| Resume |
Abstract
Background: Artemisinin-based combination therapy (ACT), used to treat uncomplicated malaria cases, is one of
the main strategies of malaria control and elimination. One of the main objectives of the Benin National Malaria
Control Program’s (NMCP) strategic plan is to ensure that at least 80% of uncomplicated malaria is treated with ACT
within 24 h. Therefore, it was of great interest to measure whether the country case management of fever amongst
children under five, adhered to the NMCP’s strategic plan and look into the barriers to the use of ACT.
Methods: A cross-sectional survey based on a cluster and multi-stage sampling was conducted in two rural health
districts in Benin. We recruited 768 and 594 children under five years were included in the northern and in the
southern respectively. Data was collected on the general use of ACT and on the correct use of ACT that adheres to
the NMCP’s strategy, as well as the barriers that prevent the proper management of fever amongst children. To
assess the certain predictors of ACT usage, logistic regression was used, while taking into account the cluster
random effect.
Results: Among febrile children aged 6 to 59 months, 20.7% in the south and 33.9% in north received ACT. The
correct use of ACT, was very low, 5.8% and in southern and 8.6% northern areas. Caregivers who received information
on ACT were 3.13 time more likely in the south and 2.98 time more likely in the north to give ACT to their feverish
child, PPR = 3.13[1.72–4.15] and PPR = 2.98 [2.72–3.11] respectively. Chloroquine and quinine, other malaria treatments
not recommended by NMCP, were still being used in both areas: 12.3 and 3.3% in the south and 11.4 and 3.0% in the
north.
Conclusion: In Benin, the use and the correct use of ACT for febrile children remains low. The study also showed that
having received information about the use of ACT is positively associated with the use of ACT. This point highlights the
fact that efforts may not have been sufficiently integrated with social communication, which should be based on the
behavioural determinants of populations. |