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...
Published in: | Malaria Journal |
---|---|
Main Authors: | , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
BMC
2017
|
Subjects: | |
Online Access: | https://doi.org/10.1186/s12936-017-1836-6 https://doaj.org/article/9334b85be89549778c9df39f3fa888e5 |
id |
ftdoajarticles:oai:doaj.org/article:9334b85be89549778c9df39f3fa888e5 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:9334b85be89549778c9df39f3fa888e5 2023-05-15T15:15:29+02:00 Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria Damian U. Nwaneri Ayebo E. Sadoh Michael O. Ibadin 2017-05-01T00:00:00Z https://doi.org/10.1186/s12936-017-1836-6 https://doaj.org/article/9334b85be89549778c9df39f3fa888e5 EN eng BMC http://link.springer.com/article/10.1186/s12936-017-1836-6 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-017-1836-6 1475-2875 https://doaj.org/article/9334b85be89549778c9df39f3fa888e5 Malaria Journal, Vol 16, Iss 1, Pp 1-9 (2017) Home-based Malaria Management Morbidity Mortality Severity Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2017 ftdoajarticles https://doi.org/10.1186/s12936-017-1836-6 2022-12-31T01:57:18Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 16 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Home-based Malaria Management Morbidity Mortality Severity Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Home-based Malaria Management Morbidity Mortality Severity Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 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 |
topic_facet |
Home-based Malaria Management Morbidity Mortality Severity Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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. |
format |
Article in Journal/Newspaper |
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 |
title |
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_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_sort |
impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in nigeria |
publisher |
BMC |
publishDate |
2017 |
url |
https://doi.org/10.1186/s12936-017-1836-6 https://doaj.org/article/9334b85be89549778c9df39f3fa888e5 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 16, Iss 1, Pp 1-9 (2017) |
op_relation |
http://link.springer.com/article/10.1186/s12936-017-1836-6 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-017-1836-6 1475-2875 https://doaj.org/article/9334b85be89549778c9df39f3fa888e5 |
op_doi |
https://doi.org/10.1186/s12936-017-1836-6 |
container_title |
Malaria Journal |
container_volume |
16 |
container_issue |
1 |
_version_ |
1766345861228396544 |