Two treatments, one disease: childhood malaria management in Tanga, Tanzania

Abstract

BackgroundIn the Tanga District of coastal Tanzania, malaria is one of the primary causes of mortality for children under the age of five. While some children are treated with malaria medications in biomedical facilities, as the World Health Organization recommends, others receive home-care or treatment from traditional healers. Recognition of malaria is difficult because symptoms can range from fever with uncomplicated malaria to convulsions with severe malaria. This study explores why caregivers in the Tanga District of Tanzania pursue particular courses of action to deal with malaria in their children.MethodsQualitative data were collected through interviews with three samples: female caregivers of children under five (N = 61), medical practitioners (N = 28), and traditional healers (N = 18) in urban, peri-urban, and rural areas. The female caregiver sample is intentionally stratified to reflect the greater population of the Tanga District in level of education, marital status, gender of household head, religion, and tribal group affiliation. Qualitative data were counted, coded and analysed using NVivo7 software.ResultsResults indicate that a variety of factors influence treatment choice, including socio-cultural beliefs about malaria symptoms, associations with spiritual affliction requiring traditional healing, knowledge of malaria, and fear of certain anti-malaria treatment procedures. Most notably, some caregivers identified convulsions as a spiritual condition, unrelated to malaria. While nearly all caregivers reported attending biomedical facilities to treat children with fever (N = 60/61), many caregivers stated that convulsions are best treated by traditional healers (N = 26/61). Qualitative interviews with medical practitioners and traditional healers confirmed this belief.ConclusionResults offer insight into current trends in malaria management and have implications in healthcare policy, educational campaigns, and the importance of integrating traditional and biomedical approaches.

Knowledge, Attitudes, Practices and Risk factors about Malaria in High Endemic Rural Eastern Tanzania

“…This complies with the government and WHO recommendation that all suspected cases should be con rmed either through microscopy or rapid diagnostic test before treatment [29]. A preference for testing before taking anti-malarial drugs has also been reported in other settings [30,31].…”

“We have become doctors for ourselves”: motives for malaria self-care among adults in southeastern Tanzania

“…The failure of the initial self-medication practices to produce relief, the perceived severity of the symptoms and the perceived degree of susceptibility to the condition motivated the study participants to take a malaria test. A preference for testing before taking anti-malarial drugs has also been reported in other settings [18,42]. Although a malaria test before the use of anti-malarial drugs is recommended [60], the quality of the malaria test services offered, especially in the private sector, is questionable, and the use of such tests can lead to the over-diagnosis of malaria [61].…”

Community perceptions on malaria and care-seeking practices in endemic Indian settings: policy implications for the malaria control programme

“…However, the primary health centre was the first point of contact for sick infants and young children as the physician of the health centre was thought to possess the most necessary skills. Like most traditional societies, faith healers remained the first point of contact outside the household and public health system [15,40]. The public health system can leverage this community role of traditional healers to galvanize appropriate community behaviour.…”