© Kamla-Raj 2004 J. Hum. Ecol., 15(3): 195-197 (2004) Health Seeking Behavior Among the Fever Cases During an Outbreak of Malaria in Assam P.K. Borah, P. Dutta, A.C. Phukan and J. Mahanta INTRODUCTION Malaria is a major public health problem with an incidence of 300-500 million cases causing 1.5-2.7 million deaths annually (WHO, 1996). Knowledge, community perception regarding causation and spread of disease, its prevention and health seeking behavior of the public during the morbidity episodes especially fever (Aggarwal et al., 2001) and outbreak situation are some important facets in the control strategy of malaria. An outbreak causes panic reaction among the people and influences their health seeking behavior due to some factors inherently associated with the community. During the outbreak patient load increases in the public health facility and it is further accentuated by panic reaction. Some health seeking behavior may adversely affect the course of ongoing outbreak by causing inadequate treatment and failure, drug toxicity, drug resistance and development of complications from malaria. Further inadequate treatment increases the reservoir of parasite in the community. The present study was done to have an insight into the fever cases attending the out patient department (OPD) of a primary health centre (PHC) and State Dispensary of Nagaon district for seeking medical help regarding knowledge and treatment-seeking behavior. MATERIALS AND METHODS The present study was carried out in the month of June 2002 during malaria out break in two malarious areas of Nagaon district, Assam. A total of 184 acute febrile patients of the district, seeking medical treatment was included in the study. Information regarding knowledge, health- seeking behavior of either the patients or any adult member accompanying the patients in case of minor along with other relevant data was recorded in a predesigned proforma. Peripheral blood smear as thick and thin blood film were prepared and stained by J.S.B.-1 and J.S.B.-2 stain for microscopical examination. RESULTS The present study revealed that a major fraction (95.7%) of the study subjects were aware about the outbreak of malaria. Out of 184, 63.0% and 32.6% recognized fever and fever with chill respectively as of malaria symptoms. Only 57.6% knew that malaria is caused by the bite of the mosquito. 64.1% out of 184 used mosquito net. About 60.3% of the patients directly came to the public health facility, seeking remedy and 16.3% of patients treated themselves by taking drugs from local pharmacy and 23.4% sought treatment from untrained village level practi- tioners (UVLP) and traditional practitioners (Table 1). Table 1: Knowledge and health seeking behavior of acute febrile patients attending the hospital. Parameters No (%) i. FCT in OPD: 184 (100.0) ii. Aware About Malaria: 176 (95.7) iii. Symptoms of Malaria: Malaria causes fever 116(63.0) Malaria causes fever with chill 60(32.6) Do not know 8(4.4) iv. Cause of the Disease: By the bite of mosquito 106(57.6) Others 70(38.0) v. Use of Mosquito net to Prevent Mosquito Bite: Yes 118(64.1) No 66(35.9) vi. Seek Treatment From: Public health facility 111(60.3) Local pharmacy 30(16.3) UVLP 36(19.6) Traditional 7(3.8) FCT: Fever cases treated; OPD: Out patient department UVLP: Untrained village level practitioner The Table 2 showed an overall SPR of about 33.2% and the slide positive rate in relation to age, sex and community. Higher SPR was observed in the age group of >10-15 years, female subjects and in the tea garden workers community followed by tribal population. The