Skip to main content
Top
Published in: Malaria Journal 1/2014

Open Access 01-12-2014 | Research

Education and knowledge helps combating malaria, but not degedege: a cross-sectional study in Rufiji, Tanzania

Authors: Astrid Onarheim Spjeldnæs, Andrew Y Kitua, Bjørn Blomberg

Published in: Malaria Journal | Issue 1/2014

Login to get access

Abstract

Background

Traditional medicine is readily available in Tanzania, and local terms like degedege is widely used for malaria-like illnesses, often associated with supernatural forces. Malaria prevention and intervention efforts can benefit from policy-makers’ awareness of local perceptions and beliefs in the rural areas affected by malaria. This study measured knowledge, attitudes and behaviour towards malaria and malaria-like illnesses.

Methods

A cross-sectional survey was conducted in a rural area in Rufiji, Tanzania. A case report form employing a scoring system was used to capture participants’ knowledge of malaria and another for preventive actions against malaria. Logistic regression was used to assess factors associated with knowledge and preventive action.

Results

Most of the participants possessed good knowledge about malaria transmission (82.1%), prevention (85.2%) and where to get treatment (96.4%). Fewer were familiar with fever (58.2%) and other common symptoms of malaria (32.7%), and even fewer actually put their knowledge into action. The action score measured the use of bed net, treatment of nets, indoor use of insecticide residual spraying (IRS), and proportion of households with tight windows, among the participants. As many as 35.7% scored zero on preventive actions, while 37.2% achieved a high action score. Education level and belonging to the age group 30 to 49 were significantly associated with higher knowledge. Education level was associated with higher score for preventive action (OR 2.3, CI 95% 1.2-1.4). Participants generally perceived degedege, a local name for an illness with convulsion, as different from malaria both with regards to cause and possible preventive and curative interventions.

