seeking for child illnesses among slum dwellers of Nairobi, Kenya. A survey round of the Nairobi Urban Demographic Surveillance System (NUDSS) generated information on 2-week child morbidity, illness symptoms, perceived illness severity and use of modern health services. During this round of data collection, interviewers visited a total of 15,174 households, where 3015 children younger than 5 years lived. Of the 999 (33.1%) children who were reported to have been sick, medical care of some sort was sought for 604 (60.5%). Lack of finances (49.6%) and a perception that the illness was not serious (28.1%) were the main reasons given for failure to seek health care outside the home. Health care seeking was most common for sick children in the youngest age group (0-11 months). Caretakers sought medical care more frequently for diarrhoea symptoms than for coughing and even more so when the diarrhoea was associated with fever. Perception of illness severity was strongly associated with health care seeking. Household income was significantly associated with health care seeking up to certain threshold levels, above which its effects stabilized. Improving caretaker skills to recognize danger signs in child illnesses may enhance health-seeking behaviour. Integrated Management of Child Illnesses (IMCI) programmes must be accessible free of charge to the urban poor in order to increase health care seeking and bring about improvements in child survival.

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Determinants of delay in care seeking among children under five with fever in Dodoma region, central Tanzania: a cross-sectional study

Telemu Kassile, Razack Lokina, Phares GM Mujinja … (2014)

Background Early diagnosis and timely treatment of malaria is recognized as a fundamental element to the control of the disease. Although access to health services in Tanzania is improved, still many people seek medical care when it is too late or not at all. This study aimed to determine factors associated with delay in seeking treatment for fever among children under five in Tanzania. Methods A three-stage cluster sampling design was used to sample households with children under five in Dodoma region, central Tanzania between October 2010 and January 2011. Information on illness and health-seeking behaviours in the previous four weeks was collected using a structured questionnaire. A multivariable logistic regression was used to investigate determinants of delay in treatment-seeking behaviour while accounting for sample design. Results A total of 287 under-five children with fever whose caretakers sought medical care were involved in the study. Of these, 55.4% were taken for medical care after 24 hours of onset of fever. The median time of delay in fever care seeking was two days. Children who lived with both biological parents were less likely to be delayed for medical care compared to those with either one or both of their biological parents absent from home (OR = 0.42, 95% CI: 0.24, 0.74). Children from households with two to three under-five children were more likely to be delayed for medical care compared to children from households with only one child (OR = 1.54, 95% CI: 1.04, 2.26). Also, children living in a distance ≥5 kilometres from the nearest health facility were about twice (95% CI: 1.11, 2.72) as likely to delay to be taken for medical care than those in the shorter distances. Conclusion Living with non-biological parents, high number of under-fives in household, and long distance to the nearest health facility were important factors for delay in seeking healthcare. Programmes to improve education on equity in social services, family planning, and access to health facilities are required for better healthcare and development of children.

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Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study

Alemayehu Getahun, Kebede Deribe, Amare Deribew (2010)

Background Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia. Methods A case control study was conducted from March 15 to April 20, 2010. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of developing sign and symptom, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of developing sign and symptom of malaria. Data were collected by trained enumerators using structured questionnaire. Data were entered in to Epi Info version 6.04 and analyzed using SPSS version 16.0. To identify determinants, multiple logistic regression was done. Results A total of 155 mothers of cases and 155 mothers of controls were interviewed. Mothers of children who were in a monogamous marriage (OR = 3.41, 95% CI: 1.39, 8.34), who complained about the side effects of anti-malarial drugs (OR = 4.96, 95% CI: 1.21, 20.36), who had no history of child death (OR = 3.50, 95% CI: 1.82, 6.42) and who complained about the higher cost of transportation to reach the health institutions (OR = 2.01, 95% CI: 1.17, 3.45) were more likely to be late for the treatment of malaria in under-five children. Conclusion Effective malaria control programmes should address reducing delayed presentation of children for treatment. Efforts to reduce delay should address transport cost, decentralization of services and increasing awareness of the community on early diagnosis and treatment.

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Author and article information

Journal

Journal ID (nlm-ta): Afr Health Sci

Journal ID (iso-abbrev): Afr Health Sci

Title: African Health Sciences

Publisher: Makerere Medical School (Kampala, Uganda )

ISSN (Print): 1680-6905

ISSN (Electronic): 1729-0503

Publication date (Print): September 2018

Volume: 18

Issue: 3

Pages: 552-559

Affiliations

[1 ] Malaria Control and Elimination Partnership in Africa (MACEPA) - PATH: A Catalyst for Global Health, Finote Selam, Ethiopia

[2 ] School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia

[3 ] School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia

Author notes

Corresponding author: Gebremedhin Berhe Gebregergs, Mekelle University, Mekelle, Ethiopia P.O.Box: 1871 Telephone number +251912761885 Fax number +251344416681 bgebrish04@ 123456gmail.com

Article

Publisher ID: jAFHS.v18.i3.pg552

DOI: 10.4314/ahs.v18i3.12

PMC ID: 6307022

PubMed ID: 30602987

SO-VID: ccd365d4-a08d-4bec-8b81-ddc2fa0580b1

License:

Licensee African Health Sciences. This is an Open Access article distributed under the terms of the Creative commons Attribution License ( https://creativecommons.org/licenses/BY/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Determinants of delay in seeking treatment among malaria patients in Dera district, NorthWest Ethiopia: a case control study

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Abstract

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Malaria vaccine development

Most cited references 12

Determinants of health care seeking for childhood illnesses in Nairobi slums.

Determinants of delay in care seeking among children under five with fever in Dodoma region, central Tanzania: a cross-sectional study

Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study

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