BMC Public Health 2009, 9:259 http://www.biomedcentral.com/1471-2458/9/259 Results Background characteristics of the mothers A total of 2087 mothers with at least one child under the age of five years were interviewed from 3708 visited households in 18 kebeles. About 44% of the households did not have a woman with a child less than the age of 5 years. Of the total women with at least one child <5 years identified during the survey, almost all participated in the study, representing a response rate of 97.6%. A total of 24 and five women participated in three FGDs and five in- depth interviews, respectively. Table 1 summarizes the background characteristics of the study mothers. Almost all (99.8%) were in the age group of 16–50 years, with a mean (± SD) age of 27 (± 6) years. A significant number of the mothers had no education (86.8%), and almost all (98%) were housewives. The average number of persons per household was 5.9, rang- ing from 2 to 15. The mean (± SD) number of living chil- dren per woman was 4 (± 2.3). The main source of income for most (98.6%) households was subsistence farming and livestock rearing. Almost all (99.1%) of the study Table 1: Background characteristics of mothers, Adami Tulu District, Ethiopia, 2003 Characteristics (n = 2087) Age in years 15–24 25–34 35–44 45–54 Marital status Currently married Widow Divorced or separated Never married (single) Religion Muslim Orthodox Christian Protestant Christian Other Ethnicity Oromo Siltie Gurage Amhara Other Educational status Illiterate Read only Read and write Elementary (grade 1–6) Junior/secondary (grade 7–12) Occupation Housewife Farmer Other N 639 1059 355 34 2035 35 9 8 1902 132 38 15 1905 111 39 12 20 1812 30 37 196 12 2045 38 4 % 30.6 50.8 17.0 1.6 97.5 1.7 0.4 0.4 91.1 6.3 1.8 0.7 91.3 5.3 1.9 0.6 0.9 86.8 1.4 1.8 9.4 0.6 98.0 1.8 0.1 households did not have a toilet facility at the time of the study. Firewood was the main type of fuel used for cook- ing in 89% of the surveyed households. The main source of drinking water included pond (43.7%), pipe water (28%) and river (19.5%). Firewood and water fetching in this community is exclusively conducted by the women and girls. Perceived childhood health problems and their local terminology We solicited information from women about the most common health problems of children in the area. Table 2 lists the Afan Oromo terms and their English equivalents for the common childhood illnesses reported by mothers. Malaria (99%), followed by diarrhea (56.7%) and eye dis- eases (34.3%), were the commonly reported childhood health problems. Mothers who reported malaria as a major health problem among children were further asked why they perceived malaria so, and 57% said that it was a common disease in the area, 54.5% reported that it was very severe and immediately kills a child, 51.5% replied that it mostly affected children, and 0.5% reported that it was incurable. The respondents used the local term busaa to refer to malaria. Busaa is literally translated as malaria, and we use this term in some instances in this paper when referring to malaria to emphasize the local term. Busaa was described as a term that included symptoms such as fever, shivering, chills, headache, back pain, loss of appetite, joint pain and vomiting. Almost all participants in all FGDs and in- depth interviews considered busaa as a serious disease that commonly affects children. No other disease was consid- ered common in the area and more dangerous than malaria as illustrated in the expression stated below. "The most common disease in this area is busaa. First, it makes the body cold, followed by headache and sometimes diarrhea. It is particularly common during this period (October–November) of the year". (FGD, Aneno village). Perceived symptoms and severity of malaria Most mothers knew the symptoms of malaria. Overall, fever (97%), shivering and chills (94.2%), headache (72.1%) and back pain (60.8%) were considered as the most frequent symptoms associated with malaria. Other less frequently mentioned symptoms of malaria included loss of appetite (37.7%), body or joint pain (22.4%), vomiting (11.4%), and diarrhea (3.4%). Very few mothers (<1%) knew none of the symptoms of malaria. It was apparent that most mothers were able to recognize multi- ple symptoms of malaria, and the majority reported two or more symptoms, with 91.8% citing both fever and shiv- ering/chills (Table 3). About 28% of the 2024 interview- ees recognized fever, shivering/chills, headache, back pain Page 4 of 12 (page number not for citation purposes)