Factors that determine early timing of malaria treatment for children under five years in Uganda

Abstract

Background: Malaria has continued to be a public health problem in Uganda today despite the efforts aimed at its control and elimination. Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages, and therefore, decrease mortality. Thus the current study assessed factors that determine early timing of malaria treatment for children under five years in Uganda.

Method: The most recent Uganda Demographic and Health Survey data (UDHS 2016) was used for the study. The survey collected information from 3,317 women with children who had history of malaria in the last weeks before the survey. The data were extracted and recoded using STATA Version 15. Descriptive statistics and Chi-square test were used to identify significant factors. Multivariate logistic regression model was used to determine the factors associated with timing of malaria treatment. The results were reported in Odds Ratios with 95% Confidence Intervals (CI) at p<0.05 level of significance.

Results: Seventy three percent of the mothers sought malaria treatment for their children within 48 hours after onset of fever. Bivariate analysis identified wealth index (ꭓ ² = 14.37, p = 0.049) and working status (ꭓ ²= 7.713, p = 0.024) of the mother to be associated with timing of malaria treatment. There was no relationship between other factors as place of residence, education level, age and sex of the child and distance to health facility.

Logistic regression identified variables that were independently associated with timing of malaria treatment at 95% confidence interval, which included; working status (OR=0.656, CI=0.470-0.915); highest wealth quintile (OR= 2.031, CI=1.106-3.723); religion (OR= 1.366; CI=1.307-1.800); and having no problem getting permission to go to healthy facility (OR= 1.536, CI= 1.033-2.285). Marital status was also found to be strongly associated with timing of malaria treatment for those mothers who were currently in union (OR=0.547, CI = 0.297-1.009) and formerly in union (OR=0.498, CI = 0.255-0.975).

Conclusion and Recommendation: Although mother’s age, sex of the child, age of the child, place of residence, education level, and distance to health facility are all determinants for timing of malaria treatment, in the binary logistic regression analysis, working status, marital status, religion, wealth index and permission to get to health facility were identified as the only important factors associated with timing of malaria treatment for children under five years in Uganda. Health promotion programs should target mothers with low wealth status, especially in rural areas so as to increase accessibility to health services. Free treatment options should be provided to increase the proportion of mothers seeking timely malaria treatment for children under five years.