Conclusion

Respondents considered degedege to have supernatural causes and to need treatment by a traditional healer. This may be one reason for care-seeking shopping and care-seeking delay. Regarding degedege as a separate entity may explain why malaria is not perceived as a serious health problem in the area, and why little preventive actions are taken. While the elders have high status in the society, their lack of knowledge of malaria may impact the care-seeking pattern of their families.
Appendix
Available only for authorised users
Literature
4.
go back to reference Makundi EA, Malebo HM, Mhame P, Kitua AY, Warsame M: Role of traditional healers in the management of severe malaria among children below five years of age: the case of Kilosa and Handeni Districts, Tanzania. Malar J. 2006, 5: 58-10.1186/1475-2875-5-58.PubMedCentralCrossRefPubMed Makundi EA, Malebo HM, Mhame P, Kitua AY, Warsame M: Role of traditional healers in the management of severe malaria among children below five years of age: the case of Kilosa and Handeni Districts, Tanzania. Malar J. 2006, 5: 58-10.1186/1475-2875-5-58.PubMedCentralCrossRefPubMed
5.
go back to reference WHO: Management of severe malaria - A Practical Handbook. 2012, Geneva, Switzerland: World Health Organization, 3 WHO: Management of severe malaria - A Practical Handbook. 2012, Geneva, Switzerland: World Health Organization, 3
6.
7.
go back to reference Comoro C, Nsimba SED, Warsame M, Thomson G: Local understanding, perceptions and reported practices of mothers/guardians and health workers on childhood malaria in a Tanzanian district - implications for malaria control. Acta Trop. 2003, 87: 305-313. 10.1016/S0001-706X(03)00113-X.CrossRefPubMed Comoro C, Nsimba SED, Warsame M, Thomson G: Local understanding, perceptions and reported practices of mothers/guardians and health workers on childhood malaria in a Tanzanian district - implications for malaria control. Acta Trop. 2003, 87: 305-313. 10.1016/S0001-706X(03)00113-X.CrossRefPubMed
8.
go back to reference Muela SH, Ribera JM, Tanner M: Fake malaria and hidden parasites-the ambiguity of malaria. Anthropol Med. 1998, 5: 43-61. 10.1080/13648470.1998.9964548.CrossRef Muela SH, Ribera JM, Tanner M: Fake malaria and hidden parasites-the ambiguity of malaria. Anthropol Med. 1998, 5: 43-61. 10.1080/13648470.1998.9964548.CrossRef
9.
go back to reference Kaatano GM, Muro AIS, Medard M: Caretakers’s perceptions, attitudes and practices regarding childhood febrile illness and diarrhoeal diseases among riparian communities of lake Victoria, Tanzania. Tanzan J Health Res. 2006, 8: 3- Kaatano GM, Muro AIS, Medard M: Caretakers’s perceptions, attitudes and practices regarding childhood febrile illness and diarrhoeal diseases among riparian communities of lake Victoria, Tanzania. Tanzan J Health Res. 2006, 8: 3-
10.
go back to reference Dillip A, Hetzel MW, Gosoniu D, Kessy F, Lengeler C, Mayumana I, Mshana C, Mshinda H, Schulze A, Makemba A, Pfeiffer C, Weiss MG, Obrist B: Socio-cultural factors explaining timely and appropriate use of health facilities for degedege in south-eastern Tanzania. Malar J. 2009, 8: 144-10.1186/1475-2875-8-144.PubMedCentralCrossRefPubMed Dillip A, Hetzel MW, Gosoniu D, Kessy F, Lengeler C, Mayumana I, Mshana C, Mshinda H, Schulze A, Makemba A, Pfeiffer C, Weiss MG, Obrist B: Socio-cultural factors explaining timely and appropriate use of health facilities for degedege in south-eastern Tanzania. Malar J. 2009, 8: 144-10.1186/1475-2875-8-144.PubMedCentralCrossRefPubMed
11.
