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Abstract：
BACKGROUND: A good understanding of the demand for malaria rapid diagnostic test (MRDT), malaria health care-seeking behavior, and drug use among community members is crucial to malaria control efforts. The aim of this study was to assess the demand (use and/or request) for MRDT, health care-seeking behavior, and drug use, as well as associated factors, among rural community members (both children and adults) with fever or malaria-like illness in Ebonyi state, Nigeria.
METHODS: A cross-sectional household survey was conducted between October 1st and November 7th, 2018, in 18 rural geographical clusters. Data was collected using a structured interviewer-administered questionnaire. Descriptive analysis was done using summary statistics. Associated factors (socio-demographic, knowledge and opinion level) were assessed using bivariate and multivariate binomial logistic regressions while the overall effects of these factors were assessed using the \"postestimation test\" command in Stata.
RESULTS: A total of 1310 children under 5 years of age and 2329 children ages 5 years and above and adults (excluding pregnant women) (3639 overall) participated in the study. Among the 1310 children under 5 years of age: 521 (39.8%) received MRDT of which the caregivers of 82 (15.7%) requested for the MRDT; 931 (71.1%) sought care with public/private sector providers (excluding traditional practitioners/drug hawkers) the same/next day; 495 (37.8%) sought care at government primary health centres, 744 (56.8%) sought care with the patent medicine vendors (PMVs); 136 (10.4%) sought care with traditional practitioners; 1020 (77.9%) took ACTs (=88.2%, 1020/1156 of those who took anti-malarial drugs). Generally, lower values were respectively recorded among the 2329 children ages 5 years and above and adults (excluding pregnant women). The most important overarching predictor of the demand for MRDT and care-seeking behaviour was the knowledge and opinion level of respondent female heads of households about malaria and malaria diagnosis.
CONCLUSIONS: Among the rural community members with fever or malaria-like illness in Ebonyi state, Nigeria, while majority did not receive MRDT or diagnostic testing, and sought care with the PMVs, most took anti-malaria drugs, and mostly ACTs. Interventions are needed to improve the knowledge and opinion of the female heads of households about malaria and malaria diagnosis.
METHODS: A cross-sectional household survey was conducted between October 1st and November 7th, 2018, in 18 rural geographical clusters. Data was collected using a structured interviewer-administered questionnaire. Descriptive analysis was done using summary statistics. Associated factors (socio-demographic, knowledge and opinion level) were assessed using bivariate and multivariate binomial logistic regressions while the overall effects of these factors were assessed using the \"postestimation test\" command in Stata.
RESULTS: A total of 1310 children under 5 years of age and 2329 children ages 5 years and above and adults (excluding pregnant women) (3639 overall) participated in the study. Among the 1310 children under 5 years of age: 521 (39.8%) received MRDT of which the caregivers of 82 (15.7%) requested for the MRDT; 931 (71.1%) sought care with public/private sector providers (excluding traditional practitioners/drug hawkers) the same/next day; 495 (37.8%) sought care at government primary health centres, 744 (56.8%) sought care with the patent medicine vendors (PMVs); 136 (10.4%) sought care with traditional practitioners; 1020 (77.9%) took ACTs (=88.2%, 1020/1156 of those who took anti-malarial drugs). Generally, lower values were respectively recorded among the 2329 children ages 5 years and above and adults (excluding pregnant women). The most important overarching predictor of the demand for MRDT and care-seeking behaviour was the knowledge and opinion level of respondent female heads of households about malaria and malaria diagnosis.
CONCLUSIONS: Among the rural community members with fever or malaria-like illness in Ebonyi state, Nigeria, while majority did not receive MRDT or diagnostic testing, and sought care with the PMVs, most took anti-malaria drugs, and mostly ACTs. Interventions are needed to improve the knowledge and opinion of the female heads of households about malaria and malaria diagnosis.
摘要：
背景：对疟疾快速诊断测试（MRDT）的需求有很好的了解，疟疾寻求医疗保健的行为，社区成员之间的毒品使用对疟疾控制工作至关重要。本研究的目的是评估MRDT的需求（使用和/或要求），寻求医疗保健的行为，和吸毒，以及相关因素，在Ebonyi州患有发烧或疟疾样疾病的农村社区成员（包括儿童和成人）中，尼日利亚。
方法：在10月1日至11月7日之间进行了横断面家庭调查，2018年，在18个农村地理集群中。使用结构化的面试官管理的问卷收集数据。使用汇总统计进行描述性分析。相关因素(社会人口，知识和意见水平）使用双变量和多变量二项逻辑回归进行评估，而这些因素的总体影响则使用Stata中的“后估计检验”命令进行评估。
结果：共有1310名5岁以下儿童和2329名5岁及以上儿童和成人（不包括孕妇）（总共3639名）参加了这项研究。在1310名5岁以下儿童中：521名（39.8％）接受MRDT，其中82名（15.7％）的护理人员要求MRDT；931名（71.1％）在当天/第二天向公共/私营部门提供者（不包括传统从业人员/小贩）寻求护理；495名（37.8％）在政府初级保健中心寻求护理，744（56.8％）向专利药供应商（PMV）寻求护理；136（10.4％）向传统从业者寻求护理；1020（77.9％）服用了ACTs（=88.2％，服用抗疟疾药物的人的1020/1156）。一般来说,在2329名5岁及以上儿童和成人(不包括孕妇)中,数值分别较低.MRDT需求和寻求护理行为的最重要的总体预测指标是受访者女性户主对疟疾和疟疾诊断的知识和意见水平。
结论：在Ebonyi州患有发烧或疟疾样疾病的农村社区成员中，尼日利亚,虽然大多数人没有接受MRDT或诊断测试，并向PMV寻求护理，大多数人服用抗疟疾药物，主要是ACTs。需要采取干预措施，提高女性户主对疟疾和疟疾诊断的认识和意见。
方法：在10月1日至11月7日之间进行了横断面家庭调查，2018年，在18个农村地理集群中。使用结构化的面试官管理的问卷收集数据。使用汇总统计进行描述性分析。相关因素(社会人口，知识和意见水平）使用双变量和多变量二项逻辑回归进行评估，而这些因素的总体影响则使用Stata中的“后估计检验”命令进行评估。
结果：共有1310名5岁以下儿童和2329名5岁及以上儿童和成人（不包括孕妇）（总共3639名）参加了这项研究。在1310名5岁以下儿童中：521名（39.8％）接受MRDT，其中82名（15.7％）的护理人员要求MRDT；931名（71.1％）在当天/第二天向公共/私营部门提供者（不包括传统从业人员/小贩）寻求护理；495名（37.8％）在政府初级保健中心寻求护理，744（56.8％）向专利药供应商（PMV）寻求护理；136（10.4％）向传统从业者寻求护理；1020（77.9％）服用了ACTs（=88.2％，服用抗疟疾药物的人的1020/1156）。一般来说,在2329名5岁及以上儿童和成人(不包括孕妇)中,数值分别较低.MRDT需求和寻求护理行为的最重要的总体预测指标是受访者女性户主对疟疾和疟疾诊断的知识和意见水平。
结论：在Ebonyi州患有发烧或疟疾样疾病的农村社区成员中，尼日利亚,虽然大多数人没有接受MRDT或诊断测试，并向PMV寻求护理，大多数人服用抗疟疾药物，主要是ACTs。需要采取干预措施，提高女性户主对疟疾和疟疾诊断的认识和意见。
