Household and socioeconomic factors associated with childhood febrile illnesses and treatment seeking behaviour in an area of epidemic malaria in rural Ethiopia

To assess household and socioeconomic factors associated with childhood febrile illnesses and treatment seeking behaviour, a study was conducted in Adami Tulu district in Ethiopia during the peak malaria transmission season in 2003. All mothers/caretakers of children <5 years of age were interviewed regarding their household characteristics, history of febrile illness (malaria) among children and actions taken 2 weeks prior to the survey. Of 3873 children, 21% had experienced fever in the past 2 weeks. Household ownership of a mosquito net (odds ratio (OR) = 0.4, 95% CI 0.3-0.7) and prior spraying of the house with aerosols (OR = 0.7, 95% CI 0.5-0.9) or DDT (OR = 0.8, 95% CI 0.6-0.9) were associated with lower risk of febrile illnesses, whilst sharing the house with livestock increased the risk (OR = 1.3, 95% CI 1.1-1.6). Treatment was sought for 87% of febrile children, with public facilities, private clinics and community health workers accessed fairly equally (26-27%). Home management was uncommon (6.4%). More febrile children from households in the middle (37.1%) and highest (44.6%) wealth categories sought treatment within 24 h compared with the lowest category (18.3%). Widescale use of vector control measures such as mosquito nets and insecticide spraying of houses can effectively reduce the incidence of febrile illnesses among children.