Incidence and management of malaria in two communities of different socio–economic level, in Accra, Ghana

Abstract

Two adjacent communities of differing socio-economic levels were selected, in Accra, Ghana, for the study of the home management of malaria. The youngest child in each selected household, each of which had a child aged < 5 years, was recruited for weekly follow-up, following informed consent. Malaria was the most common condition reported by the 'caregivers' (mothers of the subjects and others caring for the subjects) in each community, with 2.0 episodes of clinical malaria/child during the 9-month study. Most (89%) of the caregivers in the better-off community had been educated beyond primary-school level, but 55% of the caregivers in the poorer community had either received no formal education or only primary-school education. This difference was also reflected by the educational facilities provided to the children studied: 52% of the those in the better-off community attended nurseries, kindergartens or creches, compared with 8% of the children investigated in the poorer community. The proportion of caregivers who purchased drugs without prescription or used left-over drugs to treat clinical malaria in the children was higher in the poorer community (82% v. 53%), and a child from the poorer community was less likely to have been taken to a clinic or hospital to be treated for malaria than a child from the better-off community (27% v. 42%). During the follow-up period two children died, one from each community. Treatment of malaria in young children is likely to be less effective in the poorer community, where a lack of economic access to health services was demonstrated.

Spatial variation and socio-economic determinants of Plasmodium falciparum infection in northeastern Tanzania

“…Similar findings have been reported elsewhere [6,26,27]. Poor housing was also among the risk factors for malaria in the study area, whereby individuals living in houses built of mud and thatched roofs were at a higher risk compared to individuals of similar socio-economic status but living in better houses.…”

“…High level of urbanization is also associated with less malaria and this is attributable to high pollution levels which affects mosquito larvae development, good housing [4], better access to health facilities and high bed nets coverage [5,6]. Other factors which affects transmission of malaria include rainfall, topography, land use and socio-economic status (SES) [7].…”

“Souls of the ancestor that knock us out” and other tales. A qualitative study to identify demand-side factors influencing malaria case management in Cambodia

“…As demonstrated by other research studies [18,26,33,34], this study shows that treatment-seeking behaviour for malaria in Cambodia often starts with self-treatment prior to any biological diagnosis. When deciding how to treat oneself for suspected cases of malaria fever, Cambodians who work in forested areas weigh their beliefs in the effectiveness of these home-based treatments against their appraisal of available outside treatment options, such as proximity to health facilities, availability of financial resources and perceptions of the illness’ severity.…”

Symptomatic malaria diagnosis overestimate malaria prevalence, but underestimate anaemia burdens in children: results of a follow up study in Kenya

“…However, the overlapping of malaria symptoms with other tropical diseases impairs its specificity and therefore, encourages the indiscriminate use of anti-malarials for managing febrile conditions in endemic areas. This practice was understandable in the past when inexpensive and well-tolerated anti-malarials were still effective [17,18]. …”