Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey

Omale, Ugwu I.; Oka, Onyinyechukwu U.; Okeke, Ifeyinwa M.; Azuogu, Benedict N.; Alo, Chihurumnanya; Madubueze, Ugochukwu C.; Eze, Irene I.; Okeke, Kingsley C.; Utulu, Rowland; Akpan, Uduak E.; Iloke, Chijioke V.; Nnubia, Anthonia O.; Ibemesi, Desi O.; Nnabu, Chukwuka R.; Anene, Ogechukwu C.

doi:10.1186/s12913-021-06865-8

Table 3 Factors associated with the demand for MRDT among participants¹

From: Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey

Factors	The use of MRDT				The request for MRDT
Factors	cOR (95% CI)	p-value	aOR (95% CI)	p-value	cOR (95% CI)	p-value	aOR (95% CI)	p-value
Children under 5 years of age
Age group (months)		0.2752^A		0.1566^A		0.0783^A		0.0892^A
< 12	1.0	–	1.0	–	1.0	–	1.0	–
12–23	1.3 (0.8–2.1	0.227	1.3 (0.8–2.1)	0.230	7.5 (1.7–33.5)	0.009	8.5 (1.8–40.8)	0.007
24–35	1.5 (0.9–2.2)	0.061	1.6 (1.0–2.4)	0.037	4.4 (0.9–19.5)	0.051	6.7 (1.4–32.1)	0.017
36–47	1.1 (0.7–1.7)	0.582	1.1 (0.7–1.7)	0.643	3.9 (0.8–17.8)	0.073	4.8 (1.0–22.5)	0.049
48–59	1.2 (0.8–1.8)	0.463	1.2 (0.8–1.8)	0.419	4.5 (1.0–19.7)	0.049	5.7 (1.2–26.8)	0.027
Sex		–		–		–		–
Male	1.3 (1.0–1.5)	0.030	1.2 (0.9–1.5	0.060	1.5 (0.9–2.4)	0.121	1.4 (0.8–2.4)	0.184
Female	1.0	–	1.0	–	1.0	–	1.0	–
Educ. level of resp³		0.0155^A		0.0550^A		0.0012^A		0.2705^A
No education	1.0	–	1.0	–	1.0	–	1.0	–
Primary	0.9 (0.7–1.4)	0.991	0.9 (0.6–1.3)	0.502	1.04 (0.4–2.6)	0.931	0.8 (0.3–2.1)	0.645
Secondary	1.2 (0.8–1.7)	0.218	1.1 (0.7–1.6)	0.645	2.3 (0.9–5.3)	0.056	1.3 (0.5–3.4)	0.595
Tertiary	2.1 (1.2–3.6)	0.008	2.0 (1.0–4.0)	0.041	4.4 (1.6–12.1)	0.005	2.2 (0.6–8.0)	0.234
Occupation of resp³		0.0058^A		0.0281^A		0.0011^A		0.2142^A
Farmer	1.0	–	1.0	–	1.0	–	1.0	–
Trader	1.4 (1.1–1.8)	0.007	1.3 (0.9–1.7)	0.065	2.3 (1.3–4.2)	0.007	1.9 (0.9–3.8)	0.050
Teacher	1.8 (0.9–3.3)	0.056	1.1 (0.5–2.1)	0.900	4.8 (1.7–13.2)	0.003	1.9 (0.5–6.9)	0.322
Civil servant	1.4 (0.7–2.9)	0.373	0.8 (0.3–1.9)	0.638	6.8 (2.0–23.1)	0.002	3.9 (0.8–17.0)	0.073
Others*	0.8 (0.6–1.2)	0.286	0.7 (0.5–1.1)	0.100	3.3 (1.5–7.2)	0.003	2.3 (0.9–5.4)	0.064
Knowledge/opinion⁴ of respondent³		0.0050^A		0.0254^A		0.0025^A		0.0397^A
Poor	1.0	–	1.0	–	1.0	–	1.0	–
Fair	2.0 (1.3–3.1)	0.002	1.8 (1.2–2.9)	0.008	1.9 (0.4–8.1)	0.413	1.2 (0.3–5.5)	0.822
Good	2.1 (1.3–3.3)	0.001	1.8 (1.2–2.9)	0.011	4.1 (0.9–17.7)	0.062	2.3 (0.5–10.6)	0.292
Children ages 5 yrs. & above & adults²
Age group (years)		0.0643^A		0.5723^A		0.4673^A		0.6065^A
5–14	1.4 (1.1–1.9)	0.021	1.03 (0.7–1.4)	0.838	2.0 (0.9–4.5)	0.108	1.2 (0.5–3.0)	0.651
