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Determinants of caregiver's knowledge and practices regarding childhood fever management in a developing setting: a
Ibrahim A Ogunyinka1, Kazeem A Oshikoya2, Kazeem B Yusuff3
1Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria.
Insights
Caregiver knowledge and practices for childhood fever in Northern Nigeria are suboptimal. Primary caregivers and those with young children (≤3 years) showed significant differences in fever management, highlighting the need for targeted educational strategies.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Childhood fever is a common symptom of illness and an adverse effect of interventions, causing caregiver anxiety and leading to non-evidence-based practices.
- These practices can result in medication errors, resource waste, and healthcare system overuse, particularly in developing regions.
- Determinants of caregiver practices in domiciliary fever management are not well understood in these settings.
Purpose of the Study:
- To assess the knowledge and practices of childhood fever management among caregivers in Northern Nigeria.
- To identify the determinants influencing these knowledge and practices in a domiciliary context.
Main Methods:
- A cross-sectional study was conducted using a 41-item questionnaire administered to 2,400 caregiver-child pairs in Northern Nigeria.
- Data collection occurred between August 2020 and February 2021.
- The questionnaire demonstrated reliability for both knowledge (Cronbach's Alpha = 0.689) and practice (Cronbach's Alpha = 0.814).
Main Results:
- Over two-thirds (68.3%) of caregivers exhibited fever phobic tendencies.
- Paracetamol was the most frequently used medication, accounting for 31.3% of reported adverse medication administration events.
- Only 7% of knowledgeable caregivers practiced evidence-based fever management, compared to 41.6% of less knowledgeable ones. Being a primary caregiver and having children aged ≤3 years were significant determinants of both knowledge and practice.
Conclusions:
- Childhood fever management knowledge and practices among caregivers in Northern Nigeria are suboptimal.
- Being a primary caregiver and having young children (≤3 years) significantly influence fever management knowledge and practices.
- Targeted educational interventions are crucial to improve childhood fever management by empowering caregivers with evidence-based information.
Introduction:
Fever is both a sign of various diseases (chief of which are infectious in nature) and an adverse effect of certain interventions (e.g. vaccines, drugs) in the pediatric population. It elicits anxiety among caregivers and healthcare professionals alike resulting in non-evidence based practices, adverse medication administration events, waste of scarce resources and overutilization of health facilities. The determinants of these practices among caregivers in the domiciliary contexts have not been well characterized in developing settings.
Methods:
We assessed the knowledge and practices of childhood fever and their determinants among caregivers in domiciliary settings in Northern Nigeria using a 41-item questionnaire between August 2020 and February 2021.
Results:
The questionnaire is reliable (knowledge: Cronbach's Alpha = 0.689; practice: Cronbach's Alpha = 0.814) and collected data on a total of 2,400 caregiver-child pairs, who participated in the study. Over two-third (68.3%; 1,640) of the caregivers expressed fever phobic tendencies. Paracetamol was the most commonly used medication and constituted 31.3% of medication administration adverse events reported by the caregivers. Only one out of every six knowledgeable caregivers engaged in evidence-based home childhood fever management practices (7% vs. 41.6%) with being a primary caregiver [Knowledge: odd ratio (OR): 2.81, 95% CI: 0.38; 5.68; p value: 0.04; Practice: OR: 1.65, 95% CI: 0.09; 7.33; 0.02] and having a child/children aged ≤3 years (knowledge: OR: 7.03, 95% CI: 4.89; 9.67, p value: 0.003; practice OR: 3.11, 95% CI: 1.27; 8.59, 0.007) determining both the knowledge and practices of childhood fever management in a household.
Conclusions:
The knowledge and practice of childhood fever management among caregivers were sub-optimal with being a primary caregiver and having a child/children aged ≤3 years being the significant determinants of each domain. These gaps underscore the dire need for targeted strategies aimed at improving childhood fever management by educating caregivers.
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