Tumwesigire Sam, Watson Sharon
Kabale Regional Hospital, PO Box 7, Kabale, Uganda.
Afr Health Sci. 2002 Dec;2(3):94-8.
Malaria is common among communities of Kabale district, and many young children die of the illness. Despite a good distribution of health facilities, able to handle malaria patients, families and individuals tend to depend on self-treatment, or private clinics where drugs used may be of doubtful quality. This study reports on health seeking behaviour by families with children suspected to have malaria.
A community-based, cross-sectional survey among 209 rural peasant families living in 12 villages, chosen from the 5 most malaria-affected sub-counties was done. Using a questionnaire, respondents' reactions to the disease and what decisions they took were recorded. Reasons for choices such as drugs used, location of treatment and malaria control methods were recorded.
Ninety seven percent lived within easy reach of a public health facility. Over 2/3 knew how malaria was transmitted and how it presented. They believed it was best treated at public heath facilities using western type of medicine. Fifty percent of the children, who attended public health units, were treated within 24 of illness. Thirty eight percent of the caretakers knew how to correctly use chloroquine. The caretakers relied on fever, vomiting and refusal to feed as the main symptoms for their diagnosis of malaria. Only 31% of the families sought treatment from government health facilities. Fifty three percent of the families sought treatment from drug shops/vendors. Unfortunately only 38% of the families knew the correct regimen of chloroquine, 4.3% for sulpha-doxine pyrimethamine and 0.5% for quinine. One quarter could afford malaria treatment, and one out of five missed treatment because of poverty. Concerning prevention, 90% stated at least one method but only 21.2% used them.
Despite reasonable knowledge for diagnosis of malaria, awareness of correct treatment is limited. Paradoxically government health units appear to play a minor role in the treatment of malaria.
疟疾在卡巴莱区的社区中很常见，许多幼儿死于这种疾病。尽管卫生设施分布良好，有能力处理疟疾患者，但家庭和个人往往依赖自我治疗，或依赖使用质量可能存疑的药物的私人诊所。本研究报告了疑似患有疟疾的儿童家庭的就医行为。
对从5个疟疾感染最严重的乡中选出的12个村庄的209个农村农民家庭进行了一项基于社区的横断面调查。使用问卷调查记录了受访者对该疾病的反应以及他们做出的决定。记录了选择使用的药物、治疗地点和疟疾控制方法等选择的原因。
97%的人居住在距离公共卫生设施较近的地方。超过2/3的人知道疟疾的传播方式和症状表现。他们认为使用西药在公共卫生设施治疗效果最佳。在公共卫生单位就诊的儿童中，50%在发病24小时内得到治疗。38%的看护人知道如何正确使用氯喹。看护人将发烧、呕吐和拒食作为诊断疟疾的主要症状。只有31%的家庭从政府卫生设施寻求治疗。53%的家庭从药店/小贩处寻求治疗。不幸的是，只有38%的家庭知道氯喹的正确用药方案，知道磺胺多辛-乙胺嘧啶正确用药方案的占4.3%，知道奎宁正确用药方案的占0.5%。四分之一的家庭能够负担疟疾治疗费用，五分之一的家庭因贫困而错过治疗。关于预防，90%的人至少提及一种预防方法，但只有21.2%的人采用了这些方法。
尽管对疟疾诊断有一定了解，但正确治疗的意识有限。矛盾的是，政府卫生单位在疟疾治疗中似乎作用较小。
