Predictors of time to initial treatment after malaria onset: A case of under-five children in South Sudan

Abstract

The objective of this study was to establish the predictors associated with health seeking behaviors after onset of malaria in South Sudan. The investigations were made on caretaker and child specific factors using the 2013 Malaria Indicator Survey data. Investigations were however based on 1093 records of children who were aged below five years that had a fever in the last two weeks at the time of the study. The analysis was done using a time-to-event approach comprising a Log-rank Chi-square test and Cox-Proportional Hazard regression. In the results, the median time-to-seeking treatment for malaria after onset of fever among children by the time of the study was 2 days (range, 0-90). The predictors of malaria treatment seeking status were region, mother’s highest education level and whether the child was still sick or not at the time of the study (p < 0.05). Particularly, mothers from the Equatorial Region, mothers with post primary education and those who had children that were not still sick by the time of the study were more likely to seek malaria treatment after onset of a fever. The results from this study indicate that there is still a gap regarding timely seeking of treatment by mother or care-taker after onset of a fever. Also a median time of 2 days for seeking treatment is worrying basing on the fact that the WHO recommends immediate treatment seeking as soon as a fever is realized in a child. In the effort to encourage caregivers of children to seek timely malarial treatment promptly the study recommends combined efforts by all stake holders in scaling up public awareness campaigns. Also, approaches addressing the low health seeking behavior should target none educated mothers or care takers since those are the ones that are less likely to seek treatment after onset of a fever should be formulated.