Child malaria treatment practices among mothers in the district of Yanfolila, Sikasso region, Mali

We studied chili malaria treatment practices among mothers living in the Di strict of Yanfolia in southern Mali. For sampling, we first chose five of 1 3 health areas with probability proportional to size. Then villages, compou nds and mothers with at least one child aged 1-5 years were randomly chosen . We assessed the spleen size of one 1-5 year-old child of each mother, col lected a thick blood film and recorded the body temperature of every child whose mother thought he/she was sick. 399 mothers in 26 villages were inter viewed with a structured questionnaire divided into two parts. If the child had had soumaya (a term previously associated with uncomplicated malaria) during the past rainy season, we asked about signs and symptoms, health-see king behaviour (who the mother consulted first) and treatment. If not, info rmation about knowledge of the disease and treatment to be given was collec ted. 86% of the mothers interviewed stared that their child had been sick a nd almost half of them had had soumaya. All mothers named at least one sign by which they recognized the disease. Vomiting, fever and dark urine/yello w eyes/jaundice were the three most common signs mentioned. 75.8% managed t heir child's disease at home and used both traditional and modern treatment . The most common anti-malarial drug was chloroquine, often given at inappr opriate dosage. The sensitivity and specificity of the mothers' diagnosis w as poor, although this might be explained by the large percentage of childr en who had already been treated at the time of the interview. The results o f our survey call for prompt educational action for the correct treatment o f uncomplicated malaria/soumaya, particularly for mothers and possibly for shopkeepers. The high spleen rate (58.1%) among randomly selected children confirms that malaria is a common disease in this area. Improved case-manag ement at home could only be beneficial.