Environmental Survey and Health Seeking Behavior of Caregive | 18113
International Research Journals

Environmental Survey and Health Seeking Behavior of Caregivers of Children Suspected to have Malaria in Takwa-Bay, Lagos State


Iwalokun BA, Agomo PU, Egbuna KN, Iwalokun SO, Adebodun V, Olukosi OO, Aina O, Okoh HI, Agomo CU, Ajibaye O, Orok O, Enya VNV, Akindele S, and Akinyele MO

Malaria is the single most important cause of illness and deaths in Nigerian children especially in rural areas where effective case management and prevention are compromised by delayed recognition of the disease and poor treatment decisions, poor access to integrated malaria vector control and therapeutic intervention strategies. To design efficacious and cost-effective malaria control activity with potentials for optimal social benefits in a rural area, an understanding of perception of malaria and health seeking behaviors of caregivers is highly imperative. This study was carried out to characterize Takwa-Bay for malaria risk factors and document existing knowledge, attitudes and practices related to malaria recognition, control and treatment in the area. This cross-sectional descriptive study enrolled 112 respondents from 47 households of 171 under 5 years of age children that were selected by multistage random sampling method from 11 clusters drawn from the 4 major settlements in Takwa-Bay: Takwa-Bay, Ebute-Oko, Abagbo and Ogogoro in Lagos, Nigeria. The respondents, who were caregivers were administered open/close-ended pilot tested questionnaire that was designed based on key informant interviews to capture demographic and socio-economic variables coupled with their knowledge of malaria and health seeking behavior. The area was also environmentally assessed to capture malaria transmission indicators. Data were analyzed statistically using SPSS software version 11.0. A total of 112 respondents aged 21 - 53 years (mean + SD age = 32.9+8.7 years).were studied. Of the 112 respondents, 59 (52.7%) were females (P >0.05), 76.8% had formal education predominated by primary school attendance (50.9%; P <0.05), 27.7% were traders, 13.4% were artisans, 18.8% were housewives and 8% were unemployed. The respondents (88.5%) were ranked within the 1 st and 2nd quartiles of wealth index suggesting poor to moderately poor socio-economic status. The respondents had good knowledge of malaria aetiology (77.7 – 100%) and classical symptoms of uncomplicated malaria such as fever, malaise, headache and loss of appetite (87.5 - 96.4 %). But knowledge of danger signs seen in severe malaria such as convulsion, coma, jaundice and respiratory distress (28.6 – 57.6%) were significantly low (P < 0.05) Community members and the health post were mentioned as the major sources of information by the respondents compared to radio, television and traditional medicine practitioners (4.5 – 11.6 vs. 19.6 – 58%; P <0.05). Data on health seeking behavior indicated that the respondents employed allopathic medicines (71.4%), traditional medicines (20.5%) or both (8%) to treat their sick children. Self medication was practiced by 57.1% of the respondents. Reasons given for self medication included timeliness, knowledge about treatment of malaria, non-availability of doctors in the health post, poor attitude of health workers and lack of drugs at the health post, while the use of traditional medicines was based on cultural belief of efficacy of natural products, and the free to low cost associated with their procurement. Western medicines used were CQ (32.5%), SP (42.5%), artemisinin monotherapy (13.8%) and ACT (3.8%), analgesics (75%), antibiotics (46.3%) and haematinnics (51.3%). The use of allopathic medicine was associated with having a formal education (OR (95%CI) = 11.6 (3.8-36.4) and younger age [OR (95%CI) = 5.0 (1.5-16.3)], while self medication was favorably practiced by the male gender [(OR (95%CI) = 5.4 (2.2-13.4)]. Leaves of Vernonia amygdalina, Morinda lucida and Azadirachta indica were among the plants used for malaria treatments. More than 60% of the households’ survey were located < 400 m to water bodies and surrounded by mosquito breeding promoting factors. We conclude that Takwa-Bay is a malaria prone and poor rural area that is currently characterized by poor home management of the disease despite good awareness of malaria among the caregivers. Therefore, there is a need to improve perception of malaria and bridge the existing gap between knowledge and health seeking behaviour in Takwa-Bay through provision of health education with emphasis on danger signs of malaria and training of health care providers with emphasis on the procurement and sales of ACTs as nationally approved therapies for malaria in Nigeria. Home management of malaria (HMM) by caregivers should also be improved through provision of key messages regarding malaria treatment using information, education and communication (IEC) materials. The formal health system in Takwa-Bay should also be strengthened through regular supply of ACT to avert stock outs, provision of doctors and training of health personnel on the treatment guidelines and client friendliness. Ownership and use of long lasting insecticidal nets (LLIN) should also be improved in the area.

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