title: Prevention and treatment strategies used for the community management of childhood fever in Kampala, Uganda.
abstract: To assess malaria-related prevention and treatment strategies in an urban parish of Kampala, Uganda, a questionnaire was administered to 339 randomly selected primary caregivers of children 1-10 years of age. Our study population was relatively stable and well educated, with better access to health services than many in Africa. Ownership of an insecticide-treated net (ITN) was reported by 11% of households and was predicted only by greater household wealth (highest quartile versus lowest quartile: odds ratio [OR] 21.8; 95% confidence interval [CI], 2.74-173). Among women, 5% reported use of an ITN and 11% used intermittent preventive therapy (IPT) during their last pregnancy. Use of appropriate IPT during pregnancy was predicted only by completion of secondary education or higher (OR, 2.87; 95% CI, 1.13-7.21). Children of 123 (36%) caregivers had experienced an episode of fever in the past 2 weeks. Of these, 22% received an anti-malarial that could be considered "adequate" (combination therapy or quinine). Only 1% of febrile children received adequate treatment at the correct dose within 24 hours of onset of fever. The only independent predictor of treatment with an adequate anti-malarial was accessing a clinic or hospital as the first source of care. In this urban area, use of appropriate malaria control measures occurs uncommonly.
authors.affiliation: Department of Medicine, San Francisco General Hospital, University of California, 94110, USA. Sarah.Kemble@ucsf.edu
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Kemble
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Davis
authors.forename: Talemwa
authors.initials: T
authors.lastname: Nalugwa
authors.forename: Denise
authors.initials: D
authors.lastname: Njama-Meya
authors.forename: Heidi
authors.initials: H
authors.lastname: Hopkins
authors.forename: Grant
authors.initials: G
authors.lastname: Dorsey
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Staedke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000962:Antimalarials / Q000627:therapeutic use*; D001512:Bedding and Linens; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D005334:Fever; D006801:Humans; D007223:Infant; D007306:Insecticides / Q000008:administration & dosage; D008288:Malaria / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D011795:Surveys and Questionnaires; D013997:Time Factors; D014454:Uganda / Q000453:epidemiology; D014505:Urban Population
chemical_list: D000962:Antimalarials; D007306:Insecticides