Childhood malaria: mothers\' perception and treatment-seeking behaviour in a community in Ebonyi State, South East Nigeria

Context: Childhood malaria continues to be a major cause of childhood morbidity and mortality. Caregivers ability to detect the illness in children early and institute effective treatment is critical to illness outcome. The investigation of mothers\' perception of malaria and treatment-seeking behaviour in childhood malaria in a community in Ebonyi State, South-East Nigeria was therefore the aim of this study. Methods: Using a cross-sectional descriptive study design, interviewer-administered structured questionnaires were administered to a sample of 236 mothers drawn by multi-staged sampling to collect information on their perception of and recognition of signs and symptoms of malaria in children and treatment-seeking behaviour. Findings: The mean age of the respondents was 40.63 years. Only 35.2% of them knew the cause of malaria. No significant association was found between education and this knowledge. Majority (59.3%) of the respondents perceived malaria as a serious problem. Fever and chills were the most common symptoms recognised by 72% and 60.2% of the mothers respectively as being associated with malaria in children. The incidence of history of fever, indicative of malaria in children of the respondents within one month of the survey was 74.6%. The health centre was the most preferred choice where treatment was first sought (21%) for the bout of fever while government hospitals and community health workers were sources of treatment for 15.9% and 14.6% respectively. Other sources of treatment were treatment at home, patent medicine dealers, private hospital and traditional healers used by 13.6%, 10.2 % and 7.4% respectively. The dominant reasons for choice of the health centre were availability of Doctor / trained personnel (73%) and good service (67.6%). Proximity was the major factor (92.3%) for choice of the community health workers. Low cost of care and good personal experience were the main reasons for the choice of traditional healers and home treatment respectively. The mean number of days between when illness was noticed and time treatment was instituted was 3 days. Conclusion: The low level of awareness of mothers of the cause of malaria, the poor treatment-seeking behaviour shown by the low level of use of the health facilities as a place where treatment is first sought, and the delay in seeking treatment for childhood malaria, suggest a need for intensified health education intervention programmes. Measures to relieve poverty and reduce cost of allopathic care should also be put in place.Keywords: childhood malaria, mother\'s perception, treatment-seeking behaviour, early diagnosis, effective treatment, community based Journal of Community Medicine and Primary Health Care 2005, 17(1): 45-5