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RefWorks
Reference Manager
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Zotero
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Self-Reported Symptoms at Last Febrile Illness as a Predictor of Treatment-Seeking in Western Kenya: A Cross-Sectional Study
Valerie Madera-Garcia
Valerie Madera-Garcia
College of Public Health, University of Arizona, Tucson, Arizona;
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Jenna E. Coalson
Jenna E. Coalson
Eck Institute for Global Health, University of Notre Dame, Notre Dame, Indiana;
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Maja Subelj
Maja Subelj
National Institute of Public Health, University of Ljubljana, Ljubljana, Slovenia;
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Melanie L. Bell
Melanie L. Bell
College of Public Health, University of Arizona, Tucson, Arizona;
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Mary H. Hayden
Mary H. Hayden
Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, Colorado;
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Maurice Agawo
Maurice Agawo
Kenya Medical Research Institute, Kisian Research Station, Kenya
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Stephen Munga
Stephen Munga
Kenya Medical Research Institute, Kisian Research Station, Kenya
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Kacey C. Ernst
Kacey C. Ernst
College of Public Health, University of Arizona, Tucson, Arizona;
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ABSTRACT.
Timely treatment-seeking behavior can reduce morbidity and mortality due to infectious diseases. Patterns of treatment-seeking behavior can differ by access to health care, and perceptions of disease severity and symptoms. We evaluated the association between self-reported symptoms at last illness and the level of treatment-seeking behaviors. We analyzed cross-sectional data from 1,037 participants from the lowlands and highlands of Western Kenya from 2015 using logistic regression models. There was considerable heterogeneity in the symptoms and treatment-seeking behaviors reported among individuals who were febrile at their last illness. A greater number of self-reported categories of symptoms tended to be associated with a higher likelihood of treatment-seeking in both sites. Participants were significantly more likely to seek treatment if they reported fever, aches, and digestive symptoms at last illness than just fever and aches or fever alone, but the frequency of treatment-seeking for fever in combination with aches and respiratory symptoms did not follow a consistent pattern. Among those who sought treatment, most used a formal source, but the patterns were inconsistent across sites and by the number of symptoms categories. Understanding the drivers of treatment-seeking behavior after febrile illness is important to control and treat infectious diseases in Kenya.
- Supplemental Materials (PDF 383 KB)
Author Notes
Financial support: The present analyses were conducted with no funding sources. The primary study was funded via NIH/NIAID R15 Al100118-01.
Authors’ addresses: Valerie Madera-Garcia, Melanie L. Bell, and Kacey C. Ernst, College of Public Health, University of Arizona, Tucson, E-mails: vmaderag1@gmail.com, melaniebell@arizona.edu, and kernst@email.arizona.edu. Jenna E. Coalson, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, E-mail: jcoalson@gmail.com. Maja Šubelj, National Institute of Public Health, University of Ljubljana, Ljubljana, Slovenia, E-mail: maja.majasubelj@gmail.com. Mary H. Hayden, Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, CO, E-mail: mhayden@uccs.edu. Maurice Agawo and Stephen Munga, Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya, E-mail: magawo@gmail.com and munga_os@yahoo.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
  Chuma J , Okungu V , Molyneux C , 2010. Barriers to prompt and effective malaria treatment among the poorest population in Kenya. Malar J 9: 144.
-
2.
  Birhanu Z , Abebe L , Sudhakar M , Dissanayake G , Yihdego YY , Alemayehu G , Yewhalaw D , 2016. Malaria related perceptions, care seeking after onset of fever and anti-malarial drug use in malaria endemic settings of southwest Ethiopia. PLoS One 11: e0160234.
-
3.
  Okeke TA , Okafor HU , 2008. Perception and treatment seeking behavior for malaria in rural Nigeria: implications for Control. J Hum Ecol 24: 215–222.
-
4.
  Omondi CJ , Onguru D , Kamau L , Nanyingi M , Ong’amo G , Estambale B , 2017. Perennial transmission of malaria in the low altitude areas of Baringo County, Kenya. Malar J 16: 257.
-
5.
  Battle KE et al.2016. Treatment-seeking rates in malaria endemic countries. Malar J 15: 20.
-
6.
  Smith LA , Bruce J , Gueye L , Helou A , Diallo R , Gueye B , Jones C , Webster J , 2010. From fever to anti-malarial: the treatment-seeking process in rural Senegal. Malar J 9: 333.
