Knowledge and misconceptions about malaria among secondary school students and teachers in Kassala, eastern Sudan

An exploratory study of community factors relevant for participatory malaria control on Rusinga Island, western Kenya

Background

Capacity strengthening of rural communities, and the various actors that support them, is needed to enable them to lead their own malaria control programmes. Here the existing capacity of a rural community in western Kenya was evaluated in preparation for a larger intervention.

Methods

Focus group discussions and semi-structured individual interviews were carried out in 1,451 households to determine (1) demographics of respondent and household; (2) socio-economic status of the household; (3) knowledge and beliefs about malaria (symptoms, prevention methods, mosquito life cycle); (4) typical practices used for malaria prevention; (5) the treatment-seeking behaviour and household expenditure for malaria treatment; and (6) the willingness to prepare and implement community-based vector control.

Results

Malaria was considered a major threat to life but relevant knowledge was a chimera of scientific knowledge and traditional beliefs, which combined with socio-economic circumstances, leads to ineffective malaria prevention. The actual malaria prevention behaviour practiced by community members differed significantly from methods known to the respondents. Beside bednet use, the major interventions implemented were bush clearing and various hygienic measures, even though these are ineffective for malaria prevention. Encouragingly, most respondents believed malaria could be controlled and were willing to contribute to a community-based malaria control program but felt they needed outside assistance.

Conclusion

Culturally sensitive but evidence-based education interventions, utilizing participatory tools, are urgently required which consider traditional beliefs and enable understanding of causal connections between mosquito ecology, parasite transmission and the diagnosis, treatment and prevention of disease. Community-based organizations and schools need to be equipped with knowledge through partnerships with national and international research and tertiary education institutions so that evidence-based research can be applied at the grassroots level.

Malaria in adolescence: burden of disease, consequences, and opportunities for intervention

The problem of malaria in adolescence has largely been overshadowed by the huge burden of disease in young children. A substantial number of adolescents are at risk from malaria infection, but the burden of disease and consequences of infection in this age-group have rarely been studied. Our understanding of specific risk factors and beneficial interventions for adolescents is also limited. Data show that, from an adolescent viewpoint, malaria is a common cause of clinical illness and a preventable cause of death, even in areas of stable malaria transmission. Younger adolescents might be at a higher risk than older adolescents, because of immunological and hormonal factors. There are limited data about the adverse consequences of malaria in non-pregnant adolescents. However, in pregnant adolescents, the consequences of malaria are of great concern and simple interventions might lead to a substantial benefit. Malaria infection in adolescents is an under-recognised problem, and the prevention, diagnosis, and treatment of malaria should have a high priority within adolescent health programmes.

Self-medication practices in Khartoum State, Sudan

OBJECTIVE

The aim of this study was to estimate the prevalence of self-medication with proprietary medicines and herbs in Khartoum State, Sudan, and to evaluate factors associated with self-medication.

METHODS

A pre-piloted questionnaire was used to collect data from a sample of 1,200 individuals, selected from all three cities of Khartoum State using a multistage stratified clustered sampling.

RESULTS

The response rate was 83.3%. Medicines, including herbs, were used by 81.8% of the respondents without a medical consultation within 2 months prior to the study period. Proprietary medicines alone were used by 28.3% (CI: 25.6-31.2), herbs alone by 20.7% (CI: 18.3-23.4), while 32.8% (CI: 29.9-35.8) had used both. Self-medication with proprietary medicines was least common with the middle-aged (OR: 0.12; 0.09-0.17), the elderly (OR: 0.29; 0.20-0.42) and low level of education [illiterate (OR: 0.26, 0.18-0.37) and primary/intermediate school (OR: 0.07, 0.04-0.11)]. It was most associated with low (OR: 5.3; 3.8-7.4) and middle income (OR: 4.3; 3.1-5.9), but no gender difference was found (P>0.05). Self-medication behaviour with herbs was most associated with middle-age (OR: 1.7; 1.3-2.2), female gender (OR: 2.2 (1.7-2.8) and lowest income earners (OR: 2.5; 1.9-3.5).

CONCLUSIONS

The prevalence of self-medication with medicines including herbs in urban areas of Khartoum State is high. Self-medication behaviour varies significantly with a number of socio-economic characteristics. Our findings have major public health policy implications for countries like Sudan.