Community knowledge and perceptions on the management of non-malarial fevers under reduced malaria burden and implications on the current malaria treatment policy in Morogoro, Tanzania

ObjectiveTo investigate community knowledge and perceptions on the management of non-malarial fevers under reduced malaria burden and the implications on the uptake of artmether-lumefantrine (ALu) for malaria treatment.MethodsA cross sectional survey was carried out in Morogoro Municipality in March 2015 to examine community knowledge and perceptions on the management of fever among under-fives and effectiveness of ALu for malaria treatment. Household members were interviewed on knowledge of common childhood illnesses, recognition of fever symptom, and illnesses that present with fever; under-fives with a history of fever and malaria test and use of antimalarials in the last two weeks. Notion of whether every fever is due to malaria and the perceived effectiveness of ALu for malaria treatment was also assessed.ResultsFever was reported in 1 146 (69.2%) under-fives, with malaria being the commonest illness (81.8%) which was highly associated with fever (92.1%); other conditions associated with fever were respiratory (60.0%) and gastroenteric (47.8%) conditions. Malaria test was positive in 257/1 140 (22.5%) under-fives; however 23.2% received ALu. The large majority (84.6%) had the notion that not all fevers are due to malaria. About two thirds (63.4%) believed that ALu has reduced fever episodes; however only about a half (54.6%) rated ALu as being very effective. More than two thirds (70.4%) of the respondents would prefer to continue using ALu as a 1st line drug.ConclusionsFever is still a major health problem recognized to be associated with not only malaria. There is a need for continuous public education that ALu is still effective.