Fever and malaria in children under 5 years of age in Benin: Do we have accurate statistics?

Introduction. In Benin, mothers generally seek health care for their children with fever and malaria only when complications appear, including severe anemia, convulsions, and coma. Statistics from the national health system are based on consultations at national health care centers and do not take into account existing cases in the community. Objectives. To determine the prevalence of malaria from the analysis of subjects with fever and their management in two participating villages. This evaluation - and a better approach to fighting childhood malaria - rely on habits of management and care-seeking and the extent of parental participation. Methods. Parents in two villages were interviewed about their practices in managing fever in children and about active malaria screening. Results. The prevalence of (thick smear-positive) malaria was the same in both villages (p > 0.05). Parents brought children to health centers for consultation in only 6% of the cases of fever. Treatment was administered immediately within 48 hours for most children (75%) but only 15% received adequate anti-malarial treatment. Discussion. Care-seeking is highly associated with perceptions and representations of childhood fever: for every case treated at the health centre, 16 remain in the community. Conclusion. Adequate management of fever and the malaria often associated with it requires understanding the perceptions and representations of parents, which will make it possible to learn the true proportion of malaria in fevers in the two villages and thus to apply appropriate strategies.