title: Presumptive self-diagnosis of malaria and other febrile illnesses in Sierra Leone.
abstract: BACKGROUND
  The objective of this study was to evaluate the prevalence of self-diagnosis of malaria and other febrile illnesses in Bo, Sierra Leone.
  
  
  METHODS
  All households in two neighboring sections of Bo were invited to participate in a cross-sectional survey.
  
  
  RESULTS
  A total of 882 households (an 85% participation rate) that were home to 5410 individuals participated in the study. Of the 910 individuals reported to have had what the household considered to be malaria in the past month, only 41% were diagnosed by a healthcare professional or a laboratory test. Of the 1402 individuals reported to have had any type of febrile illness within the past six months, only 34% had sought a clinical or laboratory diagnosis. Self-diagnosis of influenza, yellow fever, typhoid, and pneumonia was also common.
  
  
  CONCLUSIONS
  Self-diagnosis and presumptive treatment with antimalarial drugs and other antibiotic medications that are readily available without a prescription may compromise health outcomes for febrile adults and children.
authors.affiliation: Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, University of Liverpool, UK ; Mercy Hospital Research Laboratory, Bo, Sierra Leone ; Njala University, Bo, Sierra Leone.
authors.forename: Rashid
authors.initials: R
authors.lastname: Ansumana
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Jacobsen
authors.forename: Aiah Albert
authors.initials: AA
authors.lastname: Gbakima
authors.forename: Mary Hamer
authors.initials: MH
authors.lastname: Hodges
authors.forename: Joseph Morrison
authors.initials: JM
authors.lastname: Lamin
authors.forename: Tomasz Andrzej
authors.initials: TA
authors.lastname: Leski
authors.forename: Anthony Peter
authors.initials: AP
authors.lastname: Malanoski
authors.forename: Baochuan
authors.initials: B
authors.lastname: Lin
authors.forename: Moses John
authors.initials: MJ
authors.lastname: Bockarie
authors.forename: David Andrew
authors.initials: DA
authors.lastname: Stenger
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000962:Antimalarials / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000706:statistics & numerical data*; D012651:Self Medication / Q000706:statistics & numerical data*; D012807:Sierra Leone; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials
keywords: Malaria; West Africa; community pharmacy services; fevers; health services accessibility; self-care