Factors influencing coartem uptake of children 6 to 59 months old with umcomplicated malaria in Ntungamo District, Uganda.

Abstract

INTRODUCTION: Artemisinin based combination therapies are recommended for malaria treatment. In Ntungamo district, only 38% of the children aged 6 to 59 months receive coartem following onset of fever compared to national target of 55%. The objective of the study was to identify factors influencing coartem uptake in children aged 6 to 59 months with uncomplicated malaria in Ntungamo. MATERIALS AND METHODS A Cross sectional study was conducted in Rihama and Rushenyi counties, Ntungamo district using qualitative and quantitative data collection techniques. Quantitative data collection involved a home survey of caretakers whose children under five had had uncomplicated malaria two weeks prior to the study. While qualitative data collection included semi-structured key informant interviews. Quantitative data was analyzed using Epi info software and SPSS. Univariate, Bivariate and multiple variable analyses were used. Odds ratios were used to determine associations between the outcome and independent variables. Qualitative data was analyzed manually for content and recurrent themes. RESULTS: A Total of 201 caretakers were enrolled in the study during the period of data collection. Having good knowledge on malaria signs and symptoms (adj. OR: 4.19, 1.56-11.23), Attaining secondary school education (adj. OR: 2.40, 1.62-25.33), Living within a five kilometre radius from a health facility (adj. OR: 3.59, 1.72-7.48), Mother taking care of the child most of the time (adj. OR:4.90, 1.24-14.60), Owing a radio at home (adj. OR:3.00, 1.57-16.21) and listening to the malaria control radio programmes (adj. OR:1.71, 1.67-21.25), Accessing information education and communication material at the health facility (adj. OR: 3.79, 1.13-12.64), And good interpersonal relationship (adj. OR 5.65, 1.89-16.87) of health workers were associated with attendance of a health facility and receipt of coartem. Rating the conduct of health worker repulsive and delay in seeking treatment for child (adj. OR: 0.11, 0.03-0.38 and 0.10: 0.02-0.44) negatively influenced receiving of coartem. The proportion of children who received coartem within 24 hours from onset of fever according to national policy was 38.3. CONCLUSIONS: Caretaker’s good knowledge on signs and symptoms, on danger signs of malaria, availability of appropriate drugs, access to information education and communication materials and physical access to a health facility and good interpersonal relationship of health workers influence uptake of coartem. There is need to further build on existing community structures to enhance community knowledge through information education and communication programmes and improve access may be through community medicine distributors.