Mothers' Perception, Knowledge and Practices regarding Childhood Malaria in Sudan

This is a descriptive, cross-sectional, community-based study. Five areas representing the endemicity categories in Sudan were selected (Khartoum, Shandi, Gadarif, Kenana and Wau). 655 mothers of children under 5 years were chosen through a multi stage random sampling; 200 of them at health facilities accompanying their febrile children, who were examined and a BFFM was taken for them and 455 mothers at household level. 330 (50.4%) of mothers, reported fever in last two weeks, 180(55.6%) of these were due to malaria. However, the reported incidence of malaria during the survey time was only 11(5.5%). The perceived causes of fever were malaria in 396(62.8%) and pneumonia in 286(43.3%). Convulsions as a risk of high fever was mentioned by 373 (57.9%). Educated mothers significantly had better knowledge about fever causes and risk factors than illiterates. The causes of malaria as perceived by mothers include: mosquito 558(86.3%), exhaustion, dirt, bad food and blood transfusion. Fever and vomiting were the commonest symptoms of malaria mentioned by 532(82%) and 380(58.6%) respectively. More than 254 (40%) mothers think that severe malaria presents with convulsions, while only 25 (3.9%) mentioned jaundice and/or pallor. Education significantly affects knowledge of danger signs. 595 (93.4%) mothers thought that BFFM was important, but 366 (56.4%) believed that antipyretics given at home will affect the result. 485(74.7%) of mothers sought help at a HF for childhood fever, 276(42.5%) gave home-treatment and 52(8%) visited traditional healers. For malaria 608(93.7%) visited a HF, 26 (4%) gave home treatment and only 28(4.3%) went to traditional healers; however, only 13(6.6%) visited HF within 24 hrs of fever. xi For convulsion, 355(55.8%) would visit HF and only 22(3.2%) mentioned traditional healers. Home-treatment of fever included cool bath in 327(57.8%), paracetamol in 122(21.6%) and home remedies in 62(11%). Traditional treatment of malaria also included use of Ardaib, Neam, Bee stings and others. Chloroquine was the commonest antimalarial mentioned by 597(93.7%) and artemether was reported by 54(8.5%). Correct chloroquine dose was given by 67(72%) and two thirds of mothers preferred oral drugs. Bed nets as prevention method was mentioned by 524(80.8%), but only 214(59.3%) were using them. The direct cost of malaria treatment is in average 4.7 us $; and the radio was the main source of information. Education and age of the mother affects their knowledge and practices. Implementing IMCI strategy and reducing the cost of treatment for under 5 years children are important in improving health seeking behavior and then malaria control