Treatment-seeking paths in the management of severe malaria in children under 15 years of age attended in reference hospitals of Kinshasa, Democratic Republic of Congo
10.2149/tmh.2014-19
- Author:
Félicien Ilunga-Ilunga
;
Alain Levêque
;
Léon Okenge Ngongo
;
Samia Laokri
;
Michèle Dramaix
- Publication Type:Journal Article
- Keywords:
treatment-seeking path;
households;
severe malaria;
Kinshasa (DRC)
- From:Tropical Medicine and Health
2014;():-
- CountryJapan
- Language:English
-
Abstract:
Background: In the Democratic Republic of Congo (DRC), fewstudies have focused on treatment-seeking paths selected by caretakers for themanagement of severe childhood malaria in an urban environment. The presentstudy aims at describing the treatment-seeking paths according to thecharacteristics of households, and the subsequent impact on pre-hospitalisationdelay and malarial fatality, as well as on the main syndromes associated withsevere childhood malaria. Methods: This descriptive study included data collected in nine hospitals ofKinshasa between January and November 2011. A total of 1,350 children, under 15years of age and hospitalised for severe malaria, were included in the study. Results: Regarding the management of malaria, 31.5% of households directly wentto the health centre or hospital while 68.5% of them opted for self-medication,church and/or traditional healing therapy. The most frequent first-line optionwas self-medication, adopted by more than 61.5% of households. Nevertheless,rational self-medication relying on the use of antimalarial drugs recommendedby the WHO (artemisinin-based combinations), was only reported for 5.5% ofchildren. Only 12.5% of households combined 2 or 3 traditional options. Thefollowing criteria influenced the choice of a modern vs. a traditional path: household socioeconomic level, residentialenvironment, mother educational level and religious beliefs. When caretakersopted for traditional healing therapy, the pre-hospitalisation delay was longerwhile the occurrence of respiratory distress, severe anaemia and mortality wasmore frequent. Conclusion: The implementation of a malaria action plan in the Democratic Republic of Congo shouldtake into account the diversity and pluralistic character of treatment-seekingbehaviours, in order to promote the most appropriate options (hospital andrational self-medication) and avoid the deadliest severe forms.
