Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

11.3 TREATMENT OF CHILDREN WITH FEVERIn malaria-endemic areas of sub-Saharan Africa, acute malaria clinical disease is almostalways confined to young children who suffer high parasite densities. If untreated, this can progressvery rapidly to severe malaria which can cause death. The diagnosis of malaria is based on clinicalcriteria (clinical diagnosis) and supplemented by the detection of parasites in the blood(parasitological or confirmatory diagnosis).11.4 PROMPT TREATMENT WITH ANTIMALARIAL DRUGSEarly treatment of malaria is critical to a positive outcome. Progression to severe malaria isoften rapid, and children may die within 48 hours of onset of illness. Treatment must therefore beprompt. Studies show that provision of early treatment for persons with uncomplicated malaria withinthe community reduces progression to severe disease (Armstrong Schellenberg et al., 2002).For each child under age five in the 2007-08 THMIS, mothers were asked if the child had hadfever in the two weeks preceding the survey, whether treatment was sought for the fever, and the typeof treatment given to the child for each episode. Table 11.5 shows the results.Nineteen percent of children under age five in Mainland Tanzania and 24 percent in Zanzibarhad a fever during the two weeks preceding the survey. Among children with a fever, 57 percent inMainland and 66 percent in Zanzibar received treatment with antimalarial drugs. The prevalence forMainland in the 2004-05 TDHS was similar (58 percent), but it was lower in Zanzibar (61 percent).Thirty-four percent of children with a fever in Mainland and 34 percent in Zanzibar received drugs onthe same day or the day after the fever started. These figures are significantly lower than those in the2004-05 TDHS (48 percent of children in Mainland and 51 percent in Zanzibar received prompttreatment for fever).Children living in urban areas are more likely than those in rural areas to receive antimalarialdrugs (69 percent and 54 percent, respectively). Similar figures are found in the 2004-05 TDHS (65and 57 percent, respectively). Furthermore, urban children are more likely than rural children toreceive treatment promptly.There are striking differences in the timing of treatment of children with fever across regions.Children in Arusha are the least likely to receive malaria treatment on the same day or the day afterthe fever started (5 percent), while children in Morogoro are most likely to receive prompt treatment(61 percent). In the 2004-05 TDHS the same regions showed similar extremes with Morogoro treating83 percent of children with a fever promptly, compared with 20 percent of children with a fever inArusha.The probability of having a fever in the two weeks preceding the survey does not differ muchby wealth quintile or education of the mother. However, children whose mothers have completedprimary school education and children from households in the highest wealth quintiles are more likelyto receive antimalarial drugs, and more likely to receive them quickly. The same findings werereported in the 2004-05 TDHS.140 | Malaria