The online version of this article (doi:10.1186/1475-2875-11-63) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
UH and LS conceived the study design, prepared the data, performed the analysis, interpreted results and produced the final manuscript. MH, RH, TY and GG were responsible for the conception, overall scientific management, interpretation of results, and critically reviewed the final report. EF was responsible for the interpretation of results and critically reviewed the final report. Principal investigator of the project: UH. All authors read and approved the final manuscript.
Malaria treatment-seeking practices vary worldwide and Bangladesh is no exception. Individuals from 88 villages in Rajasthali were asked about their treatment-seeking practices. A portion of these households preferred malaria treatment from the National Control Programme, but still a large number of households continued to use drug vendors and approximately one fourth of the individuals surveyed relied exclusively on non-control programme treatments. The risks of low-control programme usage include incomplete malaria treatment, possible misuse of anti-malarial drugs, and an increased potential for drug resistance.
The spatial patterns of treatment-seeking practices were first examined using hot-spot analysis (Local Getis-Ord Gi statistic) and then modelled using regression. Ordinary least squares (OLS) regression identified key factors explaining more than 80% of the variation in control programme and vendor treatment preferences. Geographically weighted regression (GWR) was then used to assess where each factor was a strong predictor of treatment-seeking preferences.
Several factors including tribal affiliation, housing materials, household densities, education levels, and proximity to the regional urban centre, were found to be effective predictors of malaria treatment-seeking preferences. The predictive strength of each of these factors, however, varied across the study area. While education, for example, was a strong predictor in some villages, it was less important for predicting treatment-seeking outcomes in other villages.
Understanding where each factor is a strong predictor of treatment-seeking outcomes may help in planning targeted interventions aimed at increasing control programme usage. Suggested strategies include providing additional training for the Building Resources across Communities (BRAC) health workers, implementing educational programmes, and addressing economic factors.
Authors’ original file for figure 112936_2011_2065_MOESM1_ESM.pdf
Authors’ original file for figure 212936_2011_2065_MOESM2_ESM.jpeg
Authors’ original file for figure 312936_2011_2065_MOESM3_ESM.jpeg
Authors’ original file for figure 412936_2011_2065_MOESM4_ESM.jpeg
Authors’ original file for figure 512936_2011_2065_MOESM5_ESM.jpeg
Authors’ original file for figure 612936_2011_2065_MOESM6_ESM.jpeg
Authors’ original file for figure 712936_2011_2065_MOESM7_ESM.jpeg
Authors’ original file for figure 812936_2011_2065_MOESM8_ESM.jpeg
Authors’ original file for figure 912936_2011_2065_MOESM9_ESM.jpeg
Authors’ original file for figure 1012936_2011_2065_MOESM10_ESM.jpeg
Authors’ original file for figure 1112936_2011_2065_MOESM11_ESM.jpeg
Authors’ original file for figure 1212936_2011_2065_MOESM12_ESM.jpeg
Authors’ original file for figure 1312936_2011_2065_MOESM13_ESM.jpeg
Authors’ original file for figure 1412936_2011_2065_MOESM14_ESM.jpeg
The Global Fund. [ http://www.theglobalfund.org/en/about/diseases/malaria/]
WHO: World malaria report. 2010, World Health Organization, Geneva
The Global Fund. [ http://portfolio.theglobalfund.org/en/Country/Index/BAN]
Tobgay T, Lhazeen K: Malaria perceptions and practices in Bhutan. Southeast Asian J Trop Med Public Health. 2010, 41: 274-279. PubMed
Yadav SP: A study of treatment seeking behaviour for malaria and its management in febrile children in rural part of desert, Rajasthan, India. J Vector Borne Dis. 2010, 47: 235-242. PubMed
Tynan A, Atkinson JA, Toaliu H, Taleo G, Fitzgerald L, Whittaker M, Riley I, Schubert M, Vallely A: Community participation for malaria elimination in Tafea Province Vanuatu: part II Social and cultural aspects of treatment-seeking behaviour. Malar J. 2011, 10: 204-10.1186/1475-2875-10-204. PubMedCentralCrossRefPubMed
Chuma J, Abuya T, Memusi D, Juma E, Akhwale W, Ntwiga J, Nyandigisi A, Tetteh G, Shretta R, Amin A: Reviewing the literature on access to prompt and effective malaria treatment in Kenya: implications for meeting the Abuja targets. Malar J. 2009, 8: 243-10.1186/1475-2875-8-243. PubMedCentralCrossRefPubMed
Kengeya-Kayondoa JF, Seeleya JA, Kajura-Bajenjaa E, Kabungaa E, Mubirua E, Sembajjaa F, Muldera D: Recognition, treatment seeking behaviour and perception of cause of malaria among rural women in Uganda. Acta Trop. 1994, 58: 267-273. 10.1016/0001-706X(94)90020-5. CrossRef
Okeke TA, Okafor H: Perception and Treatment Seeking Behavior for Malaria in Rural Nigeria: Implications for Control. J Hum Ecol. 2008, 24: 215-222.
