Prevalence and Factors Associated with Prompt Diagnosis and Treatment of Fever among Under-five Children in Zambia; Evidence from a Country-wide Cross-Sectional Survey.

Introduction: Prompt diagnosis and appropriate treatment of fever can prevent severe disease and mortality. Delayed diagnosis and treatment of infections contribute significantly to the high under-five mortality ratio, especially in sub-Saharan Africa. This study assessed the prevalence and associated factors to prompt diagnosis and treatment of fever among under-five children in Zambia. Methods: The study used secondary data from the Malaria Indicator Survey of 2021. Descriptive statistics using measures of frequencies, medians and interquartile ranges were done, and cross-tabulations and logistic regression were used to assess measures of association. The significance level was set at a P-value of 0.05 and a confidence level of 95%. The data was analysed in STATA 14.  Results: A total of 3003 under-five children were included; 728 (19.5%) had a fever in the two weeks preceding the survey. The prevalence of prompt health-seeking behaviour was 57.3%, which raises concerns that 42.7% of the children with fever did not have prompt treatment within the same or the next day of fever onset. Male sex aOR = 1.52 (95%CI 1.10 – 2.12) and the use of IRS aOR 1.8(1.30 – 2.50) were associated with increased odds of prompt health-seeking behaviour. Conclusion:  This study found that the prevalence of fever among under-five children in Zambia was comparable to other sub-Saharan African countries. Health-seeking behaviour among children with fever was sub-optimal, as a considerable proportion did not seek treatment. Factors associated with health-seeking behaviour among children with fever included sex and staying in a house with indoor residual spraying.