Treatment-seeking behavior and practices among caregivers of children aged ≤5 y with presumed malaria in rural Uganda

Abstract

Background We aimed to determine the rate of herbal medicine usage and the treatment-seeking patterns of children aged ≤5 y with presumed or confirmed malaria in an endemic area of Uganda. Methods We interviewed guardians of 722 children aged 6 months to 5 y, who had experienced an episode of presumed malaria in the previous 3 months, about the illness history. Results Overall, 36.1% of patients took herbal medicines but most also sought modern medical care; 79.2% received Artemether-Lumefantrine (AL), but only 42.7% received the correct AL dose. Of the 36.6% of patients treated in drug shops, 9.8% had a diagnostic test and 30.2% received the correct dose of AL. Antibiotics were frequently provided with AL at drug shops (62%) and formal health centers (45%). There were no significant differences in the self-reported outcomes associated with different treatments. Conclusion Almost all of the patients who took herbal medicine also took modern antimalarials, so further research is needed to explore potential interactions between them. Although formal health facilities provided the correct diagnosis and dose of AL to a majority of children with malaria, many children still received inappropriate antibiotics. Quality of care was worse in drug shops than in formal health facilities.

“Testing for malaria does not cure any pain” A qualitative study exploring low use of malaria rapid diagnostic tests at drug shops in rural Uganda

“…Despite their popularity, many drug shops are unlicensed or operated by vendors who lack the qualifications required by the National Drug Authority [7][8][9]. Drug shop vendors do not always have formal training in malaria case management [10] or provide treatment in accordance with national guidelines [5,7,[9][10][11][12]. Perhaps most critically, not all clients receiving antimalarials from drug shops have a confirmed malaria diagnosis.…”

“…While RDT use in public facilities in Uganda is high, with an estimated diagnostic testing coverage of 84% [1], RDTs remain underused in the private sector. Previous studies found only 10 to 30% of clients treated for malaria at drug shops received an RDT [11][12][13]. Even when RDTs are used at the drug shop, clients often purchase antimalarials despite a negative result [13].…”

Knowledge of Malaria and Its Uncomplicated Treatment with Argemone mexicana L. in Selected Districts of Jimma Zone, Oromia Regional State, Ethiopia: A Community-Based Cross Sectional Survey

“…A similar study in Uganda also found that modern health care was more sought than herbal medicine. 30 Several factors affect treatment seeking behaviors of traditional medicine users like perceived efficacy, safety, age, availability of modern medicine, and cost. 9 In another study in Mali, respondents preferred a modern health facility when they had malaria.…”

Community prevalence of Helicobacter pylori and dyspepsia and efficacy of triple therapy in a rural district of eastern Uganda

“…A previous study looking at dyspepsia in this region found that out of nine randomly selected health centers in the Namutumba District, none of the health centers had the capacity to test for H. pylori, and only two of the nine health centers prescribed appropriate triple therapy for clinically significant dyspepsia [ 14 ]. Moreover, unlicensed pharmacies provide approximately 40% of all healthcare to people in the Namutumba District [ 57 ]. Though diagnostic kits for H. pylori are relatively inexpensive [ 37 ], instituting government-level policies to make these tests widely available and providing a standard of care for management of dyspeptic patients prior to empiric antibiotic usage would be a more effective method to appropriately manage H. pylori infection and limit antibiotic resistance.…”