Community perceptions and treatment seeking for malaria in Baringo district, Kenya: implications for disease control.

BACKGROUND: Malaria is one of the leading causes of morbidity and mortality in Kenya. Its control depends on many factors, some of which have not been studied at the level of rural community.
OBJECTIVE: To identify what households in a Kenyan rural community perceive to be the cause and symptoms of malaria and their treatment behaviour for malaria.
SETTING: Community-based study conducted in Marigat division of Baringo district.
DESIGN: Cross-sectional study utilising qualitative ethnographic and semi-quantitative methods. Multi-stage cluster stratified procedure was used to select the villages, after which screening interviews were used to identify households. Finally, interviews and informal discussions were conducted with 463 heads of households with self-reported cases of malaria. The study was conducted between April and October 1992.
RESULTS: The study findings indicate that the community has multiple aetiologies for malaria. Of the 463 heads of households interviewed, 258 (58.5%) associated the cause of the disease to the mosquito. Other aetiological beliefs included: wild vegetables (13.1%), water (11%) and milk (9.8%). Many of the respondents (90%) could identify malaria by several correct symptoms. In the treatment of malaria, various health resources such as public health facilities, over-the counter medications, private clinics and herbal medicines are used. For first choice of care, many households used public health facilities. However, if the malaria illness persisted, other forms of treatment especially private clinics and medicinal plants seem to have been preferred.
CONCLUSION: Understanding community perceptions of aetiology, symptom identification and treatment of malaria is an important step towards the control of the disease.