VALIDITY OF MOTHERS HISTORY REGARDING ANTIMALARIAL DRUG-USE IN MALAWIAN CHILDREN UNDER 5 YEARS OLD

History obtained from parents and carers is an important, and often th e only, source of information for health workers treating children for malaria, but its validity has not been well evaluated, At 2 hospitals in Malawi, we obtained malaria treatment histories from mothers of 97 3 ill children reported to have had fever as part of the illness. Urin e samples were collected from 755 of the 973 children (78%). Of the 75 5, 457 (61%) were reported to have received some kind of treatment. Am ong those who reportedly received treatment, 79 (17%) were said to hav e received chloroquine and 23 (5%) a sulphonamide-containing medicine; however, when urine specimens were tested for antimalarial drugs, chl oroquine was found in 182 specimens (40%) and a sulphonamide in 148 (3 2%). Among urine specimens collected from 291 children who were report ed to have received no treatment (no report was recorded for 7 childre n), chloroquine was detected in 56 (19%) and a sulphonamide in 44 (15% ). Although not statistically significant, mothers often reported a ch ild as not having received an antimalarial drug if the child was young er than 12 months or had been sick for more than 3 d. The mothers' inf ormation regarding home treatment of fever in children was highly inac curate. Malaria treatment histories, whether collected at health facil ities or in surveys of knowledge, attitudes, and practices, must be in terpreted with caution.