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Published in: Malaria Journal 1/2015

Open Access 01-12-2015 | Research

Caregivers’ treatment-seeking behaviour for children under age five in malaria-endemic areas of rural Myanmar: a cross-sectional study

Authors: Moe Moe Thandar, Myat Phone Kyaw, Masamine Jimba, Junko Yasuoka

Published in: Malaria Journal | Issue 1/2015

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Abstract

Background

A community-based malaria intervention was introduced through fixed and mobile clinics in rural Myanmar. This study attempted to identify treatment-seeking behaviour of caregivers for children under five and the determinants of appropriate treatment-seeking behaviour in mobile clinic villages (MV) and non-mobile clinic villages (NMV) in malaria-endemic rural areas in Myanmar.

Methods

A cross-sectional study was conducted in 23 MV and 25 NMV in Ingapu Township, Myanmar. Appropriate treatment-seeking behaviour was operationally defined as seeking treatment from trained personnel or at a health facility within 24 hours after the onset of fever. Multiple logistic regression analyses were conducted to identify the determinants of appropriate treatment-seeking behaviour.

Results

Among the 597 participants in both types of villages, 166 (35.3%) caregivers sought appropriate treatment. No significant difference in appropriate treatment-seeking behaviour was found between the two types of villages (adjusted odds ratio (AOR), 0.80; 95% confidence interval (CI), 0.51-1.24). Determinants of behaviour include proximity to public health facilities (AOR, 5.86; 95% CI, 3.43-10.02), knowledge of malaria (AOR, 1.90; 95% CI, 1.14-3.17), malaria prevention behaviour (AOR, 1.76; 95% CI, 1.13-2.76), treatment at home (AOR, 0.26; 95% CI, 0.15-0.45), and treatment and transportation costs (AOR, 0.52; 95% CI, 0.33-0.83).

