7 research outputs found
Community knowledge variation, bed-net coverage, the role of a district health care system and their implications for malaria control in Southern Malawi
This paper presents data on the pattern of knowledge of caregivers, bed-net coverage and the role of a rural district healthcare system, and their implications for malaria transmission, treatment, prevention and control in Chikhwawa, southern Malawi, using multi-level logistic regression modelling with Bayesian estimation. The majority of caregivers could identify the main symptoms of malaria, that the mosquito was the vector, and that insecticide-treated nets (ITN) could be used to cover beds as an effective preventative measure, although cost was a prohibitive factor. Use of bed nets displayed significant variation between communities. Groups that were more knowledgeable on malaria prevention and symptoms included young mothers, people who had attended school, wealthy individuals, those residing closest to government hospitals and health posts, and communities that had access to a health surveillance assistant (HSA). HSAs should be trained on malaria intervention programmes, and tasked with the responsibility of working with village health committees to develop community-based malaria intervention programmes. These programmes should include appropriate and affordable household improvement methods, identification of high-risk groups, distribution of ITNs and the incorporation of larval control measures, to reduce exposure to the vector and parasite. This would reduce the transmission and prevalence of malaria at community level
Suicidal ideation and associated factors among in-school adolescents in Zambia
A cross sectional study was conducted to estimate the prevalence and
correlates of suicidal ideation among in-school adolescents in Zambia.
Backward logistic regression analysis was conducted to assess the
association between relevant predictor variables and suicidal ideation
within the last 12 months. A total of 1970 in-school adolescents who
participated in the Zambia Global School-Based Health Survey in 2004
responded to the question on suicidal ideation. Overall, 54.0% were
males, 40.8% were current drinkers, and 35.9% ever smoked marijuana
(cannabis). Altogether 31.3% reported suicidal ideation in the past 12
months (males= 31.1%; females= 31.4%). Being male (OR=1.05; 95%CI 1.03,
1.05); being <14 years old (OR=1.21; 95%CI 1.19, 1.23), having been
drunk (OR=1.28; 95%CI 1.27, 1.29), worried (OR=1.05; 95%CI 1.04, 1.06),
sad or hopeless in the past 12 months (OR=1.02; 95%CI 1.01, 1.03) and
ever used marijuana (OR=1.18; 95%CI 1.17, 1.19) were positively
associated with suicidal ideation. Loneliness appeared to be protective
(OR= 0.92; 95%CI 0.91, 0.92). All the results, except for ever smoked
marijuana and ever been drunk, may have been biased due to non-response
to the question on suicidal ideation. A series of cross sectional
studies should be conducted to monitor changes in behavioural factors
among others ever smoked marijuana and ever been drunk in order to
broaden our understanding of factors that may be causing adolescents to
seriously consider committing suicide
Care-seeking behaviour and implications for malaria control in Southern Malawi
Although malaria is a controllable and preventable disease, it remains among the leading causes of mortality and morbidity in southern Malawi. The importance of early diagnosis and prompt treatment with hospital prescribed drugs and effective home management to control malaria is well established; however, these in part depend on how households make their decisions when family members have suffered from malaria. This study examines the behaviour of households with regard to decisions they make in managing malaria illness. Using hierarchically built data from a survey of 1,400 mothers nested within 33 communities, a series of two-level logistic regression models with Bayesian estimation was used to determine predictors of care-seeking behaviour towards malaria when a family member or a child was perceived to have malaria. The results show that most families normally visit or use medication prescribed at health facilities for both adult (80%) and child (86%) members when they are perceived to have malaria. The main obstacle to accessing the nearest health facility was distance and transport costs (73%) and the main problems encountered at health facilities were long waiting time or absence of health workers (73%) and shortage of drugs (35%). Among the main predictor variables for choices of treatment for childhood malaria was the absence of a health surveillance assistant for those that visited hospitals [β=0.56; 95% CI:-0.86,-0.26]; bought medication from open markets [β=0.51; 95% CI:0.20,0.82]; and those that used other traditional methods or did nothing [β=0.70; 95% CI:-0.04,1.44; p=0.06].. The results have an important role to play in the control and prevention of malaria in Malawi. The results reveal the need for increased awareness about the dangers of purchasing drugs from non-medical and/or uncertified private institutions and sources such as those found in open markets. They also show the important role of community health workers in the delivery of health systems. The study recommends empowerment of community health workers through rigorous and relevant health promotion programmes to update both their knowledge and their skills in communication and counselling
Care-seeking behaviour with regard to attitude, practices, limitations and implications for diarrhoea control in the Southern Malawi.
This article discusses care-seeking behaviour with regard to attitude, practices, limitations and implications for diarrhoea control in the Southern Malawi
Household and community variations and nested risk factors for diarrhoea prevalence in Southern Malawi : a binary logistic multilevel analysis
This paper examines household and community-level influences on diarrhoeal prevalence in southern Malawi. A Bayesian multi-level modelling technique is used in the estimation of hierarchically built data from a survey of individuals nested within households nested within communities. Households have strong unobserved influence on diarrhoeal illness (s2u ¼ 4.476; 95%CI: 2.081, 6.871). A joint Wald test of significance shows that an individual's age [w24 ¼ 55:921; p ¼ 0:000] and school [w22 ¼ 18:203; p ¼ 0:000] have strong influence on an individual's diarrhoeal prevalence. An individual's history of malarial-like illness also has a strong positive relationship with diarrhoeal prevalence [b ¼ 0.606, p ¼ 0.000]. Household factors that influence diarrhoea include employment status of head of household [b ¼ 70.619, p 5 0.021], maternal age [b ¼ 70.013, p 5 0.003], and size of household [b ¼ 70.669, p ¼ 0.000]. The positive relationship between diarrhoea and malaria-like episodes highlights common risk factors hence the need for common approaches to combat the diseases. Significant household effects underline the importance of household considerations in policy issues