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Background The World Health Organisation currently recommends the use of artemisinin-based combination drugs for treatment of uncomplicated malaria in high malaria endemic regions. However, comprehensive understanding of factors affecting treatment of malaria with antimalarials is lacking in many rural communities in Africa. This study seeks to test the following hypothesise: 1. That socio-economic and demographic factors at the household level affect treatment of self reported malaria/fever with antimalarials in the Kilombero/Ulanga and Rufiji valleys in Tanzania 2. Distance of a household to a health facility affects treatment of malaria/fever with antimalarials in the Kilombero/Ulanga and Rufiji valleys in Tanzania. Methods: Secondary data analysis of a cross- sectional household survey on antimalarials carried out in 2005 in the Kilombero/Ulanga and Rufiji valleys in Tanzania. Georeferenced health facilities and households’ datasets from the Rufiji and Ifakara demographic surveillance systems sites were also used to estimate distance variables. Results: Out of a total of 1433 participants who reported malaria/fever, 32% (95% CI: 29.29, 34.89) obtained treatment with antimalarials. Among them, 36% obtained treatment with Sulfadoxine Pyreminthamine (SP) as a monotherapy and 44% treated malaria/fever with SP and Artesunate as a combination therapy.8% used quinine while 11 % used Amodiaquine and Artesunate. The remaining 1% used chloroquine. After adjusting for all confounding variables in a multivariate survey logistic regression model, age group, education level of the household head and district of residence were found, with statistical evidence, to be associated with treatment of reported malaria/fever with antimalarials. Background The World Health Organisation currently recommends the use of artemisinin-based combination drugs for treatment of uncomplicated malaria in high malaria endemic regions. However, comprehensive understanding of factors affecting treatment of malaria with antimalarials is lacking in many rural communities in Africa. This study seeks to test the following hypothesise: 1. That socio-economic and demographic factors at the household level affect treatment of self reported malaria/fever with antimalarials in the Kilombero/Ulanga and Rufiji valleys in Tanzania 2. Distance of a household to a health facility affects treatment of malaria/fever with antimalarials in the Kilombero/Ulanga and Rufiji valleys in Tanzania. Methods: Secondary data analysis of a cross- sectional household survey on antimalarials carried out in 2005 in the Kilombero/Ulanga and Rufiji valleys in Tanzania. Georeferenced health facilities and households’ datasets from the Rufiji and Ifakara demographic surveillance systems sites were also used to estimate distance variables. Results: Out of a total of 1433 participants who reported malaria/fever, 32% (95% CI: 29.29, 34.89) obtained treatment with antimalarials. Among them, 36% obtained treatment with Sulfadoxine Pyreminthamine (SP) as a monotherapy and 44% treated malaria/fever with SP and Artesunate as a combination therapy.8% used quinine while 11 % used Amodiaquine and Artesunate. The remaining 1% used chloroquine. After adjusting for all confounding variables in a multivariate survey logistic regression model, age group, education level of the household head and district of residence were found, with statistical evidence, to be associated with treatment of reported malaria/fever with antimalarials. Conclusion: The results suggest that participant’s age, education level of household head and location of district are important predictors of treatment of malaria with antimalarials in rural Tanzania. The implementation of any antimalarials policy in Tanzania would therefore, require a careful consideration of these factors.

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