Conclusions

Caregivers’ treatment-seeking behaviour was poor for fever cases among children under age five, and did not differ significantly between MV and NMV. It is necessary to educate caregivers, particularly for early treatment seeking and appropriate use of health care options for fever, and catering to their medical needs. These findings can help promote awareness and prevention, and improve the quality of interventions at the community level.
Literature
1.
go back to reference Haque U, Scott LM, Hashizume M, Fisher E, Haque R, Yamamoto T, Glass GE: Modelling malaria treatment practices in Bangladesh using spatial statistics. Malar J 2012, 11:63. 10.1186/1475-2875-11-63CrossRefPubMedCentralPubMed Haque U, Scott LM, Hashizume M, Fisher E, Haque R, Yamamoto T, Glass GE: Modelling malaria treatment practices in Bangladesh using spatial statistics. Malar J 2012, 11:63. 10.1186/1475-2875-11-63CrossRefPubMedCentralPubMed
2.
go back to reference WHO: World Malaria Report 2013. Geneva: World Health Organization; 2013. WHO: World Malaria Report 2013. Geneva: World Health Organization; 2013.
3.
go back to reference WHO: 10 facts on malaria. Geneva: World Health Organization; 2014. WHO: 10 facts on malaria. Geneva: World Health Organization; 2014.
4.
go back to reference WHO: T3: Test. Treat. Track initiative. Geneva: World Health Organization; 2012. WHO: T3: Test. Treat. Track initiative. Geneva: World Health Organization; 2012.
5.
go back to reference Das A, Ravindran TS: Factors affecting treatment-seeking for febrile illness in a malaria endemic block in Boudh district, Orissa, India: policy implications for malaria control. Malar J 2010, 9:377. 10.1186/1475-2875-9-377CrossRefPubMedCentralPubMed Das A, Ravindran TS: Factors affecting treatment-seeking for febrile illness in a malaria endemic block in Boudh district, Orissa, India: policy implications for malaria control. Malar J 2010, 9:377. 10.1186/1475-2875-9-377CrossRefPubMedCentralPubMed
6.
go back to reference Sumba PO, Wong SL, Kanzaria HK, Johnson KA, John CC: Malaria treatment-seeking behaviour and recovery from malaria in a highland area of Kenya. Malar J 2008, 7:245. 10.1186/1475-2875-7-245CrossRefPubMedCentralPubMed Sumba PO, Wong SL, Kanzaria HK, Johnson KA, John CC: Malaria treatment-seeking behaviour and recovery from malaria in a highland area of Kenya. Malar J 2008, 7:245. 10.1186/1475-2875-7-245CrossRefPubMedCentralPubMed
7.
go back to reference Hetzel MW, Obrist B, Lengeler C, Msechu JJ, Nathan R, Dillip A, Makemba AM, Mshana C, Schulze A, Mshinda H: Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania. BMC Public Health 2008, 8:317. 10.1186/1471-2458-8-317CrossRefPubMedCentralPubMed Hetzel MW, Obrist B, Lengeler C, Msechu JJ, Nathan R, Dillip A, Makemba AM, Mshana C, Schulze A, Mshinda H: Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania. BMC Public Health 2008, 8:317. 10.1186/1471-2458-8-317CrossRefPubMedCentralPubMed
8.
go back to reference Yadav SP, Sharma RC, Joshi V: Study of social determinants of malaria in desert part of Rajasthan, India. J Vector Borne Dis 2005, 42:141–146.PubMed Yadav SP, Sharma RC, Joshi V: Study of social determinants of malaria in desert part of Rajasthan, India. J Vector Borne Dis 2005, 42:141–146.PubMed
9.
go back to reference Ahmed SM, Haque R, Haque U, Hossain A: Knowledge on the transmission, prevention and treatment of malaria among two endemic populations of Bangladesh and their health-seeking behaviour. Malar J 2009, 8:173. 10.1186/1475-2875-8-173CrossRefPubMedCentralPubMed Ahmed SM, Haque R, Haque U, Hossain A: Knowledge on the transmission, prevention and treatment of malaria among two endemic populations of Bangladesh and their health-seeking behaviour. Malar J 2009, 8:173. 10.1186/1475-2875-8-173CrossRefPubMedCentralPubMed
10.
