ArticleMalaria journal2025
Predictors and characteristics of malaria treatment-seeking in Malawi: a longitudinal cohort study.
Article in Malaria journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
backgroundPrompt diagnosis and treatment are essential for malaria control but are typically assessed only among children under five. Older children and adults also experience malaria and may act as reservoirs for transmission but barriers such as distance to facilities, supply shortages, and mistrust of the health system limit access to care across age groups. This study aimed to determine how demographic and parasitological factors influence treatment-seeking behaviour over time.
methodsA community-based, open-enrollment longitudinal cohort study was conducted in rural Malawi from April 2019 to May 2020. Data were collected during monthly scheduled active case detection (ACD) visits and passive case detection (PCD) visits at local health centres. Malaria-related treatment-seeking behaviour was assessed using two outcomes: (1) self-reported treatment-seeking between ACD visits and (2) attendance at study-linked health centres during illness. Treatment-seeking was categorized as occurring in the formal or informal sectors. Mixed-effects logistic regression models were used to identify predictors of formal-sector treatment-seeking and health centre attendance, adjusting for clustering at the individual and household levels. Poisson regression was used to estimate rate ratios of PCD visits per person-year.
resultsThe study enrolled 962 participants who contributed 7293 total visits, including 6794 ACD and 499 PCD visits. Most reported treatment-seeking (82%, 720/880 visits) occurred in the formal health sector and longer walking time and higher household head education were associated with reduced odds of formal treatment-seeking (OR = 0.28 for > 90 min vs. < 30 min; OR = 0.41 for secondary education vs. no education). In longitudinal models, older age, male sex, and greater distance to the facility were consistently associated with lower odds of attending PCD visits. Fever was positively associated with subsequent PCD visits (OR = 1.60(1.16-2.21)), but Plasmodium falciparum infection and parasite density were not. The overall PCD visit rate was 70 per 100 person-years and was significantly lower among older children, adults, males, and households farther from health facilities.
conclusionsDespite free access to malaria care, barriers to treatment persist. These findings highlight the need for more equitable, community-based approaches to malaria diagnosis and treatment across all age groups.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.