Malaria [Elektronische Ressource] : perceptions and treatment practices among mothers of children under 10 years in rural Ghana / vorgelegt von Eckhardt, Stefan

Sujets

• Gesundheit

Informations

• Publié par: justus-liebig-universitat_giessen
• Publié le: 01 janvier 2006
• Nombre de lectures: 28
• Poids de l'ouvrage: 1 Mo

Extrait

Malaria: Perceptions and Treatment Practices Among Mothers of Children
Under 10 Years in Rural Ghana


















Inauguraldissertation
zur Erlangung des Grades eines Doktors der Medizin
des Fachbereichs Medizin
der Justus-Liebig-Universität Gießen

















vorgelegt von Eckhardt, Stefan
aus Frankfurt am Main




Gießen (2004)


Aus dem Institut für Hygiene
Direktor/Leiter: Professor Eikmann







































Gutachter: Prof. Dr. Korte

Gutachter: Frau Prof. D. Fischer

Tag der Disputation: 27.06.2005




Table of contents

1. Background............................................................................................................. 1
2. Methods.................................................................................................................. 7
2.1 Study Design..................................................................................................... 7
2.2 Study Site.......................................................................................................... 7
2.3 Study Population ............................................................................................. 10
2.4 Data Collection................................................................................................ 10
2.4.1 Community Entry ...................................................................................... 10
2.4.2 The Micro-Census .................................................................................... 10
2.4.3 The General Village Information ............................................................... 11
2.4.4 The Focus Group Discussion.................................................................... 11
2.4.5 The Questionnaire .................................................................................... 12
2.4.6 The Sampling............................................................................................ 14
2.5 Data Handling.................................................................................................. 14
3. Results.................................................................................................................. 16
3.1 Demographic Data .......................................................................................... 16
3.2 The Focus Group Discussion .......................................................................... 16
3.3 The Questionnaire........................................................................................... 22
3.3.1 Data on the Study Population Sample ...................................................... 22
3.3.2 Knowledge of Malaria ............................................................................... 23
3.3.2.1 Perceptions of Malaria........................................................................ 23
3.3.2.2 Knowledge of the Mosquito Vector..................................................... 25
3.3.3 Malaria Prevention.................................................................................... 25
3.3.4 Incidence of Perceived Malaria................................................................. 26
3.3.5 Malaria Treatment Strategies.................................................................... 27
3.3.5.1 Factors Influencing the Choice of Treatment...................................... 28
3.3.5.1.1 Predictors of Clinic Attendance.................................................... 28
3.2.5.1.2 Predictors of Antimalarial Home Treatment................................. 30
3.3.5.1.3 Decision Dynamics within Households and their Influence.......... 32
3.3.5.2 Costs and Sources of Treatment........................................................ 36
3.3.6 Quality of Antimalarial Drug Treatment..................................................... 36
4. Discussion ............................................................................................................ 39
4.1 Perceptions of Malaria..................................................................................... 40
I
4.2 Incidence of Perceived Malaria ....................................................................... 41
4.3 Clinical Malaria................................................................................................ 42
4.4 Fever Detection............................................................................................... 43
4.5 Treatment Seeking Behavior and Quality of Treatment................................... 45
4.6 Decision Making Dynamics within Households ............................................... 51
4.7 Interventions.................................................................................................... 53
4.8 Conclusions..................................................................................................... 56
5. References ........................................................................................................... 58
6. Summary .............................................................................................................. 70
6.1 English Version ............................................................................................... 70
6.2 German Version .............................................................................................. 72
7. Annex:................................................................................................................... 74
7.1 Abbreviations................................................................................................... 74
7.2 Danksagung .................................................................................................... 75
7.3 Lebenslauf....................................................................................................... 76
7.4 Data Entry Forms ....................................................................................................... 78



















II
List of Figures

Figure 1: Map of Ghana…………………………………………………………………. 9
Figure 2: The study sample……………………………………………………………... 15
Figure 3: Ethnic distribution of the study population……………………………….. 17
Figure 4: Study population in age groups……………………………………………… 17
Figure 5: Education of the study population above 14 years………………………... 17

List of Tables
Table1: Main malaria symptoms in different ethnic groups mentioned by
participants after an open-ended question…………………………………………….. 18
Table 2: Caretaker participation in the study compared by age, number of
household members and distances…………………………………………………….. 22
Table 3: Caretaker participation compared by ethnicities and education………….. 23
Table 4: Perceived main malaria symptoms after an-open ended question and
after probing reported by mothers and fathers of children <10 years………………. 24
Table 5: Perceived severe malaria symptoms after an open-ended question and
after probing reported by mothers and fathers of children <10 years………………. 24
Table 6: Perceived causes of malaria …………………………………………………. 25
Table 7: Malaria prevention methods used in households…………………………… 26
Table 8: Treatment actions for perceived childhood malaria within 48 hours after
onset of symptoms……………………………………………………………………….. 27
Table 9: Correlations of the variable “Visit of health facility within 48 hours after
start of symptoms” as treatment strategy……………………………………………… 29
Table 10: Factors significantly influencing the presentation of children with
perceived malaria at health posts within the first 48 hours after onset of
symptoms: A logistic regression analysis……………………………………………… 30
Table 11: Factors significantly influencing the antimalarial drug use in perceived
malaria within the first 48 hours after onset of symptoms: A logistic regression
analysis…………………………………………………………………………………….. 31
Table 12: Final treatment decision and payment made by mother or father for
perceived childhood malaria episode…………………………………………………... 32
Table 13: Correlations of decision-making factors within households and the visit
of a health facility as treatment strategy……………………………………………….. 33
III
Table 14: Correlations of decision-making factors within households and the use
of antimalarial drugs as treatment strategy……………………………………………. 33
Table 15: Factors significantly influencing the presentation of children with
perceived malaria at health post within the first 48 hours after onset of symptoms:
A logistic regression analysis……………………………………………………………. 34
Table 16: Factors significantly influencing the antimalarial drug use in perceived
malaria within the first 48 hours after onset of symptoms: A logistic regression
analysis……………………………………………………………………………