go back to reference Lowassa A, Mazigo HD, Mahande AM, Mwang'onde BJ, Msangi S, Mahande MJ, Kimaro EE, Elisante E, Kweka EJ: Social economic factors and malaria transmission in Lower Moshi, northern Tanzania. Parasit Vectors 2012, 5:129. 10.1186/1756-3305-5-129CrossRefPubMedCentralPubMed Lowassa A, Mazigo HD, Mahande AM, Mwang'onde BJ, Msangi S, Mahande MJ, Kimaro EE, Elisante E, Kweka EJ: Social economic factors and malaria transmission in Lower Moshi, northern Tanzania. Parasit Vectors 2012, 5:129. 10.1186/1756-3305-5-129CrossRefPubMedCentralPubMed
11.
go back to reference Oberlander L, Elverdan B: Malaria in the United Republic of Tanzania: cultural considerations and health-seeking behaviour. Bull World Health Organ 2000, 78:1352–1357.PubMedCentralPubMed Oberlander L, Elverdan B: Malaria in the United Republic of Tanzania: cultural considerations and health-seeking behaviour. Bull World Health Organ 2000, 78:1352–1357.PubMedCentralPubMed
12.
go back to reference Xu JW, Xu QZ, Liu H, Zeng YR: Malaria treatment-seeking behaviour and related factors of Wa ethnic minority in Myanmar: a cross-sectional study. Malar J 2012, 11:417. 10.1186/1475-2875-11-417CrossRefPubMedCentralPubMed Xu JW, Xu QZ, Liu H, Zeng YR: Malaria treatment-seeking behaviour and related factors of Wa ethnic minority in Myanmar: a cross-sectional study. Malar J 2012, 11:417. 10.1186/1475-2875-11-417CrossRefPubMedCentralPubMed
13.
go back to reference Getahun A, Deribe K, Deribew A: Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study. Malar J 2010, 9:320. 10.1186/1475-2875-9-320CrossRefPubMedCentralPubMed Getahun A, Deribe K, Deribew A: Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study. Malar J 2010, 9:320. 10.1186/1475-2875-9-320CrossRefPubMedCentralPubMed
14.
go back to reference UNICEF: Country Program Overview 2011–2015. UNICEF: Country Program Overview 2011–2015.
15.
go back to reference National Malaria Control Programme, Myanmar: Malaria Situation in Myanmar. 2010. National Malaria Control Programme, Myanmar: Malaria Situation in Myanmar. 2010.
16.
go back to reference Kyawt Kyawt S, Pearson A: Knowledge, attitudes and practices with regard to malaria control in an endemic rural area of Myanmar. Southeast Asian J Trop Med Public Health 2004, 35:53–62. Kyawt Kyawt S, Pearson A: Knowledge, attitudes and practices with regard to malaria control in an endemic rural area of Myanmar. Southeast Asian J Trop Med Public Health 2004, 35:53–62.
17.
go back to reference Myanmar MOH: Annual Vector Borne Disease Contol (VBDC) Programme Data. 2011. Myanmar MOH: Annual Vector Borne Disease Contol (VBDC) Programme Data. 2011.
18.
go back to reference Ohnmar , Tun M, San S, Than W, Chongsuvivatwong V: Effects of malaria volunteer training on coverage and timeliness of diagnosis: a cluster randomized controlled trial in Myanmar. Malar J 2012, 11:309. 10.1186/1475-2875-11-309CrossRefPubMedCentralPubMed Ohnmar , Tun M, San S, Than W, Chongsuvivatwong V: Effects of malaria volunteer training on coverage and timeliness of diagnosis: a cluster randomized controlled trial in Myanmar. Malar J 2012, 11:309. 10.1186/1475-2875-11-309CrossRefPubMedCentralPubMed
19.
20.
go back to reference Lim S, Yasuoka J, Poudel KC, Ly P, Nguon C, Jimba M: Promoting community knowledge and action for malaria control in rural Cambodia: potential contributions of Village Malaria Workers. BMC Res Notes 2012, 5:405. 10.1186/1756-0500-5-405CrossRefPubMedCentralPubMed Lim S, Yasuoka J, Poudel KC, Ly P, Nguon C, Jimba M: Promoting community knowledge and action for malaria control in rural Cambodia: potential contributions of Village Malaria Workers. BMC Res Notes 2012, 5:405. 10.1186/1756-0500-5-405CrossRefPubMedCentralPubMed
21.
go back to reference Hasegawa A, Yasuoka J, Ly P, Nguon C, Jimba M: Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers. Malar J 2013, 12:292. 10.1186/1475-2875-12-292CrossRefPubMedCentralPubMed Hasegawa A, Yasuoka J, Ly P, Nguon C, Jimba M: Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers. Malar J 2013, 12:292. 10.1186/1475-2875-12-292CrossRefPubMedCentralPubMed
22.
