Malaria treatment-seeking behaviour and its associated factors: A cross-sectional study in rural East Nusa Tenggara Province, Indonesia

Abstract

Introduction. The World Health Organization recommends seeking medical treatment within 24 hours after transmission of malaria to reduce the risk of severe complications and its onwards spread. However, in some parts of Indonesia, including East Nusa Tenggara Province (ENTP), this adherence is not achieved for a range of reasons including delays in visiting health centres. This study aims to determine factors related to the poor understanding of appropriate malaria treatment–seeking behaviour (AMTSB) of rural adults in ENTP. AMTSB was defined as seeking treatment at professional health facilities within 24 hours of the onset of malaria symptoms. Methods. A cross–sectional study was conducted in the East Sumba, Belu, and East Manggarai district of ENTP between October and December 2019. A multi–stage cluster sampling procedure was applied to enrol 1495 participants aged between 18 and 89 years old. Data were collected through face–to–face interview. Multivariable logistic regression analyses were used to assess significant factors associated with the poor understanding of AMTSB. Results. 86% of participants were found to be familiar with the term malaria. However, poor understanding level of AMTSB in rural adults of ENTP achieved 60.4% with a 95% confidence interval (CI): 56.9 — 63.8. The most important factors associated with the poor understanding were lower levels of education, low socio–economic status (SES), occupation, and distance to the nearest health facilities. The poor understanding of AMTSB was significantly higher for adults with no education (adjusted odds ratio (AOR) 3.42, 95% CI: 1.81, 6.48); having low SES (AOR: 1.87, 95% CI: 1.19, 2.96); residing three km away from the nearest health facilities (AOR: 1.73, 95% CI: 1.2, 2.5); and working as housewife (AOR: 1.63, 95%CI: 1.01 — 2.63). Ethnicity, and family size were not associated with the poor understanding of AMTSB. Conclusion. The proportion of rural adults having a poor understanding of AMTSB was high leading to ineffective implementation of artemisinin&ndash]based combination therapies as the method to treat malaria in ENTP. Improving awareness of AMTSB for rural adults having low-level education, low SES, working as a housewife, and living three km from the nearest health facilities is critical to support the efficacy of malaria treatment in ENTP, as well as to advance the Indonesian government′s objective to achieve malaria elimination by 2030.

Associate Issues in Delayed Care Seeking Behavior in Households Suffering from Malaria

“…Chukwuocha, Okpanma, Nwakwuo, and Dozie (2014) found that age, marital status, educational status of murder and family socioeconomic status add determinants of delay in care-seeking behaviour of children under five suffering from malaria. Guntur, Kingsley, and Islam (2021) found that low level of education, Low economic status, distance to health facilities and occupation were determinants of delay in seeking care for Malaria in Indonesia.…”