Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria
Abstract Background Home-based management of malaria involves prompt delivery of effective malaria treatment at the community by untrained caregiver. The aim of this study was to document home-based treatment of suspected malaria by non-medical caregivers and to identify its health impact on malaria...
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | Malaria Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12936-017-1836-6 |
| _version_ | 1818162473461612544 |
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| author | Damian U. Nwaneri Ayebo E. Sadoh Michael O. Ibadin |
| author_facet | Damian U. Nwaneri Ayebo E. Sadoh Michael O. Ibadin |
| author_sort | Damian U. Nwaneri |
| collection | DOAJ |
| description | Abstract Background Home-based management of malaria involves prompt delivery of effective malaria treatment at the community by untrained caregiver. The aim of this study was to document home-based treatment of suspected malaria by non-medical caregivers and to identify its health impact on malaria outcome (severe malaria prevalence, parasite load and mortality) in children (6–59 months). Methods A descriptive cross-sectional study carried out from June 2012–July 2013. Data was obtained by researcher-administered questionnaire and malaria was confirmed in each child by microscopy. Analysis was by Statistical Package for Scientific Solutions version 16. Results Of the 290 caregivers (31.2 ± 6.1 years)/child (21.3 ± 14.4 months) pairs recruited, 222 (76.6%) caregivers managed malaria at home before presenting their children to hospital. Majority (99.0%) practiced inappropriate home-based malaria treatment. While only 35 (15.8%) caregivers used the recommended artemisinin-based combination therapy, most others used paracetamol either solely or in combination with anti-malarial monotherapy [153 (69.0%)]. There was no significant difference in mean [±] parasites count (2055.71 ± 1655.06/µL) of children who received home-based treatment and those who did not (2405.27 ± 1905.77/µL) (t = 1.02, p = 0.31). Prevalence of severe malaria in this study was 111 (38.3%), which was statistically significantly higher in children who received home-based malaria treatment [90.0%] (χ2 = 18.4, OR 4.2, p = 0.00). The mortality rate was 62 per 1000 and all the children that died received home-based treatment (p < 0.001). While low socio-economic class was the significant predictor of prevalence of severe malaria (β = 0.90, OR 2.5, p = 0.00), late presentation significantly predicted mortality (β = 1.87, OR 6.5, p = 0.02). Conclusions The expected benefits of home-based management of malaria in under-fives were undermined by inappropriate treatment practices by the caregivers leading to high incidence of severe malaria and mortality. |
| first_indexed | 2024-12-11T16:34:13Z |
| format | Article |
| id | doaj.art-9334b85be89549778c9df39f3fa888e5 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-11T16:34:13Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-9334b85be89549778c9df39f3fa888e52022-12-22T00:58:30ZengBMCMalaria Journal1475-28752017-05-011611910.1186/s12936-017-1836-6Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in NigeriaDamian U. Nwaneri0Ayebo E. Sadoh1Michael O. Ibadin2Department of Child Health, University of Benin Teaching HospitalDepartment of Child Health, University of Benin Teaching HospitalDepartment of Child Health, University of Benin Teaching HospitalAbstract Background Home-based management of malaria involves prompt delivery of effective malaria treatment at the community by untrained caregiver. The aim of this study was to document home-based treatment of suspected malaria by non-medical caregivers and to identify its health impact on malaria outcome (severe malaria prevalence, parasite load and mortality) in children (6–59 months). Methods A descriptive cross-sectional study carried out from June 2012–July 2013. Data was obtained by researcher-administered questionnaire and malaria was confirmed in each child by microscopy. Analysis was by Statistical Package for Scientific Solutions version 16. Results Of the 290 caregivers (31.2 ± 6.1 years)/child (21.3 ± 14.4 months) pairs recruited, 222 (76.6%) caregivers managed malaria at home before presenting their children to hospital. Majority (99.0%) practiced inappropriate home-based malaria treatment. While only 35 (15.8%) caregivers used the recommended artemisinin-based combination therapy, most others used paracetamol either solely or in combination with anti-malarial monotherapy [153 (69.0%)]. There was no significant difference in mean [±] parasites count (2055.71 ± 1655.06/µL) of children who received home-based treatment and those who did not (2405.27 ± 1905.77/µL) (t = 1.02, p = 0.31). Prevalence of severe malaria in this study was 111 (38.3%), which was statistically significantly higher in children who received home-based malaria treatment [90.0%] (χ2 = 18.4, OR 4.2, p = 0.00). The mortality rate was 62 per 1000 and all the children that died received home-based treatment (p < 0.001). While low socio-economic class was the significant predictor of prevalence of severe malaria (β = 0.90, OR 2.5, p = 0.00), late presentation significantly predicted mortality (β = 1.87, OR 6.5, p = 0.02). Conclusions The expected benefits of home-based management of malaria in under-fives were undermined by inappropriate treatment practices by the caregivers leading to high incidence of severe malaria and mortality.http://link.springer.com/article/10.1186/s12936-017-1836-6Home-basedMalariaManagementMorbidityMortalitySeverity |
| spellingShingle | Damian U. Nwaneri Ayebo E. Sadoh Michael O. Ibadin Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria Malaria Journal Home-based Malaria Management Morbidity Mortality Severity |
| title | Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria |
| title_full | Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria |
| title_fullStr | Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria |
| title_full_unstemmed | Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria |
| title_short | Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria |
| title_sort | impact of home based management on malaria outcome in under fives presenting in a tertiary health institution in nigeria |
| topic | Home-based Malaria Management Morbidity Mortality Severity |
| url | http://link.springer.com/article/10.1186/s12936-017-1836-6 |
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