go back to reference Makemba AM, Winch PJ, Makame VM, Mehl GL, Premji Z, Minjas JN, Shiff CJ: Treatment practices for degedege, a locally recognized febrile illness, and implications for strategies to decrease mortality from severe malaria in Bagamoyo District, Tanzania. Trop Med Int Health. 1996, 1: 305-313.CrossRefPubMed Makemba AM, Winch PJ, Makame VM, Mehl GL, Premji Z, Minjas JN, Shiff CJ: Treatment practices for degedege, a locally recognized febrile illness, and implications for strategies to decrease mortality from severe malaria in Bagamoyo District, Tanzania. Trop Med Int Health. 1996, 1: 305-313.CrossRefPubMed
12.
go back to reference Kassile T: Prevention and management of malaria in under-five children in Tanzania: a review. Tanzan J Health Res. 2012, 14: 14-CrossRef Kassile T: Prevention and management of malaria in under-five children in Tanzania: a review. Tanzan J Health Res. 2012, 14: 14-CrossRef
13.
go back to reference Mwenesi HA: Social science research in malaria prevention, management and control in the last two decades: An overview. Acta Trop. 2005, 95: 292-297. 10.1016/j.actatropica.2005.06.004.CrossRefPubMed Mwenesi HA: Social science research in malaria prevention, management and control in the last two decades: An overview. Acta Trop. 2005, 95: 292-297. 10.1016/j.actatropica.2005.06.004.CrossRefPubMed
15.
go back to reference Nganda RY, Drakeley C, Reyburn H, Marchant T: Knowledge of malaria influences the use of insecticide treated nets but not intermittent presumptive treatment by pregnant women in Tanzania. Malar J. 2004, 3: 8-10.1186/1475-2875-3-8.CrossRef Nganda RY, Drakeley C, Reyburn H, Marchant T: Knowledge of malaria influences the use of insecticide treated nets but not intermittent presumptive treatment by pregnant women in Tanzania. Malar J. 2004, 3: 8-10.1186/1475-2875-3-8.CrossRef
16.
go back to reference Hlongwana KW, Mabaso ML, Kunene S, Govender D, Maharaj R: Community knowledge, attitudes and practices (KAP) on malaria in Swaziland: a country earmarked for malaria elimination. Malar J. 2009, 8: 29-10.1186/1475-2875-8-29.PubMedCentralCrossRefPubMed Hlongwana KW, Mabaso ML, Kunene S, Govender D, Maharaj R: Community knowledge, attitudes and practices (KAP) on malaria in Swaziland: a country earmarked for malaria elimination. Malar J. 2009, 8: 29-10.1186/1475-2875-8-29.PubMedCentralCrossRefPubMed
17.
go back to reference Ruebush TK, Weller SC, Klein RE: Knowledge and beliefs about malaria on the pacific coastal plain of Guatemala. Am J Trop Med Hyg. 1992, 46: 9- Ruebush TK, Weller SC, Klein RE: Knowledge and beliefs about malaria on the pacific coastal plain of Guatemala. Am J Trop Med Hyg. 1992, 46: 9-
18.
go back to reference Enato EFO, Okhamafe AO, Okpere EE: A survey of knowledge, attitude and practice of malaria management among pregnant women from two health care facilities in Nigeria. Acta Obstet Gynecol Scand. 2007, 86: 33-36. 10.1080/00016340600984670.CrossRefPubMed Enato EFO, Okhamafe AO, Okpere EE: A survey of knowledge, attitude and practice of malaria management among pregnant women from two health care facilities in Nigeria. Acta Obstet Gynecol Scand. 2007, 86: 33-36. 10.1080/00016340600984670.CrossRefPubMed
19.
go back to reference Keating J, Eisele TP, Bennett A, Johnson D, Macintyre K: A description of malaria-related knowledge, perceptions, and practices in the Artibonite Valley of Haiti: implications for malaria control. Am J Trop Med Hyg. 2008, 78: 262-269.PubMed Keating J, Eisele TP, Bennett A, Johnson D, Macintyre K: A description of malaria-related knowledge, perceptions, and practices in the Artibonite Valley of Haiti: implications for malaria control. Am J Trop Med Hyg. 2008, 78: 262-269.PubMed
21.
go back to reference Gessler MC, Msuya DE, Nkunya MH, Schar A, Heinrich M, Tanner M: Traditional healers in Tanzania: the perception of malaria and its causes. J Ethnopharmacol. 1995, 48: 119-130. 10.1016/0378-8741(95)01294-N.CrossRefPubMed Gessler MC, Msuya DE, Nkunya MH, Schar A, Heinrich M, Tanner M: Traditional healers in Tanzania: the perception of malaria and its causes. J Ethnopharmacol. 1995, 48: 119-130. 10.1016/0378-8741(95)01294-N.CrossRefPubMed
