scholarly journals Determinants of treatment-seeking behavior during self-reported febrile illness episodes using the socio-ecological model in Kilombero District, Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Caroline M. Mburu ◽  
Salome A. Bukachi ◽  
Khamati Shilabukha ◽  
Kathrin H. Tokpa ◽  
Mangi Ezekiel ◽  
...  

Abstract Background Febrile diseases in Sub-Saharan Africa cause acute and chronic illness. Co-infections are common and these diseases have a complex etiology that includes zoonoses. For the implementation of appropriate treatment and control strategies, determinants of lay treatment-seeking behavior by the affected communities need to be understood. The objective of this study was to explore, using the socio-ecological model, the determinants of treatment-seeking actions among self-identified febrile illness cases in the Kilombero District of Tanzania. Methods Thirty-nine in-depth interviews were conducted with 28 men and 11 women in three villages in Kilombero district. These villages were purposively selected due to malaria endemicity in the area, animal husbandry practices, and proximity to livestock-wildlife interaction, all risk factors for contracting febrile zoonotic infections. Thematic analysis was conducted on the interviews to identify the key determinants of treatment-seeking actions. Results Study participants attributed febrile illnesses to malaria, typhoid and urinary tract infections. Treatment-seeking behavior was an iterative process, influenced by individual, socio-cultural, ecological and policy factors. Age, expendable income, previous history with a febrile illness, perceptions on disease severity, seasonal livelihood activities and access to timely healthcare were some of the determinants. Self-treatment with pharmaceutical drugs and herbs was usually the initial course of action. Formal healthcare was sought only when self-treatment failed and traditional healers were consulted after the perceived failure of conventional treatment. Delays in seeking appropriate health care and the consultation of medically unqualified individuals was very common. Conclusion The results imply that treatment-seeking behavior is shaped by multiple factors across all levels of the socio-ecological model. Public policy efforts need to focus on facilitating prompt health care seeking through community education on the complicated etiology of febrile illnesses. Improved access to timely treatment and better differential diagnostics by health professionals are essential to ensure correct and appropriate treatment and to reduce reliance of patients on unqualified persons.

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 398
Author(s):  
Urbane ◽  
Likopa ◽  
Gardovska ◽  
Pavare

Background and objectives: Fever in children is one of the most common reasons for seeking medical attention. Parents often have misconceptions about the effects to fever, which leads to inappropriate use of medication and nonurgent visits to emergency departments (ED). The aim of this study was to clarify the beliefs on the effects and management of fever and to identify healthcare seeking patterns among parents of febrile children in Latvia. Materials and Methods: Parents and legal guardians of children attending ED with febrile illness were included in the study. Participants were recruited in Children’s Clinical University Hospital (CCUH) in Riga, and in six regional hospitals in Latvia. Data on beliefs about fever, administration of antipyretics, healthcare-seeking behavior, and experience in communication with health care workers were collected via questionnaire. Results: In total, 355 participants were enrolled: 199 in CCUH and 156 in regional hospitals; 59.2% of participants considered fever itself as indicative of serious illness and 92.8% believed it could raise the child’s body temperature up to a dangerous level. Antipyretics were usually administered at median temperature of 38.0 °C, and the median temperature believed to be dangerous was 39.7 °C; 56.7% of parents usually contacted a doctor within the first 24 h of the illness. Parents who believed that lower temperatures are dangerous to a child were more likely to contact a doctor earlier and out-of-hours; 60.1% of participants had contacted their family doctor prior their visit to ED. Parental evaluation of satisfaction with the information and reassurance provided by the doctors at the hospital was higher than of that provided by their family doctor; 68.2% of participants felt safer when their febrile children were treated at the hospital. Conclusions: Fever itself was regarded as indicative of serious illness and potentially dangerous to the child’s life. These misconceptions lead to inappropriate administration of antipyretics and early-seeking of medical attention, even out-of-hours. Hospital environment was viewed as safer and more reassuring when dealing with febrile illness in children. More emphasis must be placed on parental education on proper management of fever, especially in primary care


2020 ◽  
Author(s):  
Zemene Tigabu Kebede ◽  
Kassahun Alemu Gelaye ◽  
Mehari Woldemariam Merid ◽  
Temesgen Yihunie Akalu ◽  
Ashenafi Tazebew Amare ◽  
...  

Abstract Background: In most developing countries, childhood illness and deaths are among the most challenging health issues. Most of these deaths were due to preventable causes including acute respiratory infections (ARI), diarrhea, and febrile illnesses. Thus, identification of determinants of childhood illness would help to guide strategic planning and prioritize interventions.Method: Community based cross-sectional study was conducted. A two-stage cluster sampling technique was used to select households and mothers/caregivers. A total of 2,158 mothers with at least one under-five child were included. Mothers were interviewed at their homes using structured questionnaire. Adjusted Odds Ratio with a 95% Confidence Interval and P-value <0.05 in the multivariable model were reported to show the significance and direction of association.Result: The overall prevalence of childhood illnesses was 16.5% (95% CI: 15.0, 18.2). Of all, 6.5% (95% CI: 5.5, 6.72), 7.5% (95% CI: 6.5, 8.76), and 12.0% (95% CI: 10.66, 13.40) had diarrhea, ARI, and fever, respectively. The treatment-seeking behavior of mothers/care-givers for any of the childhood illness was 22.7% (18.72, 27.42). The odds of childhood illness was higher among mothers’ age 15-19 years (AOR=2.87-; 95% CI: 1.33, 6.13), employed mothers’ (AOR=2.28; 95%CI: 1.84, 4.39), living far away from nearest health center (AOR=1.02; 95%CI: 1.01, 1.03), two under-five children (AOR=1.33;95%CI: 1.029,1.74) and three or more children in the house (AOR=2.70; 95%CI: 1.12, 6.53). About 22.8% (95% CI: 18.7, 27.4) of mothers/caregivers sought health care. Mothers’ occupation (AOR= 4.08 (95% CI: 1.35, 12.39) was the only independent predictor of treatment-seeking behavior.Conclusion: In this study, common childhood illnesses remain high while the treatment-seeking behavior of the mothers’/caregivers’ was low. Mothers’ age, occupation, distance from the nearest health center, and two or more children in the house were independent factors of childhood illness. Being a skilled/semi-skilled mothers was significantly associated with health-seeking behavior of mothers/caregivers. Thus, involving women in skilled/semi-skilled occupations would help in decreasing childhood illness and enhance health-seeking behaviors for their under-five children. Besides, providing access to health care facilities in their nearby area would be essential in reducing childhood illness.


