The Influence of Cultural Perception of Causation, Complications, and Severity of Childhood Malaria on Determinants of Treatment and Preventive Pathways

Abstract

A cluster sample of 2,052 mothers and other caregivers of children from southwest Nigeria was studied. Qualitative and quantitative methods of data collection were employed, including semi-structured questionnaires, focus groups, in-depth interviews, and parasitological investigation forms/blood smears. "Too much work" (17.7%) and "too much sun" (12.6%) were the two most-often mentioned causes of malaria. Malaria was not perceived as a serious disease. Convulsions and anemia are not perceived as complications of malaria and are preferentially treated by traditional healers. Fifty-eight and one-half percent of children with malaria were treated at home. Choice of drugs used was based on previous experience and advice from various members of the community. Fathers (53.5%) and mother (32.5%) decided on where ill children received treatment. Mothers (51.5%) paid for the drugs more often than fathers (44.6%). Symptoms described as "iba lasan," which means "ordinary fever," conform to the clinical case definition of malaria. Cultural practices that are likely to influence appropriate treatment-seeking include cultural perception of malaria as ordinary fever, wrong perceptions of severe malaria, and father's role as decision maker.

Social and environmental determinants of malaria in under five children in Nigeria: a review

“…Most cases of malaria are treated at home or with traditional healers as first line of action. 23 While this study may be biased as almost 50% of the sample had no formal education, it still does, perhaps, fairly represent the level of knowledge about malaria, its prevention and treatment in most rural communities of Nigeria.…”

“…Instead, 'too much work' (17.7%), 'staying for too long in the sun' (12.6%), 'drinking bad/dirty water' (5.3%) were most often believed to be the cause of malaria. 23 In addition, convulsion and anaemia were not seen as complications of malaria and most infant mortality are not linked to malaria, whatsoever. Most cases of malaria are treated at home or with traditional healers as first line of action.…”

Awareness and Utilisation of Artemisinin-Based Combination Therapies Among Mothers of Under-Five Children in A Local Government Area in Nigeria

“…Some of the challenges to effective treatment of malaria among children include poor perception of severity of malaria, wrong beliefs about its cause, delay in seeking appropriate treatment as well as non-compliance to treatment by the mothers and caregivers (Falade et al, 2006;Ajayi et al, 2008).The findings of this study show that large proportion of the mothers associated witch crafting to malaria illness. This belief will in turn affect their treatment seeking bebaviour.…”

“…Adewole and Faparusi (2015) also found out that 86% of their respondents used drugs like chloroquine, sulphadoxinepyrimethamine and various form of analgesic to treat malaria among their children. Falade et al, (2006) also stated that large number of women in rural areas mentioned herbal therapy as their first line of treatment because they believe it cures fevers completely. Implication of this finding is that there is need for improved health education in health facilities and various communication media for mothers and caregivers on the importance of giving their children full dose of recommended Artemisinin-Based Combination Therapy (ACT) whenever their children have malaria fever.…”

“…The finding is in consonant with the studies on malaria and malaria treatment seeking behaviour where high proportion of their respondents patronized medicine stores and pharmacies for malaria treatment. (Falade et al, 2006;Sreeramareddy et al, 2006;Sumba et al, 2008;Shretta et al, 2013) Implication of this in community health care is that there is need for regular enlightenment programmes for these outlets to improve their performance with a view to ensuring dispensing live-saving drugs. Table 4: Mothers' description of administration of their medicine of choice to their children whenever they had malaria…”