A study on presumptive diagnosis and home management of childhood malaria among Nomadic Fulani in Demsa, Nigeria

Abstract

Despite their high level of exposure, vulnerability and uniquely itinerant culture, the local knowledge of the nomadic Fulani population is not taken into account in the development of Nigeria’s home management of malaria policy. Programme-relevant information for extending access to an ethnographic study of factors that nomads use for presumption of malaria in children was collected from dry-season campsites in Demsa Local Government Area of Northeastern Nigeria. Mothers of under-five children with previous experiences at presumptive malaria management from 9 randomly selected nomadic Fulani camps were interviewed. The obtained information was used to develop a guide for key informant interviews of nomadic Fulani cultural consultants and elders, health service providers and policymakers. Findings indicate that nomads presume malaria when a child has “hot body” or lack appetite. Nomads believe that fever accumulates in the body as one steps on wet grounds during the rains. The nascent disease is triggered by the consumption of fruits that resemble the colour of urine such as the light complexioned skin of the Fulani. Fever is therefore regarded as natural affliction of the Fulani for which there is no cure. All fevers are referred to as paboje and expected to go away on the third recrudescence. Fever that persists after the third recurrence is called djonte which is treated at home without health facility support. Besides physical accessibility, the unfriendliness and lack of respect of health personnel for nomadic Fulani culture were reasons for avoiding health facilities. These factors encourage home management of djonte with antimalaria on the presumption that they are all malaria-induced. The nomads are willing to participate in interventions that will improve management of fevers and malaria among them. Although this preliminary study provides the foundation for appreciating the basis of home management of malaria among the nomads, complementary quantitative information will be required for holistic understanding of how these factors may interrelate to influence malaria intervention programme for the nomadic Fulani.