-
7.
  Yasuoka J , Kikuchi K , Nanishi K , Ly P , Thavrin B , Omatsu T , Mizutani T , 2018. Malaria knowledge, preventive actions, and treatment-seeking behavior among ethnic minorities in Ratanakiri Province, Cambodia: a community-based cross-sectional survey. BMC Public Health 18: 1206.
-
8.
  Deressa W , 2007. Treatment-seeking behaviour for febrile illness in an area of seasonal malaria transmission in rural Ethiopia. Malar J 6: 49.
-
9.
  Mitiku I , Assefa A , 2017. Caregivers’ perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study. Malar J 16: 144.
-
10.
 World Health Organization , 2021. Global Technical Strategy for Malaria 2016–2030 Update. Available at: https://www.who.int/publications/i/item/9789240031357. Accessed June 1, 2022.
-
11.
  Ndyomugyenyi R , Magnussen P , Clarke S , 2007. Malaria treatment-seeking behaviour and drug prescription practices in an area of low transmission in Uganda: implications for prevention and control. Trans R Soc Trop Med Hyg 101: 209–215.
-
12.
  Kassile T , Lokina R , Mujinja P , Mmbando BP , 2014. Determinants of delay in care seeking among children under five with fever in Dodoma region, central Tanzania: a cross-sectional study. Malar J 13: 348.
-
13.
  McCombie SC , 1996. Treatment seeking for malaria: a review of recent research. Soc Sci Med 43: 933–945.
-
14.
  Uzochukwu BSC , Onwujekwe OE , 2004. Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria. Int J Equity Health 3: 6.
-
15.
  Maslove DM , Mnyusiwalla A , Mills EJ , McGowan J , Attaran A , Wilson K , 2009. Barriers to the effective treatment and prevention of malaria in Africa: a systematic review of qualitative studies. BMC Int Health Hum Rights 9: 26.
-
16.
 Kenya Ministry of Health , 2016. The Kenya Malaria Communication Strategy 2016–2021—Kenya Ministry of Health. Available at: https://www.thecompassforsbc.org/sites/default/files/strengthening_tools/Kenya%20SBCC%202016-2020.pdf. Accessed September 2, 2020.
-
17.
  Musuva A , Ejersa W , Kiptui R , Memusi D , Abwao E , 2017. The malaria testing and treatment landscape in Kenya: results from a nationally representative survey among the public and private sector in 2016. Malar J 16: 494.
-
18.
 Division of National Malaria Programme and ICF , 2021. Kenya Malaria Indicator Survey 2020. Available at: https://dhsprogram.com/methodology/survey/survey-display-579.cfm. Accessed 2021.
-
19.
  Chuma J , Abuya T , Memusi D , Juma E , Akhwale W , Ntwiga J , Nyandigisi A , Tetteh G , Shretta R , Amin A , 2009. Reviewing the literature on access to prompt and effective malaria treatment in Kenya: implications for meeting the Abuja targets. Malar J 8: 243.
-
20.
 National Coordinating Agency for Population and Development (NCAPD) [Kenya] , Ministry of Medical Services (MOMS) [Kenya], Ministry of Public Health and Sanitation (MOPHS) [Kenya], Kenya National Bureau of Statistics (KNBS) [Kenya], Macro I 2011. Kenya Service Provision Assessment Survey 2010. Available at: https://esaro.unfpa.org/en/publications/kenya-service-provision-assessment-survey-2010-kspa. Accessed April 15, 2022.
-
21.
  East L , Arudo J , Loefler M , Evans C , 2014. Exploring the potential for advanced nursing practice role development in Kenya: a qualitative study. BMC Nurs 13: 33.
-
22.
  Amin AA , Marsh V , Noor AM , Ochola SA , Snow RW , 2003. The use of formal and informal curative services in the management of paediatric fevers in four districts in Kenya. Trop Med Int Health 8: 1143–1152.
-
23.
  Guyatt HL , Snow RW , 2004. The management of fevers in Kenyan children and adults in an area of seasonal malaria transmission. Trans R Soc Trop Med Hyg 98: 111–115.
-
24.
  Adinan J , Damian DJ , Mosha NR , Mboya IB , Mamseri R , Msuya SE , 2017. Individual and contextual factors associated with appropriate healthcare seeking behavior among febrile children in Tanzania. PLoS One 12: e0175446–e0175446.
