Rural-urban differences in maternal responses to childhood fever in South East Nigeria.
BACKGROUND
Childhood fevers due to malaria remain a major cause of morbidity and mortality among under-five children in Nigeria. The degree of vulnerability perceived by mothers will affect their perception of the severity and threat of their child's fever and the patterns of health care use. This study was undertaken to compare maternal responses to childhood fever in urban and rural areas of Enugu, south east Nigeria.


RESULTS
Data was collected with pre-tested interviewer-administered questionnaires from 276 and 124 urban and rural households respectively. In each household, only one woman aged 15-49 years who had lived in each of the urban and rural communities for at least one year and had at least one child less than 5 years old was interviewed. Malaria was mentioned as the commonest cause of childhood fevers. Rural mothers were more likely to recognize danger signs and symptoms than urban mothers. Rural mothers use more of informal than formal health services, and there is more home management of the fever with urban than rural mothers. Chloroquine, ACT, SP and Paracetamol are the main drugs given at home for childhood fevers, but the rural mothers were more likely to use leftover drugs from previous treatment to treat the fevers than urban mothers. The urban respondents were also more likely to use a preventive measure. Urban mothers sought actions faster than rural mothers and the total cost of treatment was also higher in urban areas.


CONCLUSIONS
Both urban and rural mothers are aware that malaria is the major cause of childhood fevers. Although rural mothers recognize childhood fever and danger signs better than urban mothers, the urban mothers' responses to fever seem to be better than that for rural mothers. These responses and differences may be important for geographical targeting by policy makers for malaria interventions.
Uzochukwu
Benjamin S C
BS
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria. bscuzochukwu@yahoo.com
Onwujekwe
Emmanuel O
EO
Onoka
Chima A
CA
Ughasoro
Maduka D
MD
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005334:Fever / Q000209:etiology / Q000503:physiopathology*; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D008288:Malaria / Q000150:complications; D008875:Middle Aged; D009034:Mother-Child Relations; D009549:Nigeria; D012424:Rural Population; D014505:Urban Population