How and when parents seek treatment for a child with malaria can affect outcomes. In rural Sudan, parents explore different options before seeking formal medical care, thus delaying vital treatment. In such settings effective home-based management of malaria would utilise local health infrastructure to improve treatment outcomes.

In order to effectively treat children under five years of age with malaria, it is necessary that parents recognise the symptoms and act quickly to provide the right treatment. The aim of this study, involving researchers from Sudan's National Malaria Control Programme, the Sudan Ministry of Health, the University of Juba and the University of Liverpool (UK), was to understand how parents recognise malaria in children and what treatment option they choose.

Researchers designed a study that combined qualitative and quantitative data gathering methods. They surveyed 96 mothers who had accessed medical treatment for their children with malaria. In addition, the study also conducted ten focus group interviews and observations of daily life in a number of villages in the study area. Researchers found that:

• The majority of mothers were capable of recognising the symptoms of malaria, including high fever. They also knew the seriousness of these symptoms.
• The response of mothers to malaria was normally to ask for advice but not from health facilities. Parents used medical personnel or health facilities only when a child’s condition deteriorated.
• Parents used four different types of treatment. These included traditional medicine, herbal remedies, self-treatment and finally medical care. Self-treatment was particularly common.

The choice of treatments depended on a number of factors. These were the availability of formal health facilities, the costs involved in treatment and medicines, the difficulties associated with travelling and belief in the effectiveness of traditional medicine.

In sum, the study found that Sudanese mothers tend to seek medical attention for malaria when their children’s condition deteriorates. Before reaching this state, they normally go through a series of different alternatives which result in unnecessary delays in seeking care. The study calls for a successful malaria home management strategy that includes:

• taking into account existing treatment options
• training and equipping nominated volunteers from each village to link with existing health facilities
• storing the required drugs in pharmacies, health centres and hospitals.

Source(s):
'Treatment-seeking behaviour for malaria in children under five years of age: implications for home management in rural areas with high seasonal transmission in Sudan', Malaria Journal 5(60), by Elfatih Mohamed Malik, Kamal Hanafi, Salah Hussein Ali, Eldirdieri Salim Ahmed and Khalid Awad Mohamed, 2006

Funded by: UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR); World Health Organisation Regional Office for the Eastern Mediterranean (EMRO)

id21 Research Highlight: 2 May 2007

Further Information:
Elfatih Mohamed Malik
National Malaria Control Programme (NMCP)
Federal Ministry of Health
P. O. Box 1204
Khartoum
Sudan

Tel: +249 183 769579
Fax: +249 183 770397
Contact the contributor: fatihmmalik@hotmail.com

Ministry of Health, Sudan

University of Juba, Sudan

University of Liverpool, UK

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'Hitting malaria where it hurts: household and community responses in Africa'

'Gender and treatment-seeking for child malaria in Ghana'

'Seeking treatment for childhood fevers in Tanzania'

'Be quick – seeking care for life threatening malaria in southern Tanzania'

'What mothers do: responses to childhood fever on the Kenyan Coast'

'Reducing malaria-related infant deaths: strategies for success?'

'Fighting fits: childhood malaria and seizures in sub-Saharan Africa'