RESUMO
Background: Globally unexpected 219 million malaria cases occurred in 2021, with 90% of these cases happening in the WHO Africa region and unexpected 435,000 malaria transmissions worldwide, with children less than five years being the most-at-risk (61%) of malaria infections (World Malaria Report, 2021). In 2019, IRS coverage was 94.6%. This was reason enough to assess contributing factors leading to not reaching targeted 100% of the households mapped despite massive resources. Methods: The study adopted analytical cross-sectional design. The study area was Migori County (Awendo, Uriri, Rongo, Suna East, Suna West and Nyatike sub counties) where IRS had been implemented in four sessions. The study period November 2021 to April 2022. The respondents sample size was determined using Cochran (1963) for a single population of 1,000 households. The respondents were randomly selected villages from purposively selected Migori County. Kenyatta University Ethics Review Committee and NACOSTI provided ethical clearance. Quantitative data analyzed using SPSS version 2.6 and thematically for qualitative data. A Chi-squared test used to compute statistically significant differences between independent variables at p value <0.05. Results: Some 249 (90%) of the respondents confirmed their houses were IRS- covered while 32 (10%) of the houses were not sprayed because they were not informed in advance (p value <0.000). Conclusions: Using the Chi-squared test of significance the spray operators` arrival time for IRS activities affected the respondents daily calendar of events significantly (p=0.013, <0.05) resulting into respondents’ non-participation and unmet targets.
RESUMO
Introduction: Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urbancommunities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood Illness (C-IMCI) strategy. Objective: The aim of this study was to determine the perceptions of mothers/caregivers regarding the causes of diarrhea among under-fives and how it was managed in the home before seeking help from Community Health Workers or health facilities. Design: A household longitudinal study was conducted in Nyando district; Kenya in 2004-2006 adopting both qualitative and quantitative approaches. Subjects: A total of 927 mothers/caregivers of under-fives participated in the study. Main outcome measures: Perceived causes of childhood diarrhoea; action taken during diarrhea; fluid intake; recognition of signs of dehydration; feeding during convalescence; adherence to treatment and advice. Results: Majority of the respondents 807(87.1) reported that their children had suffered from diarrhea within the last 2 weeks before commencement of the study. Diarrhea was found to contribute to 48of child mortality in the study area. Perceived causes of diarrhea were: unclean water 524(55.6); contaminated food 508(54.9); bad eye 464 (50.0); false teeth 423(45.6) and breast milk 331(35.8). More than 70of mothers decreased fluid intake during diarrhea episodes. The mothers perceived wheat flour; rice water and selected herbs as anti-diarrheal agents. During illness; 239(27.8) of the children were reported not to have drunk any fluids at all; 487(52.5) drunk much less and only 93(10.0) were reported to have drunk more than usual. A significant 831(89.6) withheld milk including breast milk with the notion that it enhanced diarrhea. Conclusion: Based on these findings; there is need to develop and implement interactive communication strategies for the health workers and mothers to address perceptions and miscon- ceptions and facilitate positive change in the household practice on management of diarrhea among under-fives