Home management of malaria.pdf

Abstract

Background: Malaria continues to be an important cause of morbidity and mortality among Nigerian children. Recent findings show that prompt administration of Artemisin based combination drugs at home can reverse this trend.
Objective: To determine the drugs administered at home and in outside (Non LAUTECH Teaching Hospital) health facilities for the treatment of malaria in children.
Methods: The parents/surrogates of children consecutively presenting with malaria at the out patient unit of the State Hospital Osogbo, Southwestern Nigeria between July 1 and 30 of September 2006 were interviewed.
Results: Three hundred and one- 159 boys and 142 girls were studied. The age range was 3 months to 13 years and the mean, 2.3 years (S.D. = 0.1). 190 (65.8%) were only treated at home by their parents with left overs of unconsumed stocks of drugs. The patent medicine stores, maternities, government hospitals, pharmacies, medical practitioners, private hospitals and primary health centers were consulted by 70(23.3%), 8(2.7%), 7(2.3%), 6(2.0%), 6(2.0%), 5(1.7%) and 1(0.3%) parents respectively for their children. 40 (13.3%) of the 301 children studied presented with complicated malaria. Only 5(1.7%) used the correct Artemisin combination therapy, while 297(98.3%) did not. The reason given by the patients who did not use the correct anti-malaria combination for not doing so was ignorance. Of the 301 subjects, the two most commonly used drugs were paracetamol in
208(69.1%) and chloroquine in 93(30.9%) children. Four (25%) of the 16 mothers with post secondary school education used the right anti malarial combination compared with 1(0.8%) of the 133 mothers who did not complete secondary school education (P<0.00), None of the 152 children whose parents did not complete primary school education used the right anti-malaria combination therapy.
Conclusion: The use of artemisin-based anti-malaria drugs by parents in this study is poor. The health care facilities consulted by the parents of these children had little or no positive influence on their health behavior regarding the home care of children with malaria. There is a need to bridge the unacceptably big gap between treatment policy enunciation and implementation by health caregivers in the homes and health service units.