Household use of sulfadoxine pyrimethamine and factors associated with its utilsation in the treatment of childhood malaria in rural Malawi.

Abstract

BACKGROUND: Malaria is a leading cause of morbidity and mortality of children in Malawi. Limited information is available on now SP is used at household level.

OBJECTIVES: To assess household use of SP and identify factors associated with its utilization in the treatment of childhood malaria in rural Malawi. PARTICIPANTS: Children under five years old who had a possible attack of malaria 2 weeks preceding the interview and consenting caretakers whose children were selected for the study. METHODOLOGY: The study was done in selected communities of kasungu district in Malawi between January to April 2002. A cross-sectional household cluster survey design was used. The study used both quantitative and qualitative methods. FINDINGS: A Total of 550 caretakers whose children had a possible malaria attack two weeks preceding the study were assessed. Of these, 68.9% gave their children medication at home at onset of fibril illness. Out of the children that were treated at home, 9.8% were reported to have received SP within 24 hours of onset fever. Among the children that received SP, 90% percent of the children of age 6 months to 36 months and 69.2% of children of age above 36 months received appropriate dosages. However, the dose was inappropriate for the one child of less than 6 months old. The main factors associated with SP use were knowledge of caretakers (OR: 6.2, CI: 1.66-23.60); availability of SP in the household (OR: 0.17, CI: 0.05-0.90) and caretaker perception of SP side effects (OR: 31.00, CI: 1.08-884.10). CONCLUSIONS: The prevalence of children less than five years old that received SP promptly is extremely low. About 1 in 10 children received SP treatment within 24 hours of onset illness. However, among the children who received SP, the majority received appropriate dosages. About 9 in 10 of children aged 6 to 36 months and about 2 out of 3 children aged over 36 months received appropriate dosages of SP. The use of SP in the treatment of children is influenced by the availability of SP as well as the knowledge and perceptions of the caretaker regarding SP.