Abstract:
Background: Malaria, a disease caused by protozoan parasites of the genus Plasmodium and transmitted by female
anopheline mosquitoes, is a major cause of morbidity, mortality and loss in productivity in humans. Baringo County is
prone to seasonal transmissions of malaria mostly in the rainy seasons.
Methods: This cross-sectional study used a mixed methods approach to collect data on knowledge and lay management
of malaria. A questionnaire survey was administered to 560 respondents while qualitative data was collected
through 20 focus group discussions in four ecological zones covering Baringo North, Baringo South and Marigat sub-
Counties of Baringo County. Analyses were done through summary and inferential statistics for quantitative data and
content analysis for qualitative data.
Results: The study communities were knowledgeable of malaria signs, symptoms, cause and seasonality but this
biomedical knowledge co-existed with other local perceptions. This knowledge, however, did not influence their first
(p = 0.77) or second choice treatments (p = 0.49) and compliance to medication (p = 0.84). Up to 88 % of respondents
reported having suffered from malaria. At the onset of a suspected malaria case community members reported
the following: 28.9 % visited a health facility, 37.2 % used analgesics, 26.6 % herbal treatments, 2.2 % remnant malaria
medicines, 2.2 % over the counter malaria medicines, 1 % traditional healers and 1.8 % other treatments. Nearly all
respondents (97.8 %) reported visiting a health facility for subsequent treatments. Herbal treatments comprised of
infusions and decoctions derived from roots, barks and leaves of plants believed to have medicinal value. Compliance
to conventional malaria treatment regime was, however, identified as a challenge in malaria management. Quick relief
from symptoms, undesirable qualities like drug bitterness and bad smell, undesirable side-effects, such as nausea and
long regimen of treatment were some of the contributors to non-compliance. Men and women exhibited different
health-seeking behaviours based on the cultural expectations of masculinity, femininity, gender roles and acceptability
of health services.
Conclusions: While knowledge of malaria is important in identifying the disease, it does not necessarily lead to
good management practice. Treatment-seeking behaviour is also influenced by perceived cause, severity of disease,
timing, anticipated cost of seeking treatment and gender, besides the availability of both traditional and conventional
medicines.
