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Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi

BACKGROUND: Universal access to, and community uptake of malaria prevention and treatment strategies are critical to achieving current targets for malaria reduction. Each step in the treatment-seeking pathway must be considered in order to establish where opportunities for successful engagement and...

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Autores principales: Ewing, Victoria L., Tolhurst, Rachel, Kapinda, Andrew, SanJoaquin, Miguel, Terlouw, Dianne J., Richards, Esther, Lalloo, David G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4472932/
https://www.ncbi.nlm.nih.gov/pubmed/26087147
http://dx.doi.org/10.1371/journal.pone.0125439
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author Ewing, Victoria L.
Tolhurst, Rachel
Kapinda, Andrew
SanJoaquin, Miguel
Terlouw, Dianne J.
Richards, Esther
Lalloo, David G.
author_facet Ewing, Victoria L.
Tolhurst, Rachel
Kapinda, Andrew
SanJoaquin, Miguel
Terlouw, Dianne J.
Richards, Esther
Lalloo, David G.
author_sort Ewing, Victoria L.
collection PubMed
description BACKGROUND: Universal access to, and community uptake of malaria prevention and treatment strategies are critical to achieving current targets for malaria reduction. Each step in the treatment-seeking pathway must be considered in order to establish where opportunities for successful engagement and treatment occur. We describe local classifications of childhood febrile illnesses, present an overview of treatment-seeking, beginning with recognition of illness, and suggest how interventions could be used to target the barriers experienced. METHODS: Qualitative data were collected between September 2010 and February 2011. A total of 12 Focus Group Discussions and 22 Critical Incident Interviews were conducted with primary caregivers who had reported a recent febrile episode for one of their children. FINDINGS AND CONCLUSION: The phrase ‘kutentha thupi’, or ‘hot body’ was used to describe fever, the most frequently mentioned causes of which were malungo (translated as ‘malaria’), mauka, nyankhwa and (m)tsempho. Differentiating the cause was challenging because these illnesses were described as having many similar non-specific symptoms, despite considerable differences in the perceived mechanisms of illness. Malungo was widely understood to be caused by mosquitoes. Commonly described symptoms included: fever, weakness, vomiting, diarrhoea and coughing. These symptoms matched well with the biomedical definition of malaria, although they also overlapped with symptoms of other illnesses in both the biomedical model and local illness classifications. In addition, malungo was used interchangeably to describe malaria and fever in general. Caregivers engaged in a three-phased approach to treatment seeking. Phase 1—Assessment; Phase 2—Seeking care outside the home; Phase 3—Evaluation of treatment response. Within this paper, the three-phased approach is explored to identify potential interventions to target barriers to appropriate treatment. Community engagement and health promotion, the provision of antimalarials at community level and better training health workers in the causes and treatment of non-malarial febrile illnesses may improve access to appropriate treatment and outcomes.
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spelling pubmed-44729322015-06-29 Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi Ewing, Victoria L. Tolhurst, Rachel Kapinda, Andrew SanJoaquin, Miguel Terlouw, Dianne J. Richards, Esther Lalloo, David G. PLoS One Research Article BACKGROUND: Universal access to, and community uptake of malaria prevention and treatment strategies are critical to achieving current targets for malaria reduction. Each step in the treatment-seeking pathway must be considered in order to establish where opportunities for successful engagement and treatment occur. We describe local classifications of childhood febrile illnesses, present an overview of treatment-seeking, beginning with recognition of illness, and suggest how interventions could be used to target the barriers experienced. METHODS: Qualitative data were collected between September 2010 and February 2011. A total of 12 Focus Group Discussions and 22 Critical Incident Interviews were conducted with primary caregivers who had reported a recent febrile episode for one of their children. FINDINGS AND CONCLUSION: The phrase ‘kutentha thupi’, or ‘hot body’ was used to describe fever, the most frequently mentioned causes of which were malungo (translated as ‘malaria’), mauka, nyankhwa and (m)tsempho. Differentiating the cause was challenging because these illnesses were described as having many similar non-specific symptoms, despite considerable differences in the perceived mechanisms of illness. Malungo was widely understood to be caused by mosquitoes. Commonly described symptoms included: fever, weakness, vomiting, diarrhoea and coughing. These symptoms matched well with the biomedical definition of malaria, although they also overlapped with symptoms of other illnesses in both the biomedical model and local illness classifications. In addition, malungo was used interchangeably to describe malaria and fever in general. Caregivers engaged in a three-phased approach to treatment seeking. Phase 1—Assessment; Phase 2—Seeking care outside the home; Phase 3—Evaluation of treatment response. Within this paper, the three-phased approach is explored to identify potential interventions to target barriers to appropriate treatment. Community engagement and health promotion, the provision of antimalarials at community level and better training health workers in the causes and treatment of non-malarial febrile illnesses may improve access to appropriate treatment and outcomes. Public Library of Science 2015-06-18 /pmc/articles/PMC4472932/ /pubmed/26087147 http://dx.doi.org/10.1371/journal.pone.0125439 Text en © 2015 Ewing et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Ewing, Victoria L.
Tolhurst, Rachel
Kapinda, Andrew
SanJoaquin, Miguel
Terlouw, Dianne J.
Richards, Esther
Lalloo, David G.
Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi
title Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi
title_full Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi
title_fullStr Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi
title_full_unstemmed Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi
title_short Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi
title_sort understanding interpretations of and responses to childhood fever in the chikhwawa district of malawi
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4472932/
https://www.ncbi.nlm.nih.gov/pubmed/26087147
http://dx.doi.org/10.1371/journal.pone.0125439
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