Objective: To investigate community knowledge and perceptions on the management of nonmalarial
fevers under reduced malaria burden and the implications on the uptake of artmetherlumefantrine
(ALu) for malaria treatment.
Methods: A cross sectional survey was carried out in Morogoro Municipality in March 2015
to examine community knowledge and perceptions on the management of fever among underfives
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.
Results: Fever was reported in 1146 (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 257/1140 (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.
Conclusions: Fever 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.