Malaria is a mosquito-borne infectious disease that affects humans, and it causes symptoms that typically include, fever, fatigue, vomiting and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. Symptoms usually begin 10–15 days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria (“Malaria,” 2022).
Globally, malaria still remains a public health threat with most widespread in Africa and several Asian nations, in contrast to the industrialized world, where it is imported from endemic regions (Talapko, Škrlec, Alebić, Jukić, & Včev, 2019). World Health Organization (WHO) estimates that in 2020 alone, 241 million clinical cases of malaria occurred, and 627,000 people died of malaria, most of them children in Africa. About 2,000 cases of malaria are diagnosed in the United States each year. Most cases in the United States are in travellers and immigrants returning from parts of the world where malaria transmission occurs, including sub-Saharan Africa and South Asia. According to Target Malaria, Every year, malaria kills over 619 000 people and infects over 247 million people; a third of the world is at risk of contracting this disease transmitted by mosquitoes. Most of the victims are children under the age of five living in Africa (Malaria, 2023). According to National Malaria control programme (NMCP), Ministry of Health Uganda, Uganda has the sixth highest number of annual deaths from malaria in Africa, as well as some of the highest reported malaria transmission rates in the world, with approximately 16 million cases reported in 2013 and over 10,500 deaths annually. In addition, malaria has an indirect impact on the economy and development in general. The socio-economic impact of malaria includes out-of-pocket expenditure for consultation fees, drugs, transport, and subsistence at a distant health facility. These costs are estimated to be between USD 0.41 and USD 3.88 per person per month (equivalent to USD 1.88 and USD 26 per household). Household expenditure for malaria treatment is also a high burden to the Ugandan population, consuming a larger proportion of the incomes in the poorest households.
Uganda has joined other countries in the world to champion several malaria interventions including; malaria case management at both private and public health facilities, including a more comprehensive and integrated package (IPTp) for malaria management among pregnancy, distribution of long-lasting insecticidal nets (LLINs), implementation of Indoor Residual Spraying (IRS), integrated community case management (ICCM) of childhood illnesses including malaria which is carried out by Community Health Workers (CHWs) locally referred to as Village Health Teams (VHTs) in Uganda (Getahun, Deribe, & Deribew, 2010a). According to NMCP, Uganda is stratified into three epidemiological/transmission zones: low (parasite prevalence: <10%), medium (parasite prevalence: 11–50%) and high (parasite prevalence: >50%). Apac district is among the zones with high prevalence, and this has been the case for the last 20 years. Given this prevalence several interventions have been targeted in this district over years including IRS, ILNs, ICCM, IPTp among others.
In bid to contribute to Uganda’s Malaria strategic roadmap, prompt access to appropriate antimalaria treatment within the first 24 hours after fever onset, is promoted by also the World Health Organization for prevention of progression from uncomplicated to severe malaria. This strategy is logical as progression to severe disease requires extensive parasite multiplication over time. Support for delay care seeking as a risk factor for severe malaria is largely based on results from cross-sectional studies demonstrating association between longer duration of symptoms and severe malaria and demonstration of rapid progression of uncomplicated to severe malaria(Mpimbaza, Ndeezi, Katahoire, Rosenthal, & Karamagi, 2017). Although studies have been conducted in primary health care settings in Uganda, there is need to further understand malaria health seeking behaviours in communities among children under the age of five years.(Muskeg et al., 2021) for example by looking at the determinants of malaria treatment seeking time by parents or caregivers of children under five years.