{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:27:35Z","timestamp":1780637255297,"version":"3.54.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In Cameroon, malaria contributes significantly to the morbidity and mortality of children under 5\u00a0years old. In order to encourage adequate treatment-seeking in health facilities, user fee exemptions for malaria treatment have been instituted. However, many children are still brought to health facilities in the late stage of severe malaria. This study sought to determine the factors affecting the hospital treatment-seeking time of guardians of children under 5\u00a0years within the context of this user fee exemption.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a cross-sectional study conducted at three randomly selected health facilities of the Buea Health District. A pre-tested questionnaire was used to collect data on the treatment-seeking behaviour and time of guardians, as well as potential predictors of this time. Hospital treatment sought after 24\u00a0h of noticing symptoms was denoted as delayed. Continuous variables were described using medians while categorical variables were described using percentages. A multivariate regression analysis was used to determine the factors affecting malaria treatment-seeking time of guardians. All statistical tests were done at a 95% confidence interval.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Most of the guardians made use of pre-hospital treatments, with self-medication being practiced by 39.7% (95% CI 35.1\u201344.3%) of them. A total of 193 (49.5%) guardians delayed seeking treatment at health facilities. Reasons for delay included financial constraints and watchful waiting at home, during which guardians waited and hoped their child could get better without requiring medicines. Guardians with estimated monthly household incomes denoted as low\/middle were significantly more likely (AOR 3.794; 95% CI 2.125\u20136.774) to delay seeking hospital treatment. The occupation of guardians was another significant determinant of treatment-seeking time (AOR 0.042; 95% CI 0.003\u20130.607). Also, guardians with tertiary education were less likely (AOR 0.315; 95% CI 0.107\u20130.927) to delay seeking hospital treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study suggests that despite user fee exemption, other factors such as educational and income levels of guardians affect malaria treatment-seeking time for children aged under five. Therefore, these factors should be considered when enacting policies aimed at increasing access of children to health facilities.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12936-023-04509-2","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T17:03:07Z","timestamp":1681405387000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["User fee exemption and malaria treatment-seeking for children under five in a Cameroonian health district: a cross-sectional study"],"prefix":"10.1186","volume":"22","author":[{"given":"Rolf Nyah Tuku","family":"Nzalie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Ngunde","family":"Palle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dickson Shey","family":"Nsagha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"4509_CR1","unstructured":"WHO. 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Administrative authorizations were obtained from the South West Regional Delegation of Public Health and the authorities of the various health facilities. The purpose of the study and the role of participants were explained in the information sheet and consent form. The questionnaire was then administered only after a potential participant had understood and signed the consent form. Participants were informed of their right to withdraw from the study whenever they deemed necessary.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there is no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"124"}}