title: Treatment of malaria fever episodes among children in Malawi: results of a KAP survey.
abstract: Caretakers of children (< 10 years of age) were questioned about management of pediatric malarial fever episodes in a nation-wide knowledge, attitudes, and practices survey conducted in Malawi. A total of 1,531 households in 30 randomly selected clusters of 51 households each were sampled and interviewed. Overall 557 caretakers reported a fever in their child in the previous 2 weeks; 43%-judged the illness as severe. Fifty-two percent of caretakers brought their febrile children to clinic. Clinic attendance was positively correlated with young age of the child (< 4 years), severe illness, and higher socioeconomic status. Seventy-four percent of clinic attenders gave their child an antimalarial; in contrast, only 42% of those not attending clinic gave an antimalarial. Optimal therapy (administration of an antimalarial promptly and at the proper dosage) was received by only 7% of febrile children. Children taken to clinic were twice as likely to receive optimal therapy as were non-attenders. Identification of critical points in the optimal therapy algorithm and characteristics of caretakers linked with sub-optimal therapy may help malaria control programs target specific groups and health education messages to improve treatment of malaria fever episodes.
authors.affiliation: Malaria Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: L
authors.initials: L
authors.lastname: Slutsker
authors.forename: L
authors.initials: L
authors.lastname: Chitsulo
authors.forename: A
authors.initials: A
authors.lastname: Macheso
authors.forename: R W
authors.initials: RW
authors.lastname: Steketee
mesh_terms: D000465:Algorithms; D000554:Ambulatory Care Facilities; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000008:administration & dosage / Q000627:therapeutic use; D003625:Data Collection; D004351:Drug Resistance; D005260:Female; D005334:Fever / Q000188:drug therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D008295:Malawi; D008297:Male
chemical_list: D000962:Antimalarials; D002738:Chloroquine