Published in PLOS One on 2026-07-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Abdulwasiu Akanfe Adegboyega, Abdulakeem Ayanleye Ahmed, Ibrahim Sebutu Bello, Olanrewaju Oloyede Oyegbade, Samuel Ademola Adegoke, Olufemi M. Olubiyi, Temitope Oluwafemi Olajubu, Kolawole Muideen Adewumi, Fatima Adenike Adegoke, Abraham Busola Oluwajuyitan
Source: PLOS One • DOI 10.1371/journal.pone.0354019
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The morbidity and possible consequent mortality resulting from malaria in children are either due to delayed treatment-seeking or preceded by an inappropriate treatment-seeking process. This study aimed to assess the relationship between the pattern of family dynamics and treatment-seeking behaviour of caregivers of under-five children with uncomplicated malaria.
This was a hospital-based cross-sectional study that recruited 350 child-caregiver pairs. An interviewer-administered questionnaire was used for data collection, and it was analysed using the Statistical Package for the Social Sciences (SPSS) software version 25. A p-value of < 0.05 was taken as statistically significant.
The family dynamics of the caregivers revealed that 82.3% of them had strong family support, four-fifths (80.3%) had functional families, and a little over half of them (58.3%) had monthly family incomes that fell below the defined household poverty line. Only 41.7% of the caregivers had appropriate treatment-seeking behaviour. Caregivers from lower-income families had 2.5 times higher odds of exhibiting inappropriate treatment-seeking behaviour compared to those from higher-income families (OR, 2.494; 95% CI, 1.486–4.184; p = 0.001). Caregivers with dysfunctional families were about four times more likely to have inappropriate treatment-seeking behaviour compared to their counterparts with functional families (OR, 3.766; 95% CI, 1.445–9.813, p = 0.007).
Significant inappropriate treatment-seeking behaviour existed among caregivers of under-five children with uncomplicated malaria. Family factors related to inappropriate treatment-seeking behaviour were family income and family functioning. Strengthening the family and counselling on appropriate treatment-seeking is crucial to reducing malaria morbidity and mortality among under-five children.
Introduction
Malaria is one of the most prevalent tropical diseases in the world [1] and it is caused by Plasmodium spp [2]. Most malaria infection in sub-Saharan Africa is caused by P. falciparum, which has a high tendency to cause severe malaria and consequent mortality [3]. Under-five children and pregnant women bear the most burden of the disease, including its severe life-threatening forms, compared to adults, owing to their lower immunity [4]. The WHO, in its 2023 World Malaria Report, ranked Nigeria first in the global malaria burden, contributing 26% of the global malaria cases and being responsible for 31% of the disease’s fatalities [5]. Malaria is the most common reason for childhood admission to Nigerian health facilities [6,7]. Iyanam et al. in Akwa Ibom State, southern Nigeria, observed that 49.8% of under-five presentations in hospitals were due to malaria and were responsible for most hospital admissions when severe [6].
Despite this burden, delayed and inappropriate treatment-seeking behaviours are still a major public health concern among caregivers of children under five with uncomplicated malaria. In a Zambian study, just 42% of caregivers of children under five sought appropriate medical attention within 24 hours of a fever episode [8]. Nigeria has one of the lowest rates of care-seeking for suspected malaria infections in the world, with less than 20% of all feverish children under the age of five being admitted to healthcare facilities for medical evaluation and parasitological testing [9]. According to Sampson and colleagues, in Imo State, South-Eastern Nigeria, only 18.6% of caregivers of children under five who had a fever engaged in appropriate health-seeking behaviour [10] even though it is recommended that appropriate malaria treatment be sought within 24 hours of the appearance of the first symptom [2,11]. However, most caregivers usually fail to meet this timeline.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Abdulwasiu Akanfe Adegboyega, Abdulakeem Ayanleye Ahmed, Ibrahim Sebutu Bello, Olanrewaju Oloyede Oyegbade, Samuel Ademola Adegoke, Olufemi M. Olubiyi, Temitope Oluwafemi Olajubu, Kolawole Muideen Adewumi, Fatima Adenike Adegoke, Abraham Busola Oluwajuyitan. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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