The Influence of Maternal Socioeconomic Status on the Management of Malaria in their Children: Implications for the 'Roll Back Malaria' Initiative
Abstract
Background: Early recognition of symptoms of malaria and commencement of appropriate and effective therapy are vital elements of the Roll Back Malaria Initiative which is aimed at reducing the impact of malaria.
Objective: To determine the influence of the socioeconomic status of mothers on their knowledge of the symptoms of malaria and its management in their children.
Design: Prospective, hospital-based survey.
Methods: Mothers of under-five children with fever were tested for their ability to recognize the symptoms of malaria by asking them the question "what do you feel is the problem with your child?” Semi-structured questionniars were administered to those who correctly made the verbal diagnosis of malaria, seeking information on the various forms of treatment they gave their children before presentation in the hospital. Mothers in the upper and lower social classes were statistically compared in terms of antimalarial drug usage before presentation, sources of drugs given to children with suspected malaria and their knowledge and attitude to intramuscular injections.
Results: Two hundred and eight (84.6 percent of the 246 mothers studied had administered drugs to their children at home before presentation at the hospital. Early presentation in the hospital (p< 0.0001), drug administration within 24 hours of onset of symptoms (p<0.0001) and disapproval of intramuscular injections (p=0.017) were significantly higher among mothers from the upper social class. Conversely, procurement of drugs from primary health centres (p=0.006), polypharmacy(p= 0.0005), use of poorly formulated branded products (p=0.005) and injections received prior to hospital visit (p=0.02) were significantly higher among respondents from the lower social class.
Conclusion: Low socio-economic status is associated with poor management of a child with malaria. It is also associated with practices that may encourage parasite resistance and treatment failure.
Keywords: Child care, malaria, socioeconomic status
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