SELF-TREATMENT OF MALARIA IN A RURAL AREA OF WESTERN KENYA

Reported are the results of a study of residents' knowledge about mala ria and antimalarial drugs and of their treatment-seeking behaviour in a rural area of western Kenya. The study subjects were generally well -informed about the symptoms of the disease. Malaria was perceived as a relatively mild illness, much less severe than acquired immunodefici ency syndrome (AIDS), measles, difficulty in breathing, and diarrhoea. Self-treatment was extremely common: of 138 episodes of febrile illne ss, 60% were treated at home with herbal remedies or medicines purchas ed at local shops, and only 18% received treatment at a health centre or hospital; no treatment was sought by the remainder. Commercially av ailable chloroquine preparations were perceived as more effective than either antipyretics or herbal remedies for the treatment of malaria, and injections were regarded as more effective than oral medications. 4-Aminoquinolines were used to treat 58% of febrile illnesses but in o nly 12% of the cases was a curative dose of greater than or equal to 2 5 mg/kg body weight employed. Even attendance at a health centre did n ot ensure adequate treatment because of the common practice of sharing medication among family members. Greatly increased attention should b e paid to the role of home treatment of malaria when policies are bein g developed for the management of febrile illnesses in sub-Saharan Afr ica.