Onwujekwe O, Chukwuogo O, Ezeoke U, Uzochukwu B, Eze S: Asking people directly about preferred health-seeking behaviour yields invalid response: an experiment in southeast Nigeria. J Public Health. 2010, 33: 93-100. CrossRef
Esri: What Is GIS?. 2011, ESRI http://www.esri.com/what-is-gis/index.html
Esri: How Mean Centers Work. ArcGIS Online Help Documentation. 2011, [ http://help.arcgis.com/en/arcgisdesktop/10.0/help/index.html#/How_Mean_Center_works/005p0000001s000000/]
Ord JK, Getis A: Local spatial autocorrelation statistics: distributional issues and an application. Geographical Analysis. 1995, 27: 286-306. CrossRef
Getis A, Ord JK: The Analysis of Spatial Association by Use of Distance Statistics. Geographical Analysis. 1992, 24: 189-206. CrossRef
Esri: How Hot Spot Analysis (Getis-Ord Gi*) works. 2011, [ http://help.arcgis.com/en/arcgisdesktop/10.0/help/index.html#/How_Hot_Spot_Analysis_Getis_Ord_Gi_works/005p00000011000000/]
Esri: Common Regression Problems, Consequences, and Solutions in Regression Analysis Basics. 2011, [ http://help.arcgis.com/en/arcgisdesktop/10.0/help/index.html#//005p00000023000000.htm]
Poole MA, Farrell PNO: The assumptions of the linear regression model. Transactions of the Institute of British Geographers. 52: 145-158.
Esri: Interpreting OLS Results. 2011, [ http://help.arcgis.com/en/arcgisdesktop/10.0/help/index.html#/Interpreting_OLS_results/005p00000030000000/]
Fotheringham SA, Brunsdon C, Charlton M: Geographically Weighted Regression: the analysis of spatially varying relationships. John Wiley & Sons. 2002
Wooldridge J: Introductory econometrics: a modern approach. 2006, Mason: Thomson South Western
Burnham KP, Anderson DR: Model selection and multimodel inference: a practical information-theoretic approach. 2002, Springer-Verlag
Sranacharoenpong K, Hanning RM, Sirichakwal PP, Chittchang U: Process and outcome evaluation of a diabetes prevention education program for community healthcare workers in Thailand. Educ Health (Abingdon). 2009, 22: 335-
Swoboda P, Starzengruber P, Fuehrer H, Matt J, Thriemer K, Ley B, Fally M, Haque R, Khan W, Noedl H: Comprehensive epidemiological research effort on febrile illness and hemoglobinopathies along the Bangladesh-Myanmar border. 2011, ASTMH; Philadelphia. The American Society of Tropical Medicine and Hygiene
Noedl H, Faiz MA, Yunus EB, Rahman MR, Hossain MA, Samad R, Miller RS, Pang LW, Wongsrichanalai C: Drug-resistant malaria in Bangladesh: an in vitro assessment. Am J Trop Med Hyg. 2003, 68: 140-142. PubMed
Konradsen F, Amerasinghe P, Van der-Hoek W, Amerasinghe F, Perera D, Piyaratne M: Strong association between house characteristics and malaria vectors in Sri Lanka. Am J Trop Med Hyg. 2003, 68: 177-181. PubMed
Tobgay T, Lhazeen K: Malaria Perceptions and Practices in Bhutan. Southeast Asian J Trop Med Publ Health. 2010, 41: 274-279.
Flu prevention through theatre: [ http://www.unicef.org/bangladesh/media_6312.htm]
Das A, Ravindran TKS: Factors affecting treatment-seeking for febrile illness in a malaria endemic block in Boudh district, Orissa. India: policy implications for malaria control. Malar J. 2010, 9: 377- PubMed
- Modelling malaria treatment practices in Bangladesh using spatial statistics
Lauren M Scott
Gregory E Glass
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II