22.
go back to reference Tanzania Commission for AIDS (TACAIDS), Zanzibar Aids Commission (ZAC), National Bureau of statistics (NBS), Office of the Chief Government Statistician (OCGS), and Macro International Inc: Tanzania HIV/AIDS and Malaria Survey 2007–08. 2008, Dar es salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and Macro International Inc. Tanzania Commission for AIDS (TACAIDS), Zanzibar Aids Commission (ZAC), National Bureau of statistics (NBS), Office of the Chief Government Statistician (OCGS), and Macro International Inc: Tanzania HIV/AIDS and Malaria Survey 2007–08. 2008, Dar es salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and Macro International Inc.
23.
go back to reference Hanson K, Nathan R, Marchant T, Mponda H, Jones C, Bruce J, Stephen G, Mulligan J, Mshinda H, Schellenberg JA: Vouchers for scaling up insecticide-treated nets in Tanzania: methods for monitoring and evaluation of a national health system intervention. BMC Public Health. 2008, 8: 205-10.1186/1471-2458-8-205.PubMedCentralCrossRefPubMed Hanson K, Nathan R, Marchant T, Mponda H, Jones C, Bruce J, Stephen G, Mulligan J, Mshinda H, Schellenberg JA: Vouchers for scaling up insecticide-treated nets in Tanzania: methods for monitoring and evaluation of a national health system intervention. BMC Public Health. 2008, 8: 205-10.1186/1471-2458-8-205.PubMedCentralCrossRefPubMed
24.
go back to reference Khatib RA, Killeen GF, Abdulla SM, Kahigwa E, McElroy PD, Gerrets RP, Mshinda H, Mwita A, Kachur SP: Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania. Malar J. 2008, 7: 98-10.1186/1475-2875-7-98.PubMedCentralCrossRefPubMed Khatib RA, Killeen GF, Abdulla SM, Kahigwa E, McElroy PD, Gerrets RP, Mshinda H, Mwita A, Kachur SP: Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania. Malar J. 2008, 7: 98-10.1186/1475-2875-7-98.PubMedCentralCrossRefPubMed
25.
go back to reference Targett GAT: Malaria: Challenges for the 1990s. Malaria Waiting for the Vaccine. 1991, Great Britain: London School of Hygiene and Tropical Medicine, John Wiley and Sons Ltd, 1-29. Targett GAT: Malaria: Challenges for the 1990s. Malaria Waiting for the Vaccine. 1991, Great Britain: London School of Hygiene and Tropical Medicine, John Wiley and Sons Ltd, 1-29.
26.
go back to reference Pulford J, Hetzel MW, Bryant M, Siba PM, Mueller I: Reported reasons for not using a mosquito net when one is available: a review of the published literature. Malar J. 2011, 10: 83-10.1186/1475-2875-10-83.PubMedCentralCrossRefPubMed Pulford J, Hetzel MW, Bryant M, Siba PM, Mueller I: Reported reasons for not using a mosquito net when one is available: a review of the published literature. Malar J. 2011, 10: 83-10.1186/1475-2875-10-83.PubMedCentralCrossRefPubMed
27.
go back to reference Maslove DM, Mnyusiwalla A, Mills EJ, McGowan J, Attaran A, Wilson K: Barriers to the effective treatment and prevention of malaria in Africa: A systematic review of qualitative studies. BMC Int Health Hum Rights. 2009, 9: 26-10.1186/1472-698X-9-26.PubMedCentralCrossRefPubMed Maslove DM, Mnyusiwalla A, Mills EJ, McGowan J, Attaran A, Wilson K: Barriers to the effective treatment and prevention of malaria in Africa: A systematic review of qualitative studies. BMC Int Health Hum Rights. 2009, 9: 26-10.1186/1472-698X-9-26.PubMedCentralCrossRefPubMed
28.
go back to reference Cook GC, Zumla A: Book Power/ELST SES ed. Manson’s Tropical Diseases (21.edit). 2003, Edinburgh, UK Cook GC, Zumla A: Book Power/ELST SES ed. Manson’s Tropical Diseases (21.edit). 2003, Edinburgh, UK
29.
go back to reference Williams HA, Jones COH: A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made?. Soc Sci Med. 2004, 59: 23-CrossRef Williams HA, Jones COH: A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made?. Soc Sci Med. 2004, 59: 23-CrossRef
30.
