MALARIA TREATMENT PRACTICES OF UNDER-FIVE CAREGIVERS AND WILLINGNESS TO ACCEPT A DIAGNOSTIC AND TREATMENT PACKAGE FOR MALARIA IN ONA-ARA LOCAL GOVERNMENT AREA, OYO STATE

Abstract

Background: Home management of malaria (HMM) using artemisinin-based combined therapy (ACT) has proved to be very effective in the treatment of malaria in rural communities. Efforts have been undertaken to increase ACT access by training community health workers and role model mothers for effective distribution. To further improve HMM parasitological confirmation of diagnosis by microscopy or rapid diagnostic test (RDT) for non complicated malaria and use of pre-referral rectal artesunate for complicated malaria have been recommended. This study is a baseline survey for an intervention study set to include RDT and rectal artesunate in HMM to further improve the effectiveness of the strategy. Methods: Cross sectional household survey of 355 under-five caregivers in the six rural wards in Ona-Ara local government area was carried out. An interviewer administered questionnaire was used to obtain information on caregivers treatment practices, willingness to accept suppositories and RDT and factors influencing willingness. Chi square test, logistic analysis and knowledge score were used to produce result. Results: The caregivers were predominantly farmers 50.7% and petty traders 34.9%. Frequently used drug for treatment of malaria this include, paracetamol 31.5%, herbs 20.7% chloroquine 18.2% while 16.3% said they name of the drug was not known. The ACTs were used by only 4.7% of the caregivers. Only 7.9% have heard about rectal artesunate. Willingness to accept RDT and rectal artesunate was agreed by 65.4% and 75.8% respectively. Reasons for not willing to accept RDT was fear of using their blood for ritual purposes while the reason for not willing to accept rectal artesunate was fear of health implications like pain, difficulty in defecating and drug not dissolving on their children. Caregivers willingness to accept RDT is significantly related to who makes decision on treatment given (p=0.04, x2= 11.422). Knowledge of symptoms and causes of malaria was significantly related to willingness to accept rectal artesunate (p=0.006, x2 =10.271). Further analysis showed that those with good and average knowledge are 0.323 and 0.439 times respectively more willing than those with poor knowledge to accept rectal artesunate(95% CI OR= 0,140-0.744 and 0.221-0.873 respectively). Conclusion: Caregivers in this study were willing to accept both RDT and rectal artesunate, effective health education of caregivers especially among decision makers stand to encourage willingness and should be addressed prior to intervention.