go back to reference Yasuoka J, Poudel KC, Poudel-Tandukar K, Nguon C, Ly P, Socheat D, Jimba M: Assessing the quality of service of village malaria workers to strengthen community-based malaria control in Cambodia. Malar J 2010, 9:109. 10.1186/1475-2875-9-109CrossRefPubMedCentralPubMed Yasuoka J, Poudel KC, Poudel-Tandukar K, Nguon C, Ly P, Socheat D, Jimba M: Assessing the quality of service of village malaria workers to strengthen community-based malaria control in Cambodia. Malar J 2010, 9:109. 10.1186/1475-2875-9-109CrossRefPubMedCentralPubMed
23.
go back to reference Yasuoka J, Poudel KC, Ly P, Nguon C, Socheat D, Jimba M: Scale-up of community-based malaria control can be achieved without degrading community health workers' service quality: the Village Malaria Worker project in Cambodia. Malar J 2012, 11:4. 10.1186/1475-2875-11-4CrossRefPubMedCentralPubMed Yasuoka J, Poudel KC, Ly P, Nguon C, Socheat D, Jimba M: Scale-up of community-based malaria control can be achieved without degrading community health workers' service quality: the Village Malaria Worker project in Cambodia. Malar J 2012, 11:4. 10.1186/1475-2875-11-4CrossRefPubMedCentralPubMed
25.
go back to reference Smith LA, Bruce J, Gueye L, Helou A, Diallo R, Gueye B, Jones C, Webster J: From fever to anti-malarial: the treatment-seeking process in rural Senegal. Malar J 2010, 9:333. 10.1186/1475-2875-9-333CrossRefPubMedCentralPubMed Smith LA, Bruce J, Gueye L, Helou A, Diallo R, Gueye B, Jones C, Webster J: From fever to anti-malarial: the treatment-seeking process in rural Senegal. Malar J 2010, 9:333. 10.1186/1475-2875-9-333CrossRefPubMedCentralPubMed
26.
go back to reference Amin AA, Marsh V, Noor AM, Ochola SA, Snow RW: The use of formal and informal curative services in the management of paediatric fevers in four districts in Kenya. Trop Med Int Health 2003, 8:1143–1152. 10.1046/j.1360-2276.2003.01140.xCrossRefPubMed Amin AA, Marsh V, Noor AM, Ochola SA, Snow RW: The use of formal and informal curative services in the management of paediatric fevers in four districts in Kenya. Trop Med Int Health 2003, 8:1143–1152. 10.1046/j.1360-2276.2003.01140.xCrossRefPubMed
27.
go back to reference Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander K: Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malar J 2009, 8:45. 10.1186/1475-2875-8-45CrossRefPubMedCentralPubMed Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander K: Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malar J 2009, 8:45. 10.1186/1475-2875-8-45CrossRefPubMedCentralPubMed
28.
go back to reference Nyamongo IK: Health care switching behaviour of malaria patients in a Kenyan rural community. Soc Sci Med 2002, 54:377–386. 10.1016/S0277-9536(01)00036-3CrossRefPubMed Nyamongo IK: Health care switching behaviour of malaria patients in a Kenyan rural community. Soc Sci Med 2002, 54:377–386. 10.1016/S0277-9536(01)00036-3CrossRefPubMed
29.
go back to reference Thera MA, D'Alessandro U, Thiero M, Ouedraogo A, Packou J, Souleymane OA, Fane M, Ade G, Alvez F, Doumbo O: Child malaria treatment practices among mothers in the district of Yanfolila, Sikasso region, Mali. Trop Med Int Health 2000, 5:876–881. 10.1046/j.1365-3156.2000.00652.xCrossRefPubMed Thera MA, D'Alessandro U, Thiero M, Ouedraogo A, Packou J, Souleymane OA, Fane M, Ade G, Alvez F, Doumbo O: Child malaria treatment practices among mothers in the district of Yanfolila, Sikasso region, Mali. Trop Med Int Health 2000, 5:876–881. 10.1046/j.1365-3156.2000.00652.xCrossRefPubMed
30.
go back to reference Ruebush TK, Kern MK, Campbell CC, Oloo AJ: Self-treatment of malaria in a rural area of western Kenya. Bull World Health Organ 1995, 73:229–236.PubMedCentralPubMed Ruebush TK, Kern MK, Campbell CC, Oloo AJ: Self-treatment of malaria in a rural area of western Kenya. Bull World Health Organ 1995, 73:229–236.PubMedCentralPubMed
31.
