Knowledge, attitudes and practices relating to malaria in a semi-urban area of Cameroon: Choices and sources of antimalarials, self-treatment and resistance

Abstract

Background: Malaria is a major public health problem in sub-Saharan Africa where it kills a child below five years ever 30 seconds. In Cameroon, malaria accounts for 40-45% of medical consultations, 57% of hospitalization days and 40% of mortality among children below 5 years. Community knowledge, attitudes and practices can enhance the fight against this disease.
Objective: To make a local analysis of the malaria problem and to  establish epidemiological and behavioural baseline data and their implications for malaria control.
Methods: The study design was an observational community-based cross-sectional study in a semi-urban setting. Two hundred and fifty three participants of different socio-demographic status took part in the study
from among 350 contacted. A structured questionnaire was administered to volunteers. The respondent’s consent was sought and gained and subjects who could not read or write or understand English language were communicated to in the local language. The questionnaire was  administered by a trained interviewer according to the schedule of the respondent. The data was analysed using SPSS.
Results: Antimalarials commonly cited for malaria treatment were  chloroquine (26.09%) and nivaquine (14.62%) and analgesics: panadol (22.92%) and paracetamol (12.25%) including native drugs (6.32%). One
hundred and forty-one (55.7%) [95% confidence interval (CI):  49.58–61.82%)] participants practiced selftreatment of malaria. Only 26.09% participants knew the correct adult malarial dosage for chloroquine and / or nivaquine. One hundred and twenty five (40.41%) [95%  CI:34.36-46.46%] participants got their antimalarials from authorized sources. One hundred and twenty five (40.41%) participants indicated that they get their antimalarials from the health center, 27(10.61%) from the shop, 24(9.49%) from hawkers, 23(9.09%) from the open market and 16 (6.3%) from herbalists. Only 66 (26.09%) [95% CI: 20.67-31.50%] participants knew the correct adult dosage for chloroquine or nivaquine treatment of malaria. Eighty five (33.6%) [95% CI: 27.78–36.57%] participants had correct knowledge of malarial resistance. Of the 85 (33.6%) participants who had knowledge of malaria resistance, 52(20.55%) ascribed malaria resistance to continuous fever for a long time during treatment, 15 (5.93%) to serious fever during treatment and 18 (7.12%) when chloroquine does not stop the malarial fever. Most (27.06%) of those who had the correct knowledge of malarial resistance were in the age group 31-35 bracket compared with other age groups (P>0.05). There was no difference in correct knowledge of malarial resistance and participant’s professions.
Conclusion: Malaria self-treatment is common but knowledge of malaria resistance is poor This method should be improved upon by giving correct information on the dosage of adult malaria treatment on radio, television, posters and newspapers because banning it will push many people to use it in hiding since it has its advantages. Malaria drug abuse can lead to drug resistance hence in-vitro and in-vivo tests are warranted to confirm malaria resistance.

Keywords: Malaria, Knowledge, attitudes and practices, antimalarials,
choices, sources, self-treatment, resistance, Cameroon