15–24	1.2 (0.8–1.7)	0.328	0.9 (0.6–1.4)	0.785	2.1 (0.8–5.1)	0.114	1.4 (0.5–3.6)	0.495
25–34	1.4 (0.9–2.1)	0.084	0.9 (0.6–1.5)	0.913	1.5 (0.5–4.1)	0.427	0.8 (0.3–2.3)	0.679
35–44	1.3 (0.8–1.9)	0.234	0.8 (0.6–1.3)	0.561	2.4 (0.9–6.4)	0.079	1.8 (0.6–4.9)	0.288
45–54	0.9 (0.6–1.4)	0.684	0.7 (0.5–1.1)	0.169	1.3 (0.4–4.3)	0.696	1.03 (0.3–3.7)	0.962
> =55	1.0	–	1.0	–	1.0	–	1.0	–
Sex		–		–		–		–
Male	1.04 (0.8–1.2)	0.705	0.9 (0.8–1.2)	0.953	1.03 (0.7–1.5)	0.864	1.04 (0.7–1.6)	0.868
Female	1.0	–	1.0	–	1.0	–	1.0	–
Educ. level of resp³		< 0.0001^A		0.0001^A		< 0.0001^A		0.0001^A
No education	1.0	–	1.0	–	1.0	–	1.0	–
Primary	1.2 (0.9–1.6)	0.050	1.1 (0.9–1.4)	0.340	1.02 (0.5–1.9)	0.953	0.9 (0.4–1.7)	0.670
Secondary	1.7 (1.4–2.1)	< 0.001	1.4 (1.1–1.8)	0.018	2.7 (1.5–4.8)	0.001	2.3 (1.2–4.5)	0.018
Tertiary	3.8 (2.6–5.5)	< 0.001	2.9 (1.8–4.7)	< 0.001	5.1 (2.6–9.9)	< 0.001	3.9 (1.6–9.3)	0.002
Occupation of resp³		< 0.0001^A		0.0112^A		0.0006^A		0.8112^A
Farmer	1.0	–	1.0	–	1.0	–	1.0	–
Trader	1.6 (1.3–1.9)	< 0.001	1.3 (1.1–1.6)	0.014	1.4 (0.9–2.2)	0.148	1.04 (0.6–1.7)	0.867
Teacher	2.5 (1.5–4.2)	0.001	1.1 (0.6–2.0)	0.751	3.1 (1.3–7.2)	0.008	1.1 (0.4–3.0)	0.816
Civil servant	2.8 (1.7–4.5)	< 0.001	1.2 (0.7–2.2)	0.479	3.9 (1.9–8.3)	< 0.001	1.3 (0.5–3.2)	0.640
Others*	1.1 (0.8–1.4)	0.745	0.8 (0.5–1.1)	0.119	2.2 (1.2–4.2)	0.016	1.5 (0.8–3.1)	0.240
Knowledge/opinion⁴ of resp³		< 0.0001^A		< 0.0001^A		0.0238^A		0.1671^A
Poor	1.0	–	1.0	–	1.0	–	1.0	–
Fair	2.8 (2.0–3.8)	< 0.001	2.5 (1.8–3.4)	< 0.001	3.1 (0.9–10.2)	0.064	3.0 (0.9–10.3)	0.072
Good	3.2 (2.3–4.5)	< 0.001	2.5 (1.8–3.5)	< 0.001	4.4 (1.3–14.4)	0.016	3.3 (0.9–11.2)	0.059

cOR = crude odds ratio from bivariate logistic regression. aOR = adjusted odds ratio from multivariate logistic regression controlling for the other factors (age group, sex, educational level, occupation, and knowledge/opinion level). ^Ap-value from overall test for the effect of the independent variables (using the postestimation test command in Stata). * Mainly include hair dressers, tailors, house wives, and students. ¹Children and adults (excluding pregnant women) with reported fever/malaria-like illness in the two weeks preceding a survey. ²Adults excluding pregnant women. ³Respondent female heads of households (the mother of the house or female primary care giver). ⁴Knowledge and opinion level of survey respondents about malaria and malaria diagnosis (knowledge and opinion score of < 50 was poor knowledge, 50–< 70 was fair, > = 70 was good)

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