-
25.
  Nyaoke BA , Mureithi MW , Beynon C , 2019. Factors associated with treatment type of non-malarial febrile illnesses in under-fives at Kenyatta National Hospital in Nairobi, Kenya. PLoS One 14: e0217980–e0217980.
-
26.
  Mutanda AL , Cheruiyot P , Hodges JS , Ayodo G , Odero W , John CC , 2014. Sensitivity of fever for diagnosis of clinical malaria in a Kenyan area of unstable, low malaria transmission. Malar J 13: 163.
-
27.
  Chipwaza B , Mugasa JP , Mayumana I , Amuri M , Makungu C , Gwakisa PS , 2014. Community knowledge and attitudes and health workers’ practices regarding non-malaria febrile illnesses in eastern Tanzania. PLoS Negl Trop Dis 8: e2896.
-
28.
  Wainaina M , Vey da Silva DA , Dohoo I , Mayer-Scholl A , Roesel K , Hofreuter D , Roesler U , Lindahl J , Bett B , Al Dahouk S , 2022. A systematic review and meta-analysis of the aetiological agents of non-malarial febrile illnesses in Africa. PLoS Negl Trop Dis 16: e0010144.
-
29.
  Riley C , Dellicour S , Ouma P , Kioko U , Omar A , Kariuki S , Ng’ang’a Z , Desai M , Buff AM , Gutman JR , 2018. Knowledge and adherence to the national guidelines for malaria diagnosis in pregnancy among health-care providers and drug-outlet dispensers in rural western Kenya. Am J Trop Med Hyg 98: 1367–1373.
-
30.
  Akulayi L et al.2017. Testing times: trends in availability, price, and market share of malaria diagnostics in the public and private healthcare sector across eight sub-Saharan African countries from 2009 to 2015. Malar J 16: 205.
-
31.
  Hamooya BM , Chongwe G , Dambe R , Halwiindi H , 2016. Treatment-seeking behaviour for childhood fever among caretakers of Chivuna and Magoye rural communities of Mazabuka District, Zambia: a longitudinal study. BMC Public Health 16: 762.
-
32.
  O’Meara WP et al.2015. Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis. Am J Trop Med Hyg 92: 1030–1037.
-
33.
  Elven J et al.2020. Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Africa, 1980–2015. BMC Med 18: 279.
-
34.
 World Health Organization , 2022. WHO Guidelines for Malaria. Available at: https://www.who.int/publications/i/item/guidelines-for-malaria. Accessed May 30, 2022.
-
35.
  Bedford KJA , Sharkey AB , 2014. Local barriers and solutions to improve care-seeking for childhood pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger: a qualitative study. PLoS One 9: e100038.
-
36.
  Fenny AP , Asante FA , Enemark U , Hansen KS , 2015. Malaria care seeking behavior of individuals in Ghana under the NHIS: are we back to the use of informal care? BMC Public Health 15: 370.
-
37.
  Coalson JE , Cohee LM , Walldorf JA , Bauleni A , Mathanga DP , Taylor TE , Wilson ML , Laufer MK , 2019. Challenges in treatment for fever among school-age children and adults in Malawi. Am J Trop Med Hyg 100: 287–295.
-
38.
  Coalson JE , Santos EM , Little AC , Anderson EJ , Stroupe N , Agawo M , Hayden M , Munga S , Ernst KC , 2020. Insufficient ratio of long-lasting insecticidal nets to household members limited universal usage in western Kenya: a 2015 cross-sectional study. Am J Trop Med Hyg 102: 1328–1342.
-
39.
  Santos EM , Coalson JE , Jacobs ET , Klimentidis YC , Munga S , Agawo M , Anderson E , Stroupe N , Ernst KC , 2019. Bed net care practices and associated factors in western Kenya. Malar J 18: 274.
-
40.
  Githeko AK , Ototo EN , Guiyun Y , 2012. Progress towards understanding the ecology and epidemiology of malaria in the western Kenya highlands: opportunities and challenges for control under climate change risk. Acta Trop 121: 19–25.
-
41.
  Matsushita N , Kim Y , Ng C F S , Moriyama M , Igarashi T , Yamamoto K , Otieno W , Minakawa N , Hashizume M , 2019. Differences of rainfall–malaria associations in lowland and highland in western Kenya. Int J Environ Res Public Health 16: 3693.
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