Babawo Lawrence Sao, Kpaka Rashid Bundu, Sesay Daniel Karim Dauda
Faculty of Health Sciences and Disaster Management, Eastern Technical University of Sierra Leone, Kenema, Sierra Leone.
District Health Management Team (DHMT), Karene District, Port Loko, Sierra Leone.
Malar J. 2025 Mar 14;24(1):83. doi: 10.1186/s12936-025-05330-9.
Malaria remains a significant public health challenge, particularly in sub-Saharan Africa, where it accounts for high morbidity and mortality rates. Sierra Leone, including Port Loko District, continues to experience a high burden of malaria despite government interventions. This study evaluates the existing government interventions for malaria treatment at Port Loko Government Hospital, examining the socio-economic determinants contributing to malaria treatment failure.
The study employed a cross-sectional study design with a quantitative approach, involving 150 health workers and 150 women of childbearing age. A purposive stratified random sampling technique was used to ensure diverse representation. Primary data were collected using structured questionnaires, while secondary data were extracted from the District Health Information System (DHIS) and hospital records. Data were analysed using SPSS version 28.0, applying descriptive statistics (frequencies, percentages, means and SD) and inferential analyses (Chi-square tests and binary logistic regression) to assess associations between socio-economic factors and treatment-seeking behaviours.
Findings revealed that 90% of health workers were aware of malaria interventions, but only 68% reported high adherence to treatment guidelines. Among women of childbearing age, 40% sought malaria treatment at drug stores or pharmacies due to financial constraints, and a significant association was observed between socio-economic status and healthcare-seeking behaviour ( = 9.32, df = 4, p = 0.05). Despite the fact that 73.3% reported the use of long-lasting insecticidal nets (LLINs), malaria prevalence remained high, suggesting additional risk factors beyond bed net usage.
This study highlighted persistent challenges in malaria control, including inadequate healthcare access, non-adherence to treatment regimens, and socio-economic constraints. Policy recommendations include strengthening malaria treatment adherence programmes, improving healthcare accessibility, and enhancing community-based malaria prevention strategies.
疟疾仍然是一项重大的公共卫生挑战，尤其是在撒哈拉以南非洲，该地区疟疾发病率和死亡率居高不下。尽管政府采取了干预措施，但包括洛科港区在内的塞拉利昂疟疾负担仍然很重。本研究评估了洛科港政府医院现有的疟疾治疗政府干预措施，考察了导致疟疾治疗失败的社会经济决定因素。
本研究采用横断面研究设计和定量方法，涉及150名卫生工作者和150名育龄妇女。采用目的分层随机抽样技术以确保具有不同的代表性。使用结构化问卷收集原始数据，同时从地区卫生信息系统（DHIS）和医院记录中提取二手数据。使用SPSS 28.0版软件进行数据分析，应用描述性统计（频数、百分比、均值和标准差）和推断性分析（卡方检验和二元逻辑回归）来评估社会经济因素与就医行为之间的关联。
研究结果显示，90%的卫生工作者知晓疟疾干预措施，但只有68%的人报告高度遵守治疗指南。在育龄妇女中，40%由于经济拮据在药店或药房寻求疟疾治疗，并且观察到社会经济地位与就医行为之间存在显著关联（χ² = 9.32，自由度 = 4，p = 0.05）。尽管73.3%的人报告使用了长效驱虫蚊帐（LLINs），但疟疾患病率仍然很高，这表明除了使用蚊帐之外还有其他风险因素。
本研究突出了疟疾控制中持续存在的挑战，包括医疗服务可及性不足、不遵守治疗方案以及社会经济限制。政策建议包括加强疟疾治疗依从性计划、改善医疗服务可及性以及加强基于社区的疟疾预防策略。
