HOME MANAGEMENT PRACTICES OF CHILDHOOD MALARIA AMONG CAREGIVERS IN OJO MILITARY CANTONMENT, LAGOS: IMPLICATION FOR CHILD SURVIVAL.

Abstract

The global incidence of malaria is estimated at 110 million clinical cases and an annual mortality of about 1 million people. In Nigeria, malaria is highly endemic and children under 5 years old are particularly at risk of severe complications accounting for 30% and 41% of mortality and morbidity respectively. At the Abuja 2000 declaration on Roll Back Malaria, commitment to ensure that by 2005, at least 60% of those suffering from malaria have access to prompt, appropriate and affordable treatment within 24 hours of onset of symptoms was made. Home management was a major strategy identified to reach these goals, and self medication in the home, is a major treatment seeking behavior in the cantonment. The objective of the study therefore was to explore knowledge of anti-malaria drugs, dosages, ability to recognize, treat malaria and therefore the impact of home management practices by caregivers on child survival in the Military Cantonment, Ojo, Lagos. Both qualitative and quantitative data collection methods were used. Five Focus Group Discussions and 8 in-depth interviews were held with caregivers and key informants. Using systematic sampling design, blocks were selected from camp clusters and alternate households within the blocks were entered. Questionnaires were administered to four hundred caregivers; one per household for the survey. Respondents comprised of 221 (55.3%) mothers, 137 (34.3%) fathers, and most 322 (80.5%) were married with mean age 29 years (SD±15.17). Many 191 (47.9%) attended secondary school while 120(30.0%) had tertiary education and their mean monthly income was 14,531 Naira (SD± 6459.8). High prevalence of malaria all year round caused by mosquitoes bite was indicated by 281(70.2%) respondents, 361(87.0%) believe it can kill and 312 (78.0%) perceived young children as most vulnerable to attack. Preventive practices are uncoordinated, including screening of windows and doors, awareness and use of ITNs is low. Home management practices of childhood malaria are high predicated on immediate treatment with medicines, mainly chloroquine 188(47.0%) and herbal preparations 32 (8.0%) available in the home. Only 149(37.2%) reported that the children became completely well on a first action prompting a second and third action in the home. Sharing of left over drugs and concurrent use with traditional herbs were common practices leading to low compliance to correct dosages. Knowledge of drug dosages was low in both tablets 33(8.25%) and syrups 86(21.5%), and 316(79.0%) respondents were not aware of color-coded pre-packs of chloroquine. Home treatment was preferred because of high costs 250 (62.5%), unfriendly attitude of workers 195(48.8%) and long waiting time 194(48.5%) in the hospital. Only 122(30.5%) sought help in the hospital, yet no policy on home management of malaria is in place. Seventy-three respondents (18.3%) reported having lost a child under 5 years old in the household and half of these were perceived to be malaria related. Based on the findings, there is the need to create awareness for caregivers on the need for correct dosages of anti-malaria drugs, pre-packaged drugs and home visits to improve managing childhood malaria within the community.