2020 ◽  
Author(s):  
Zemene Tigabu Kebede ◽  
Kassahun Alemu Gelaye ◽  
Mehari Woldemariam Merid ◽  
Temesgen Yihunie Akalu ◽  
Ashenafi Tazebew Amare ◽  
...  

Abstract Background: In most developing countries, childhood illness and deaths are among the most challenging health issues. Most of these deaths were due to preventable causes including acute respiratory infections (ARI), diarrhea, and febrile illnesses. Thus, the identification of determinants of this childhood illness would help to guide strategic planning and prioritize interventions.Method: Community based cross-sectional study was conducted. A two-stage cluster sampling technique was used to select households and mothers/caregivers. A total of 2,158 mothers with at least one under-five child were included. Mothers were interviewed at their homes using structured questionnaire. Adjusted Odds Ratio with a 95% Confidence Interval for variables with P-value <0.05 in the multivariable model were reported to show the significance and the direction of association.Result: The overall prevalence of childhood illnesses was 16.5% (95% CI: 15.0, 18.2). Of all, 6.5% (95% CI: 5.5, 6.72), 7.5% (95% CI: 6.5, 8.76), and 12.0% (95% CI: 10.66, 13.40) had diarrhea, ARI, and fever, respectively. The treatment-seeking behavior of mothers/care-givers for any of the childhood illness was 22.7% (18.72, 27.42). The odds of childhood illness was higher among mothers’ age 15-19 years (AOR=2.87-; 95% CI: 1.33, 6.13), employed mothers’ (AOR=2.28; 95%CI: 1.84, 4.39), living far away from nearest health center (AOR=1.02; 95%CI: 1.01, 1.03), two under-five children (AOR=1.33;95%CI: 1.029,1.74) and three or more children in the house (AOR=2.70; 95%CI: 1.12, 6.53). About 22.8% (95% CI: 18.7, 27.4) of mothers/caregivers sought health care. Mothers’ occupation (AOR= 4.08 (95% CI: 1.35, 12.39) was the only independent predictor of treatment-seeking behavior.Conclusion: In this study, common childhood illnesses remain high while the treatment-seeking behavior of the mothers’/caregivers’ was low. Mothers’ age, occupation, distance from the nearest health center, and two or more children in the house were independent factors of childhood illness. Being a skilled/semi-skilled mothers was significantly associated with health-seeking behavior of mothers/caregivers. Thus, involving women in skilled/semi-skilled occupations would help in decreasing childhood illness and enhance health-seeking behaviors for their under-five children. Besides, providing access to health care facilities in their nearby area would be essential in reducing childhood illness.


2016 ◽  
Vol 5 (2) ◽  
pp. 65-70
Author(s):  
Poonam P Shingade ◽  
Yasmeen Kazi ◽  
Madhavi LH

Sexually Transmitted Infections/Reproductive Tract Infections (STIs/RTIs) are a major public health problem and a leading cause of morbidity among men and women in developing countries. The aim of the study is to explore treatment seeking behavior among the married women of reproductive age presented with symptoms of STI/RTI. A hospital-based observational study was carried out at the STI/RTI Clinic of Urban Health Centre, Shivaji Nagar, Govandi, Mumbai, India. The study involved a total of 273 married females who attended clinic for their symptoms during January to March 2012. Patients were interviewed using a pretested questionnaire to explore the detail of the treatment seeking behavior regarding STIs/RTIs. Out of total women who participated in the study, only 47.6% of the women with STIs/RTIs symptoms sought health care. Among those who did not seek treatment, 58.65 % females were belonging to 21-25 years of age group. Maximum 65.6% females who were illiterate had not sought any treatment for symptoms of these diseases as compared to 65% who had taken treatment for the presented symptoms who were educated up to higher secondary and above level. 62.5% females belonging to class V had never sought treatment as compared to 100% women who were classified to class I. The poor health seeking behavior was associated with literacy and socioeconomic class of the participants. Private sector was the most favored place for taking treatment by them. Commonest reason for not seeking treatment was no female doctor at clinic. Information, Education and Communication (IEC) sessions, about STI symptoms and the benefits of treat-ment, especially targeted at women and low socioeconomic groups might be an immediately feasible measure that will help to reduce the burden of the disease.South East Asia Journal of Public Health Vol.5(2) 2015: 65-70


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