Poster Presentation First Malaria World Congress 2018

Pathways to cure: care-seeking behavior and antimalarial drug use in Eastern Indonesia (#432)

Astri Ferdiana 1 , Utsamani Cintyamena 1 , Fransiska M Sitorus 1 , Eti N Solikhah 2 , Maria E Sumiwi 3 , Supargiyono Supargiyono 2
  1. Center for Tropical Medicine, Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
  2. Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
  3. UNICEF Indonesia, Jakarta, Indonesia


Malaria remains endemic in Eastern Indonesia, however, very little is known on the care-seeking practices for malaria symptoms.


To assess the care-seeking practices for malaria symptoms and the use of antimalarial drugs among households in Eastern Indonesia.


A cross-sectional survey was conducted to households in Keerom, Papua and Lembata, East Nusa Tenggara. Multistage random sampling method was used. Knowledge and perception of malaria, care-seeking practices, and adherence of malaria treatment was assessed using a semi-structured questionnaire administered through face-to-face interview. Descriptive analyses were employed to explain the findings.


Of 900 households visited, 765 (85%) reported malaria diagnosis/symptoms in the last 6 months preceding the survey. Among those, 70.4% participants sought treatment to health facilities within 24 hours after onset. There were more delays in Lembata than in Keerom (40.2%vs22.6%, p-value<0.001). Delays was more likely among indigenous population [OR=8.09, 95%CI (4.35-15.05)] and those with good malaria knowledge ([OR=0.39, 95%CI (0.26-0.59)]. Four trajectories in care-seeking practices were revealed: 1) care-seeking at health facilities and concluded (81.1%), 2) self-treatment followed by care-seeking at health facilities (8.2%), 3) care seeking at health facilities followed with second visit to health facilities (7.7%), 4) self-treatment and concluded (2.9%). Those visiting health facilities reported having blood tests and given antimalarial drugs with correct duration and dosage (83.6%vs77.8%, respectively). Self-reported adherence was 97.2% with Keerom participants reported higher adherence (p-value=0.001). A total of 78.6% participants were asked by health workers to return to health facilities for follow-up (Lembata vs Keerom was 90.3%vs70.5%, p-value<0.001). More participants in Lembata returned for follow-up than in Keerom (60.8% vs 28.2%, p-value<0.001).


Interventions are needed to increase prompt care-seeking and uptake of diagnosis and treatment. The low attendance of follow-up visits must be improved by proper information prior to drug  administration.