Social cultural factors and the persistence of malaria among the under five-year-old children in Kisenyi slum area
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Malaria is a huge public health concern in most areas of Uganda. Malaria is more severe among children aged less than five years (the under five children, [U5]), which calls for immediate action to control the situation. This study sought to identify social-cultural factors associated with malaria among under-five children, determine the magnitude of caretaker reported malaria among these children in the urban slum of Kisenyi I, Kampala district Uganda, examine malaria-related community knowledge and health seeking practices for the U5 children, identify caretaker’s cultural values, beliefs and practices towards malaria among U5 children, and find out community recommendations in combating malaria in their area. The study site was Kisenyi I slum area. The study adopted a cross sectional design. Sample size was 158 caretakers of U5 children. Systematic sampling was used to select households with caretakers for participation in the study. Semi structured questionnaires were used for quantitative data collection, while Focus Group Discussions (FGDs) and Key Informant interviews were used for qualitative data collection. Data were captured in the computer using FoxPro version 2.6, but analysis was done using the Statistical Package for Social Sciences (SPSS). A total of 158 caretakers, and 247 children under-five years (U5) of age, were enrolled into this study. About half of the caretakers (50.6%) were knowledgeable about malaria signs among the U5s, and most (92.2%) mentioned that malaria was severe in their community. Almost all caretakers (99.4 %) identified mosquitoes as the most common cause of malaria, and that use of treated bed nets was the best malaria preventive method. About 45% of caretakers mentioned Chloroquine was the best malaria treatment drug, and two thirds (66.6%) of caretakers first treated their children at home with modern medicine prior to seeking health care elsewhere. Many of the female caretakers first consulted their male partners before seeking care for their children elsewhere. Reported malaria among the U5s was very prevalence; 65.2% of the U5s were reported to have had at least one malaria episode in the past three months before the survey. U5s malaria was more common among females compared to their male counterparts. It was concluded that, the prevalence of reported malaria among U5 in this urban slum area is very high, but almost all caretakers and the community are knowledgeable about its causes, prevention and treatment. The delayed treatment in modern facilities is because caretakers do first aid treatment at home, and have to consult their male partners before further treatment elsewhere. These findings suggest that a lot more emphasis should be put on seeking early malaria treatment from public health centers in order to reduce the possibility of under treatment. This may reduce the persistence and high prevalence of reported malaria. Also, government through Ministry of health and other stakeholders should work hand in hand with community leaders to carry out sensitizations about health with main focus on seeking early care from trained medical professionals in modern health facilities.