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.