Home Based Management of Uncomplicated P. falciparum Malaria in Children Below Five Years in Delta State


home-based management


Background: The world health organization (WHO) estimates that every 45 seconds an African child dies of malaria while several others lay ill. Also, studies have shown that home-based management of malaria could improve prompt access to antimalarial medications for African children. Objective: This study aimed at assessing the home based management practices among care givers of children below five years in Delta State. Methods: This study was a descriptive cross-sectional survey used to assess the home based management practices of malaria in children under age five. 459 consenting Caregivers of children under five (6 to 59 months) were purposively selected from different churches during Sundays and Wednesdays midweek services through balloting from two communities in Central and North Senatorial Districts of Delta State (Oghara and Obiaruku). Prior to the commencement of the study, the caregivers were thoroughly counselled on the objectives of the study, and a pretested structured interviewer administered questionnaire was used for administration in English, Urhobo and Ukwuani languages. Results: The study revealed that 86.93% respondents have good knowledge of malaria, and 60% commenced treatment within 24hrs. It also showed that 58.4% preferred anti-malarial combination therapies with arthemether-lumefantrine combination accounting for 34.0% drug options. Drug sources for home based malaria management were mainly from Pharmacy 40.5%, Drug sellers such as chemist 55.1% while information sources on choice of therapy and dosage were mainly from chemist 32.7%; health personnel 25.7%; neighbours 7.5% and self-based on previous experience 36.6%. Conclusion: The study revealed very good knowledge of malaria and good management practices as well as good treatment seeking behaviours amongst the caregivers.


WHO. Scaling-up home-based management of malaria: from research to implementation. Geneva: WHO (WHO/HTM/MAL/2004.1096), 2010; p 35.

Federal Ministry of Health (Nigeria) National Antimalarial Treatment Policy, Abuja, Nigeria (Federal Ministry of Health, 2005).

Kihara M, Carter JA, Newton CR. The effect of plasmodium on cognition: a systematic review. Tropical Medicine and International Health. 2006; 11(4):386-397. DOI: https://doi.org/10.1111/j.1365-3156.2006.01579.x [PMid:16553922]

John CC, Bangirana J, Opoka RO, Idro R, Jue KAM, Wu B, Boivin MJ. Celebral malaria in children is associated with long-term cognitive impairment. Paediatrics. 2008; 122:92-99. DOI: https://doi.org/10.1542/peds.2007-3709 [PMid:18541616 PMCid:PMC2607241]

Okeke TA, Uzochukwu BS, Okafor HU. An in-depth study of patent medicine sellers' perspectives on malaria in a rural Nigerian community. Malaria Journal. 2006; 5:97-103. DOI: https://doi.org/10.1186/1475-2875-5-97 [PMid:17078875 PMCid:PMC1635422]

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? American Journal of Tropical Medicine and Hygiene. 2007; 77:203-218. DOI: https://doi.org/10.4269/ajtmh.2007.77.203 [PMid:18165494 PMCid:PMC2657822]

WHO. Scaling-up home-based management of malaria: from research to implementation. Geneva:WHO(WHO/HTM/MAL/2004.1096), 2004.

WHO/RBM. Global strategic plan 2005-2015, 2005.

Chukwuocha U. Rapid assessment of home management of malaria among caregivers in parts of south eastern Nigeria. The Pan African Medical Journal. 2011; 10:29. [PMid:22187611 PMCid:PMC3240927]

Adeneye AK, Jegede AS, Mafe MA, Nwokocha EE. Community perceptions and home management of malaria in selected rural communities of Ogun state, Nigeria. International Journal of Malaria Research and Reviews. 2013; 1(3): 22-34.

Kassam R, Collins J, Sekiwunga R. Assets and challenges facing caregivers when managing malaria in young children in rural Uganda. Malaria Journal. 2016; 15:467. DOI: https://doi.org/10.1186/s12936-016-1521-1 [PMid:27618985 PMCid:PMC5020540]

Chukwuocha UM, Osuagwu AE, Dozie INS, Nwoke BEB, Onwuliri COE, Ukaga CN. The clinical pattern and complications of severe malaria in parts of the Imo River Basin of Nigeria. Nigerian Hospital Practice. 2009; 3(6):76-79. DOI: https://doi.org/10.4314/nhp.v3i6.45421

Okeke TA, Okafor HU. Perception and treatment seeking behavior for malaria in rural Nigeria- Implications for control. Journal of Human Ecology. 2008; 24(3):215-222. DOI: https://doi.org/10.1080/09709274.2008.11906117

ACTwatch Group. Household survey report (baseline) Republic of Uganda 03/09-04/09. http://apps.who.int/medicinedocs/documents/s18455en/s18455en .pdf (accessed 09.09.18), 2009.

