{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:36:10Z","timestamp":1789518970415,"version":"build-2803163510"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"US Center for Disease Control and Prevention","award":["Cooperative Agreement Number U2R6H000046"],"award-info":[{"award-number":["Cooperative Agreement Number U2R6H000046"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fever in under-five children (U5) is the commonest presenting complaint in general practice and mothers\u2019 recognition is an entry point for fever treatment, including malaria. This study describes rural\u2013urban disparity in fever prevalence in U5, mothers\u2019 malaria knowledge, care-seeking, testing for malaria before anti-malarial medication and the associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among 630 mother\u2013child pairs [rural (300) and urban (330)] selected randomly using a multi-stage sampling from 63 villages in Igabi LGA, Kaduna State, Nigeria. Trained female data collectors administered a pre-tested structured questionnaire to collect information on mother\u2013child demographic profiles, malaria knowledge, fever episodes in birth order last child in two weeks prior to survey, blood testing before anti-malarial use, and delayed care-seeking defined as care sought for fever &gt;\u200948\u00a0h of onset. Malaria knowledge was categorized into good, average, and poor if the final scores were \u2265\u200975th, 50th\u201374th, and &lt;\u200950th percentiles, respectively. Frequency, proportions, and odds ratio were calculated. Statistically significant was set at p-value &lt;\u20090.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age (interquartile range) of rural mothers was 30 (IQR, 10) years compared to 27 (IQR, 6) years in urban. Of the 70.0% (441\/629) U5 children with fever, 58.5% (258\/441) were in rural settlements. A third of the mothers whose child had fever sought care. Mothers in rural settlements were 2.8 (adjusted OR: 2.8, CI 1.8\u20134.2, p\u2009&lt;\u20090.01) times more likely to delay care-seeking for fever. Other significant factors were poor or no knowledge of malaria transmission, poor perception of malaria as a major health problem, and household size &gt;\u20095. Also, mothers who had no formal education were four times more likely to receive anti-malarial medications without testing for malaria compared to their educated counterpart (adjusted OR: 4.0, 95% CI 1.6\u20139.9, p\u2009&lt;\u20090.000).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rural\u2013urban disparities existed between fever prevalence in U5 children, care-seeking practices by their mothers, and factors associated with delayed care-seeking and testing the fever for malaria before anti-malarial medication. Fever treatment for high impact malaria elimination in Nigeria needs a context-specific intervention rather than \u2018one-size-fits-all\u2019 approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-020-03371-w","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T09:04:08Z","timestamp":1597741448000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Rural\u2013urban disparities and factors associated with delayed care-seeking and testing for malaria before medication use by mothers of under-five children, Igabi LGA, Kaduna Nigeria"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3468-3527","authenticated-orcid":false,"given":"Obafemi J.","family":"Babalola","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olufemi","family":"Ajumobi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"IkeOluwapo O.","family":"Ajayi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"3371_CR1","volume-title":"World malaria report 2019","author":"WHO","year":"2019","unstructured":"WHO. 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The LGA\u2019s Director of the Primary Health Care granted verbal permission and directed the ward focal persons in charge of the selected settlements to support. Participants were informed of the nature of the survey, benefit and risks, and their right to participate and decline at any time during the interview. A written informed consent was obtained from each respondent before the interview but verbally seek the permission from the household head. Participants were assured of their confidentiality and identified using code numbers.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"294"}}