go back to reference Oberländer L, Elverdan B: Malaria in the United Republic of Tanzania: cultural considerations and health-seeking behaviour. Bull World Health Org. 2000, 78: 6- Oberländer L, Elverdan B: Malaria in the United Republic of Tanzania: cultural considerations and health-seeking behaviour. Bull World Health Org. 2000, 78: 6-
31.
go back to reference de Savigny D, Mayombana C, Mwageni E, Masanja H, Minhaj A, Mkilindi Y, Mbuya C, Kasale H, Reid G: Care-seeking patterns for fatal malaria in Tanzania. Malar J. 2004, 3: 27-10.1186/1475-2875-3-27.PubMedCentralCrossRefPubMed de Savigny D, Mayombana C, Mwageni E, Masanja H, Minhaj A, Mkilindi Y, Mbuya C, Kasale H, Reid G: Care-seeking patterns for fatal malaria in Tanzania. Malar J. 2004, 3: 27-10.1186/1475-2875-3-27.PubMedCentralCrossRefPubMed
32.
go back to reference Montgomery CM, Mwengee W, Kong’ong’o M, Pool R: ‘To help them is to educate them’: power and pedagogy in the prevention and treatment of malaria in Tanzania. Trop Med Int Health. 2006, 11: 1661-1669. 10.1111/j.1365-3156.2006.01719.x.CrossRefPubMed Montgomery CM, Mwengee W, Kong’ong’o M, Pool R: ‘To help them is to educate them’: power and pedagogy in the prevention and treatment of malaria in Tanzania. Trop Med Int Health. 2006, 11: 1661-1669. 10.1111/j.1365-3156.2006.01719.x.CrossRefPubMed
33.
go back to reference Tanner M, Vlassoff C: Treatment-seeking behaviour for malaria: a typology based on endemicity and gender. Soc Sci Med. 1998, 46: 523-532. 10.1016/S0277-9536(97)00195-0.CrossRefPubMed Tanner M, Vlassoff C: Treatment-seeking behaviour for malaria: a typology based on endemicity and gender. Soc Sci Med. 1998, 46: 523-532. 10.1016/S0277-9536(97)00195-0.CrossRefPubMed
34.
go back to reference Nsimba SE, Kayombo EJ: Sociocultural barriers and malaria health care in Tanzania. Eval Health Prof. 2008, 31: 318-322. 10.1177/0163278708320164.CrossRefPubMed Nsimba SE, Kayombo EJ: Sociocultural barriers and malaria health care in Tanzania. Eval Health Prof. 2008, 31: 318-322. 10.1177/0163278708320164.CrossRefPubMed
35.
go back to reference Hetzel MW, Iteba N, Makemba A, Mshana C, Lengeler C, Obrist B, Schulze A, Nathan R, Dillip A, Alba S, Mayumana I, Khatib RA, Njau JD, Mshinda H: Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme. Malar J. 2007, 6: 83-10.1186/1475-2875-6-83.PubMedCentralCrossRefPubMed Hetzel MW, Iteba N, Makemba A, Mshana C, Lengeler C, Obrist B, Schulze A, Nathan R, Dillip A, Alba S, Mayumana I, Khatib RA, Njau JD, Mshinda H: Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme. Malar J. 2007, 6: 83-10.1186/1475-2875-6-83.PubMedCentralCrossRefPubMed
36.
go back to reference Schellenberg JR, Abdulla S, Minja H, Nathan R, Mukasa O, Marchant T, Mponda H, Kikumbih N, Lyimo E, Manchester T, Tanner M, Lengeler C: KINET: a social marketing programme of treated nets and net treatment for malaria control in Tanzania, with evaluation of child health and long-term survival. Trans R Soc Trop Med Hyg. 1999, 93: 225-231. 10.1016/S0035-9203(99)90001-9.CrossRefPubMed Schellenberg JR, Abdulla S, Minja H, Nathan R, Mukasa O, Marchant T, Mponda H, Kikumbih N, Lyimo E, Manchester T, Tanner M, Lengeler C: KINET: a social marketing programme of treated nets and net treatment for malaria control in Tanzania, with evaluation of child health and long-term survival. Trans R Soc Trop Med Hyg. 1999, 93: 225-231. 10.1016/S0035-9203(99)90001-9.CrossRefPubMed
Metadata
Title
Education and knowledge helps combating malaria, but not degedege: a cross-sectional study in Rufiji, Tanzania
Authors
Astrid Onarheim Spjeldnæs
Andrew Y Kitua
Bjørn Blomberg
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2014
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-13-200

Other articles of this Issue 1/2014

Malaria Journal 1/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.