Lay knowledge and management of malaria in Baringo county, Kenya

Abstract

BackgroundMalaria, a disease caused by protozoan parasites of the genus Plasmodium and transmitted by female anopheline mosquitoes, is a major cause of morbidity, mortality and loss in productivity in humans. Baringo County is prone to seasonal transmissions of malaria mostly in the rainy seasons.MethodsThis cross-sectional study used a mixed methods approach to collect data on knowledge and lay management of malaria. A questionnaire survey was administered to 560 respondents while qualitative data was collected through 20 focus group discussions in four ecological zones covering Baringo North, Baringo South and Marigat sub-Counties of Baringo County. Analyses were done through summary and inferential statistics for quantitative data and content analysis for qualitative data.ResultsThe study communities were knowledgeable of malaria signs, symptoms, cause and seasonality but this biomedical knowledge co-existed with other local perceptions. This knowledge, however, did not influence their first (p = 0.77) or second choice treatments (p = 0.49) and compliance to medication (p = 0.84). Up to 88 % of respondents reported having suffered from malaria. At the onset of a suspected malaria case community members reported the following: 28.9 % visited a health facility, 37.2 % used analgesics, 26.6 % herbal treatments, 2.2 % remnant malaria medicines, 2.2 % over the counter malaria medicines, 1 % traditional healers and 1.8 % other treatments. Nearly all respondents (97.8 %) reported visiting a health facility for subsequent treatments. Herbal treatments comprised of infusions and decoctions derived from roots, barks and leaves of plants believed to have medicinal value. Compliance to conventional malaria treatment regime was, however, identified as a challenge in malaria management. Quick relief from symptoms, undesirable qualities like drug bitterness and bad smell, undesirable side-effects, such as nausea and long regimen of treatment were some of the contributors to non-compliance. Men and women exhibited different health-seeking behaviours based on the cultural expectations of masculinity, femininity, gender roles and acceptability of health services.ConclusionsWhile knowledge of malaria is important in identifying the disease, it does not necessarily lead to good management practice. Treatment-seeking behaviour is also influenced by perceived cause, severity of disease, timing, anticipated cost of seeking treatment and gender, besides the availability of both traditional and conventional medicines.

Knowledge, Attitude and Treatment Seeking Behavior for Malaria in May-Aynee Administration, Eritrea

“…Fever, shivering/chills, headache, joint pain, and vomiting were stated as the cardinal signs of malaria. Fever was the predominantly (84%) recognized symptom of malaria in this study, consistent with studies from India [19], Uganda [23], and Kenya [24]. This may be due to the existence of high malaria infections since long time in the area.…”

“We don’t want our clothes to smell smoke”: changing malaria control practices and opportunities for integrated community-based management in Baringo, Kenya

“…Misconceptions about malaria etiology were not unique to this study since similar perceptions have been reported among communities in western Kenya [ 28 ]. These misguided perceptions indicate a knowledge gap that potentially influence choices of malaria prevention or treatment pattern [ 29 ]. Thus, there is need for enhanced community knowledge though public education and awareness in order to increase uptake of preventive measures.…”

“We do not bury dead livestock like human beings”: Community behaviors and risk of Rift Valley Fever virus infection in Baringo County, Kenya

“…Thus, the paucity in knowledge of RVF signs and symptoms may lead to misdiagnosis implicating other febrile ailments, such as malaria, that may be endemic in a region [ 34 ]. Inhabitants of Baringo County have been found to be knowledgeable of malaria signs the symptoms hence their ability to relate its symptomatology with that of RVF [ 35 ]. Unlike the Somalis in North Eastern Kenya who had a local name, “ sandik” (bloody nose), for RVF, [ 26 ], neither the Tugen nor Ilchamus had a widely accepted term possibly because the disease was reported for the first time in 2006–2007 [ 17 ].…”