Mothers' perceptions and knowledge on childhood malaria in the holendemic Kibaha district, Tanzania: implications for malaria control and the IMCI strategy

Prior to an intervention on improving the quality of malaria case managemen t, we assessed mothers' abilities to recognize nonsevere and severe/complic ated malaria in children when a child has fever with other physiological an d behavioural symptoms associated with malaria. Malaria was mentioned as th e commonest febrile illness (94.1%), convulsions the least (11.4%). Fever a nd enteric symptoms featured as the most important symptoms of childhood ma laria at frequencies of 93.5% and 73.8%, respectively. The need for laborat ory diagnosis was very high (98.3%), the reason being to get accurate diagn osis and treatment (89.4%). Poor outcome of treatment was ascribed to incor rect diagnosis and prescription, noncompliance at home and ineffective drug s (62.1%). Most mothers (86.6%) would take antipyretic measures first when a child has fever, and subsequently the majority (92.9%) would seek care at a modern health facility. About 50% of the mothers would give traditional treatments for childhood convulsions and wait till fits cease before the ne xt action. A high proportion of the mothers (75%) held the belief that an i njection in a child with high fever would precipitate convulsions or death. The implications of these findings for chemotherapeutic malaria control in holoendemic areas within the context of the Integrated Management of Child hood Illnesses (IMCI) strategy are discussed.