Children and medicines: self-treatment of common illnesses among Luo schoolchildren in western Kenya

In a rural area of western Kenya, primary schoolchildren's health seeking b ehaviour in response to common illnesses was investigated. 57 primary schoo lchildren (age 11-17 years, median 13 years) were interviewed weekly about their health status and health seeking activities for 30 weeks. The children each experienced on average 25 illness episodes during this pe riod. Most episodes could be categorised into 4 groups:'cold', 'headache', 'abdominal complaints' and 'injuries'. One fifth (21%) of the illness episo des were serious enough to keep the children from school. In 28% of them, a n adult was consulted, while 72% were not reported to an adult caretaker. O f the episodes without adult involvement, 81% remained untreated, while 19% were treated by the children themselves with either herbal or Western medi cines. Of all the medicines taken by the children, two thirds were provided or facilitated by adults (assisted treatment) and one third taken by the c hildren themselves without adult involvement (self-treatment). Among boys, the proportion of illnesses, which were self-treated increased with age from 12% in the youngest age group (< 13 years) to 34% in the olde st (> 14 years). In girls, the proportion of illnesses which were self-trea ted was consistently lower than among boys and remained constant around 9% for all age groups. The proportion of Western pharmaceuticals used for self-treatment increased with age from 44% in the youngest age group to 63% in the oldest (average 52% Western pharmaceuticals). Again, there were differences between boys an d girls: among the youngest age group, boys were twice as likely to use pha rmaceuticals than girls (62 versus 32% of the self-treatments, respectively ) and in the oldest age group they were nearly three times more likely (75 versus 25%, respectively). These differences in self-treatment practices an d choice of medicines between girls and boys may reflect the higher income potential of boys, who can earn money by fishing. Pharmaceuticals were generally preferred for the treatment of headache and fevers, or colds, while herbal remedies were the preferred choice for the t reatment of abdominal complaints and wounds. The most commonly used pharmac euticals were antimalarials (mainly chloroquine), painkillers and antipyret ics (mainly aspirin and paracetamol), which were stocked in most small shop s in the village at low prices and readily sold to children. Throughout primary school age Kenyan children are growing into a pluralisti c medical practice, integrating Western pharmaceuticals into the local herb al medical system, and gradually become autonomous agents in their health c are. (C) 2000 Elsevier Science Ltd. All rights reserved.