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Delay in malaria care-seeking for children under five in Africa: a systematic review
Mustapha Amoadu1, Amidu Alhassan2, Edward Odoom3
1Biomedical and Clinical Research Centre, College of Health and Allied Science, University of Cape Coast, Cape Coast, Ghana. mustapha.amoadu@ucc.edu.gh.
Insights
Delayed malaria treatment in young children in sub-Saharan Africa is prevalent due to financial, geographic, and health system barriers. These delays increase mortality and severe complications, necessitating targeted interventions.
Area of Science:
- Global Health
- Pediatric Infectious Diseases
- Public Health Policy
Background:
- Malaria in children under five in sub-Saharan Africa is a significant public health issue.
- Delayed care-seeking contributes to poor health outcomes and mortality.
- Socioeconomic, geographic, and health-system factors impede timely access to malaria treatment.
Purpose of the Study:
- To synthesize evidence on the prevalence and determinants of delayed malaria care-seeking in children under five.
- To investigate the outcomes associated with delayed malaria treatment seeking.
- To inform interventions for improving timely malaria care access.
Main Methods:
- Systematic review following Joanna Briggs Institute (JBI) guidelines.
- Reporting adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Main Results:
- Prevalence of delayed malaria care-seeking ranges widely from 2% to 95.8%.
- Key determinants include financial constraints, travel distance, traditional treatments, and perception of malaria as mild.
- Health worker attitudes and facility logistics also hinder timely care.
Conclusions:
- Interventions addressing financial barriers are crucial for timely malaria treatment access.
- Improving access to care and strengthening health systems are vital for prompt responses.
- Enhanced health system readiness can improve outcomes for children with malaria.
Background:
Delays in seeking appropriate treatment for malaria in children under five remain a major contributor to poor outcomes in sub-Saharan Africa, where multiple socioeconomic, geographic, and health-system factors influence when care is accessed. This review synthesised current evidence on the prevalence and determinants of delayed malaria care-seeking, as well as the associated outcomes among children under five in sub-Saharan Africa.
Methods:
This systematic review followed the guidelines by the Joanna Briggs Institute (JBI). This review was reported in accordance with following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Result:
The prevalence of delayed malaria care-seeking among children under five ranges from 2% to 95.8%. Factors associated with these delays include financial constraints, long travel distances, reliance on traditional treatments, and the perception of malaria as a mild illness. Additionally, health workers' attitudes and shortages of essential health facility logistics further hinder timely care-seeking by caregivers. These delays are associated with increased mortality, progression to severe malaria, and serious neurological and haematological complications.
Conclusion:
Timely access to effective malaria treatment for young children can be enhanced by interventions that address financial barriers, improve access to care, and strengthen health-system readiness to respond promptly.
