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Treatment seeking for malaria: A review of recent research


  • McCombie, S. C.


A review of literature on treatment seeking for malaria was undertaken to identify patterns of care seeking, and to assess what is known about the adequacy of the treatments used. There is considerable variation in treatment seeking patterns, with use of the official sector ranging from 10-99% and self-purchase of drugs ranging from 4-87%. The majority of malaria cases receive some type of treatment, and multiple treatments are common. The response to most episodes begins with self-treatment, and close to half of case rely exclusively on self-treatment, usually with antimalarials. A little more than half use the official health sector or village health workers at some point, with delays averaging three or more days. Exclusive reliance on traditional methods is extremely rare, although traditional remedies are often combined with modern medicines. Although use of antimalarials is widespread, underdosing is extremely common. Further research is needed to answer the question of what proportion of true malaria cases get appropriate treatment with effective antimalarial drugs, and to identify the best strategies to improve the situation. Interventions for the private and public sector need to be developed and evaluated. More information is needed on the specific drugs used, considering resistance patterns in a particular area. In order to guide future policy development, future studies should define the nature of self-treatment, record multiple treatments and attempt to identify the proportions of all cases who begin treatment with antimalarials at standardized time intervals. Hypothetical questions were found to be of limited usefulness in estimating rates of actual treatments. Whenever possible, studies should focus on actual episodes of illness and consider supplementing retrospective surveys with prospective diary-type methods. In addition, it is important to determine the specificity of local illness terms in identifying true malaria cases and the extent to which local perceptions of severity are consistent with clinical criteria for severity and symptoms of complicated malaria.

Suggested Citation

  • McCombie, S. C., 1996. "Treatment seeking for malaria: A review of recent research," Social Science & Medicine, Elsevier, vol. 43(6), pages 933-945, September.
  • Handle: RePEc:eee:socmed:v:43:y:1996:i:6:p:933-945

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    Cited by:

    1. Wiseman, Virginia & Scott, Anthony & Conteh, Lesong & McElroy, Brendan & Stevens, Warren, 2008. "Determinants of provider choice for malaria treatment: Experiences from The Gambia," Social Science & Medicine, Elsevier, vol. 67(4), pages 487-496, August.
    2. Okeke, Theodora A. & Okeibunor, Joseph C., 2010. "Rural-urban differences in health-seeking for the treatment of childhood malaria in south-east Nigeria," Health Policy, Elsevier, vol. 95(1), pages 62-68, April.
    3. Sharma, Vijaya Raj, 2008. "When to seek health care: A duration analysis for malaria patients in Nepal," Social Science & Medicine, Elsevier, vol. 66(12), pages 2486-2494, June.
    4. Amar A Hamoudi & Jeffrey D. Sachs, 1999. "The Changing Global Distribution of Malaria: A Review," CID Working Papers 02A, Center for International Development at Harvard University.
    5. Supon Limwattananon, 2010. "Private-Public Mix in Woman and Child Health in Low-Income Countries: An Analysis of Demographic and Health Surveys," Working Papers id:2799, eSocialSciences.
    6. Robyn, Paul Jacob & Fink, Günther & Sié, Ali & Sauerborn, Rainer, 2012. "Health insurance and health-seeking behavior: Evidence from a randomized community-based insurance rollout in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 75(4), pages 595-603.
    7. Mbonye, Anthony K. & Bygbjerg, Ib & Magnussen, Pascal, 2007. "Intermittent preventive treatment of malaria in pregnancy: Evaluation of a new delivery approach and the policy implications for malaria control in Uganda," Health Policy, Elsevier, vol. 81(2-3), pages 228-241, May.
    8. Leonard, Lori, 2005. "Where there is no state: household strategies for the management of illness in Chad," Social Science & Medicine, Elsevier, vol. 61(1), pages 229-243, July.
    9. Kamat, Vinay R. & Nyato, Daniel J., 2010. "Soft targets or partners in health? Retail pharmacies and their role in Tanzania's malaria control program," Social Science & Medicine, Elsevier, vol. 71(3), pages 626-633, August.
    10. repec:bla:rdevec:v:21:y:2017:i:3:p:591-626 is not listed on IDEAS
    11. Filmer,Deon P., 2002. "Fever and its treatment among the more and less poor in Sub-Saharan Africa," Policy Research Working Paper Series 2798, The World Bank.
    12. Amar Hamoudi & Jeffrey D. Sachs, 1999. "The Changing Global Distribution of Malaria: A Review," CID Working Papers 2, Center for International Development at Harvard University.
    13. Druetz, Thomas & Kadio, Kadidiatou & Haddad, Slim & Kouanda, Seni & Ridde, Valéry, 2015. "Do community health workers perceive mechanisms associated with the success of community case management of malaria? A qualitative study from Burkina Faso," Social Science & Medicine, Elsevier, vol. 124(C), pages 232-240.
    14. Eve Worrall & Suprotik Basu & Kara Hanson, 2009. "The Relationship Between Socio-Economic Status and Malaria: A Review of the Literature," Working Papers id:2021, eSocialSciences.
    15. Gregory Jones & Reidar Hagtvedt, 2008. "Marketing in Heterozygous Advantage," Journal of Business Ethics, Springer, vol. 77(1), pages 85-97, January.
    16. Langlois-Klassen, Deanne & Kipp, Walter & Rubaale, Tom, 2008. "Who's talking? Communication between health providers and HIV-infected adults related to herbal medicine for AIDS treatment in western Uganda," Social Science & Medicine, Elsevier, vol. 67(1), pages 165-176, July.
    17. Catherine A. Goodman & Paul G. Coleman & Anne J. Mills, 2001. "Changing the first line drug for malaria treatment-cost-effectiveness analysis with highly uncertain inter-temporal trade-offs," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 731-749.


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