Caregivers' perceived treatment failure in home-based management of fever among Ugandan children aged less than five years

Caregiver's perceived treatment outcome in HBMF and in alternative sources of fever treatment was assessed in a rural Ugandan setting using nine hundred and seventy eight (978) caregivers of children between two and 59 months of age, who had reported fever within two weeks prior to the study.Lower caregivers' perceived treatment failure (15% and 23%) was observed in the formal health facilities and in HBMF, compared to private clinics (38%), drug shops (55%) or among those who used herbs (56%). Under HBMF, starting treatment within 24 hours of symptoms onset and taking treatment for the recommended three days duration was associated with a lower perceived treatment failure. Conversely, vomiting, convulsions and any illness in the month prior to the fever episode was associated with a higher perceived treatment failure.In this medium malaria transmission setting, caregiver's perceived treatment outcome was better in HBMF compared to alternative informal sources of treatment.Malaria is one of the leading causes of ill health and deaths in Uganda, accounting for 46% of the illness in children, 20–40% of out-patient visit at health facilities, 25% of hospital admissions, 14% of in-patient deaths and 20–23% of – infant and childhood mortality (Uganda Ministry of Health,, surveillance reports, 2001). High malaria transmission intensity, limited access to adequate treatment, increasing parasite resistance to affordable and safe medicines (chloroquine, sulphadoxine-pyrimethamine and amodiaquine);, delayed seeking of care and inappropriate treatment at home or within communities, are some of the causes for this pervasive situation. Based on the observation that the majority of fevers in Africa are due to malaria [1], and evidence demonstrating that home management of malaria (HMM) reduces childhood morbidity and mortality [2-4], some countries have adopted the World Health Organization home-based management of fever (HBMF) strategy in an effort to improve prompt access to tr