ACTwatch Group. Household survey Uganda 2012 survey report, http://www.actwatch.info/sites/default/files/content/publications/attachments/ACTwatch%20HH%20Report%20Uganda%202012.pdf(accessed 09.09.18), 2013.

Tabuti JSR. Herbal medicines used in the treatment of malaria in Budiope county, Uganda. Journal of Ethnopharmacology. 2008; 116, 33-42. DOI: https://doi.org/10.1016/j.jep.2007.10.036 [PMid:18054454]

Zayyad MA, Bala J, Labaran KS. Home-based treatment of malaria in children under five years: pattern and practice among mothers in a university community in north western Nigeria. Nigerian Journal of Pharmaceutical Sciences. 2016; 15(2) 39-45.

Press I. Problems in the definition and classification of medical systems. Social Science and Medicine Med Anthropology. 1980; 14B(1):45-57. DOI: https://doi.org/10.1016/0160-7987(80)90040-X

Ahorlu CK, Koram KA, Ahorlu C, de Savigny D, Weiss M. Sociocultural determinants of treatment delay for childhood malaria in southern Ghana. Tropical Medicine and International Health. 2006; 11: 1022-1031. DOI: https://doi.org/10.1111/j.1365-3156.2006.01660.x [PMid:16827703]

Kamat VR, Nyato DJ. Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dar es Salaam, Tanzania. Malaria Journal. 2010; 9:61. DOI: https://doi.org/10.1186/1475-2875-9-61 [PMid:20187949 PMCid:PMC2842283]

Kassile T, Lokina R, Mujinja P, Mmbando BP. Determinants of delay in care seeking among children under five with fever in Dodoma region, central Tanzania: a cross-sectional study. Malaria Journal. 2014; 13:348. DOI: https://doi.org/10.1186/1475-2875-13-348 [PMid:25182432 PMCid:PMC4159519]

Mitiku I, Assefa A. Caregivers' perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study. Malaria Journal. 2017; 16(1)144. DOI: https://doi.org/10.1186/s12936-017-1798-8 [PMid:28390423 PMCid:PMC5385040]

WHO. World malaria report 2015. Geneva: World Health Organization; 2015.

Orimadegun AE, Amodu OK, Olumese PE, Omotade OO. Early home treatment of childhood fevers with ineffective antimalarials is deleterious in the outcome of severe malaria. Malaria Journal. 2008; 7. DOI: https://doi.org/10.1186/1475-2875-7-143

Willcox ML, Bodeker G. Traditional herbal medicines for malaria. BMJ. 2004; 329: 1156-1159. DOI: https://doi.org/10.1136/bmj.329.7475.1156 [PMid:15539672 PMCid:PMC527695]

Palafox B, Patouillard E, Tougher S, Goodman C, Kara H. ACTwatch: evidence for malaria medicine and policy. Outlet Survey Report (Baseline), Nigeria 2009. www.actwatch.info/results

Uguru NP, Onwujekwe OE, Tasie NG, Uzochukwu BS, Ezeoke UE. Do consumers' preferences for improved provision of malaria treatment services differ by their socioeconomic status and geographic location? A study in southeast Nigeria. BMC Public Health. 2010; 10: 7. DOI: https://doi.org/10.1186/1471-2458-10-7 [PMid:20051103 PMCid:PMC3397432]

Uzochukwu BSC, Ezeoke OP, Emma-Ukaegbu U, Onwujekw OE, Sibeudu FT. Malaria Treatment Services in Nigeria: A Review. Nigerian Medical Journal. 2010; 51(3): 114-119.

Uzochukwu BSC, Obikeze EN, Onwujekwe OE, Onoka CA, Griffiths UK. Cost-effectiveness analysis of rapid diagnostic test, microscopy and syndromic approach in the diagnosis of malaria in Nigeria: implications for scaling-up deployment of ACT. Malaria Journal. 2009; 8: 265. DOI: https://doi.org/10.1186/1475-2875-8-265 [PMid:19930666 PMCid:PMC2787522]

Musoke D, Karani G, Ssempebwa JC, Etajak S, Guwatudde D, Musoke MB. Knowledge and practices on malaria prevention in two rural communities in Wakiso District, Uganda. African Health Science. 2015; 15(2): 401-412. DOI: https://doi.org/10.4314/ahs.v15i2.13 [PMid:26124785 PMCid:PMC4480479]

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