go back to reference Snow RWPN, Forster D, Mwenesi H, Marsh K: The role of shops in the treatment and prevention of childhood malaria on the coast of Kenya. Trans R Soc Trop Med Hyg 1992, 86:237–239. 10.1016/0035-9203(92)90290-SCrossRefPubMed Snow RWPN, Forster D, Mwenesi H, Marsh K: The role of shops in the treatment and prevention of childhood malaria on the coast of Kenya. Trans R Soc Trop Med Hyg 1992, 86:237–239. 10.1016/0035-9203(92)90290-SCrossRefPubMed
32.
go back to reference Ohnmar , Tun M, May Aye T, San S, Wai Wai M, Chongsuvivatwong V: Access to a blood test and antimalarials after introducing rapid diagnostic tests in rural Myanmar: initial experience in a malaria endemic area. Int Health 2010, 2:275–281. 10.1016/j.inhe.2010.09.008CrossRefPubMed Ohnmar , Tun M, May Aye T, San S, Wai Wai M, Chongsuvivatwong V: Access to a blood test and antimalarials after introducing rapid diagnostic tests in rural Myanmar: initial experience in a malaria endemic area. Int Health 2010, 2:275–281. 10.1016/j.inhe.2010.09.008CrossRefPubMed
33.
go back to reference Abuya TO, Mutemi W, Karisa B, Ochola SA, Fegan G, Marsh V: Use of over-the-counter malaria medicines in children and adults in three districts in Kenya: implications for private medicine retailer interventions. Malar J 2007, 6:57. 10.1186/1475-2875-6-57CrossRefPubMedCentralPubMed Abuya TO, Mutemi W, Karisa B, Ochola SA, Fegan G, Marsh V: Use of over-the-counter malaria medicines in children and adults in three districts in Kenya: implications for private medicine retailer interventions. Malar J 2007, 6:57. 10.1186/1475-2875-6-57CrossRefPubMedCentralPubMed
34.
go back to reference Ajayi IO, Browne EN, Garshong B, Bateganya F, Yusuf B, Agyei-Baffour P, Doamekpor L, Balyeku A, Munguti K, Cousens S, Pagnoni F: Feasibility and acceptability of artemisinin-based combination therapy for the home management of malaria in four African sites. Malar J 2008, 7:6. 10.1186/1475-2875-7-6CrossRefPubMedCentralPubMed Ajayi IO, Browne EN, Garshong B, Bateganya F, Yusuf B, Agyei-Baffour P, Doamekpor L, Balyeku A, Munguti K, Cousens S, Pagnoni F: Feasibility and acceptability of artemisinin-based combination therapy for the home management of malaria in four African sites. Malar J 2008, 7:6. 10.1186/1475-2875-7-6CrossRefPubMedCentralPubMed
35.
go back to reference Beyl C, Kyaw M, Ohnmar , Maung T, Meek S, Thimasarn K, Soe A, Sintasath D, Kyaw T: Myanmar Artemisinin Resistance Containment (MARC) survey: malaria diagnosis and treatment. Washington: Poster, 62nd ASTMH Annual Meeting; 2013. Beyl C, Kyaw M, Ohnmar , Maung T, Meek S, Thimasarn K, Soe A, Sintasath D, Kyaw T: Myanmar Artemisinin Resistance Containment (MARC) survey: malaria diagnosis and treatment. Washington: Poster, 62nd ASTMH Annual Meeting; 2013.
36.
go back to reference Goodman C, Brieger W, Unwin A, Mills A, Meek S, Greer G: Medicine sellers and malaria treatment in sub-Saharan Africa: what do they do and how can their practice be improved? Am J Trop Med Hyg 2007, 77:203–218.PubMedCentralPubMed Goodman C, Brieger W, Unwin A, Mills A, Meek S, Greer G: Medicine sellers and malaria treatment in sub-Saharan Africa: what do they do and how can their practice be improved? Am J Trop Med Hyg 2007, 77:203–218.PubMedCentralPubMed
37.
go back to reference Schellenberg JA, Victora CG, Mushi A, de Savigny D, Schellenberg D, Mshinda H, Bryce J: Inequities among the very poor: health care for children in rural southern Tanzania. Lancet 2003, 361:561–566. 10.1016/S0140-6736(03)12515-9CrossRefPubMed Schellenberg JA, Victora CG, Mushi A, de Savigny D, Schellenberg D, Mshinda H, Bryce J: Inequities among the very poor: health care for children in rural southern Tanzania. Lancet 2003, 361:561–566. 10.1016/S0140-6736(03)12515-9CrossRefPubMed
Metadata
Title
Caregivers’ treatment-seeking behaviour for children under age five in malaria-endemic areas of rural Myanmar: a cross-sectional study
Authors
Moe Moe Thandar
Myat Phone Kyaw
Masamine Jimba
Junko Yasuoka
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2015
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-14-1

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