Original Article Perceptions of Malaria and pattern of treatment seeking behaviour among Tharu and Pahari

Background: Community understanding and practices relating to causation, transmission, prevention and treatment are the main socio-cultural factors that can influence malaria control but studies done social aspect of malaria control are limited in Nepal. Methods: Cross-sectional study was conducted in 2003 in Jhalari VDC of Kanchanpur district where both Tharus and Pahari communities coexist. Total of 184 households were included in the study through systematic random sampling procedure for household survey. Both qualitative and quantitative methods were applied for data collection. Results: Fever, headache, chills, shivering, joint pain and spasmodic fever were the most frequently mentioned symptoms of malaria. Though most people knew that mosquito bite might cause malaria fever, they had multiple notions of malaria causations such as hot weather, living near forest, season change, overwork and weakness. They were not clear how a mosquito gets infected and transmit the disease from one person to another. The results showed that people incorporated traditional and modern elements into their concepts of the diseases and treatment strategies. Home remedy with herbs and self-treatment with anti-malarial pills are rare in both communities. Use of government health facility is significantly higher in Paharis than in Tharus. Tharus initially consult their traditional healers and visit the drug retailers in the most cases and government facility in some cases. Tharus were less informed of free diagnosi