Factors associated with health seeking behavior for malaria treatment among caregivers of under-five children with fever in Imo State, Nigeria

Background: Malaria is a vector-borne disease that affects millions of people globally yearly. Malaria affects mainly young children under-five years and pregnant women. Appropriate health seeking-behavior (HSB) is important when seeking treatment for children under-five years with fever. Appropriate HSB among the caregivers will help the children to have better prognosis of malaria, because treatment will be initiated early. Objective: The aim of this study is to determine the HSB practices among caregivers of children under-five years with fever in Imo State Nigeria and factors associated with HSB. Methodology: A cross sectional study was conducted in Imo State, Nigeria. Multistage random sampling was employed, in the first stage four local governments out of 27 local governments was selected at random. In the second stage, simple random sampling with proportionate to size was employed to select the number of participants from each of the four selected local government. Appropriate HSB was operationally defined as seeking treatment from health facility within 24 hours of onset of fever. Data was obtained using guided self-administered questionnaire that was distributed to the caregivers. The inclusion criteria include caregivers of children under-five years that had fever two weeks prior to the study in Imo State Nigeria. Data was analyzed using IBM SPSS version 22. Result: A total of 553 respondents was recruited, response rate of 98.9 %. Only 18.6% of the caregivers demonstrated appropriate HSB. There was significant association between appropriate HSB and caregiver’s age ( χ2 =43.833, p= 0.001), caregiver’s relationship to child ( χ2 =4.573, p= 0.032), occupation ( χ2 =20.861, p= 0.001), monthly income ( χ2 =19.630, p= 0.001), number of household member ( χ2 =38.354, p= 0.001), ethnicity (χ2 =8.183, p= 0.004), child’s age (χ2 =50.619, p= 0.001), child’s gender (χ2 =26.604, p= 0.001), caregivers knowledge of malaria that children under-five are vulnerable groups (χ2 =8.103, p= 0.017), caregivers knowledge that pregnant women are vulnerable groups to malaria (χ2 =17.721, p= 0.001), caregivers knowledge on the use of mosquito coil (χ2 =4.715, p = 0.030). Regarding caregivers preventive practice, there was significant association between bringing the child home before dawn (χ2 =11.415, p= 0.003), using mosquito coil (χ2 =6.200, p= 0.045), clearing of bushes around the house (χ2 =8.922, p= 0.012) and deciding factor for child’s treatment (χ2 =24.242, p= 0.001). Using a p-value of 0.05 as the significant level, predictors of HSB in final model are occupation (aOR= 1.882; 95%CI: 1.014-3.493), number of household members (aOR=2.504; 95%CI=1.464-4.283), ethnicity (aOR=11.641; 95%CI=3.337-40.601), child’s age (aOR=2.804; 95%CI=1.485-5.295), child gender (aOR=2.760; 95%CI=1.536-4.958) and decision making (aOR= 0.142; 95%CI=0.032-0.619). Conclusion: Caregivers’ health-seeking behavior was poor for fever cases among under-five year children. It is necessary to educate caregivers, especially for early treatment and appropriate use of health facilities for fever. This finding can help promote awareness and improve interventions in communities.

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