scholarly journals The use of respondent‑driven sampling to assess febrile illness treatment-seeking behaviours among forest-goers in Cambodia and Vietnam

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mahesh Paudel ◽  
Kemi Tesfazghi ◽  
Hoa Nguyen ◽  
Sochea Phok ◽  
Shwetha Srinivasan ◽  
...  
Keyword(s):  
Private Sector ◽  
Malaria Elimination ◽  
Febrile Illness ◽  
Diagnosis And Treatment ◽  
Treatment Seeking ◽  
Respondent Driven Sampling ◽  
Public Facility ◽  
Healthcare Seeking ◽  
Populations At Risk ◽  
Increased Risk

Abstract Background Countries in the Greater Mekong sub-region (GMS) aim to eliminate all forms of malaria by 2030. In Cambodia and Vietnam, forest-goers are at an increased risk of malaria. Universal access to prompt diagnosis and treatment is a core malaria intervention. This can only be achieved by understanding the healthcare-seeking behaviour among the most vulnerable groups and eliminating barriers to prompt and effective treatment. This study aimed to explore healthcare-seeking behaviours for febrile illness among populations at risk for malaria in Cambodia and Vietnam. Methods In 2019, researchers from Population Services International (PSI) conducted a population-based survey of forest-goers in Cambodia and Vietnam using respondent-driven sampling (RDS) In Cambodia two operational districts, Oral and Phnom Srouch in Kampong Speu Province were included in the study. In Vietnam, communes located within 15 km of the forest edge in Binh Phuoc and Gia Lai Provinces were selected. Adults who had spent at least one night per week or four nights per month in the forest over the previous three months were eligible for the study. Results Some 75% of forest-goers in Cambodia and 65% in Vietnam sought treatment for illness outside the home. In Cambodia, 39% sought treatment from the private sector, 32% from community health workers, and 24% from public health facilities. In Vietnam, 62% sought care from community facilities, 29.3% from the private sector, and 6.9% went to a public facility. Among forest-goers who sought care, 33% in Cambodia and 52% in Vietnam did so within 24 h. Conclusions This study is consistent with others that show that early diagnosis and treatment of malaria remains an obstacle to malaria elimination. This study also demonstrates that there are gaps in timeliness of care seeking among forest-goers. The findings from this study around provider preference and delays in treatment-seeking can be used to strengthen the design and targeting of malaria interventions and social and behaviour change strategies to accelerate malaria elimination in Cambodia and Vietnam.

scholarly journals The Use of Respondent-Driven Sampling To Assess Febrile Illness Treatment-Seeking Behaviors Among Forest Goers in Cambodia and Vietnam

2021 ◽  
Author(s):  
Mahesh Paudel ◽  
Kemi Tesfazghi ◽  
Hoa Nguyen ◽  
Sochea Phok ◽  
Shwetha Sriniva ◽  
...  
Keyword(s):  
Private Sector ◽  
Malaria Elimination ◽  
Febrile Illness ◽  
Diagnosis And Treatment ◽  
Treatment Seeking ◽  
Respondent Driven Sampling ◽  
Public Facility ◽  
Health Seeking ◽  
Health Seeking Behaviors ◽  
Study Results

Abstract Background Countries in the Greater Mekong Subregion (GMS) aim to eliminate all forms of malaria by 2030. In Cambodia and Vietnam Forest goers are at highest risk of malaria. Universal access to prompt diagnosis and treatment is a core malaria intervention. This can only be achieved by understanding the health seeking behaviors among the most vulnerable groups and eliminating the barriers to prompt and effective treatment. This study aimed to improve understanding by exploring health seeking behaviors for febrile illness among populations at risk for malaria in Cambodia and Vietnam. Methods In 2019, researchers from Population Services International (PSI) conducted a population-based survey of forest goers in Cambodia and Vietnam using respondent-driven sampling (RDS). In Cambodia two operational districts, Oral and Phnom Srouch, in Kampong Speu Province were included in the study. In Vietnam, communes located within 15 km of the forest edge in Binh Phuoc and Gia Lai provinces were selected. Adults who had spent at least one night per week or four nights per month in the forest over the past three months were considered potential participants for the study. Results 75% in Cambodia and 65% in Viet Nam of forest goers sought treatment outside the home for illness. In Cambodia 39% sought treatment from the private sector, 32%, from community health workers and 24% from public health facilities. In Vietnam, 62% sought care from community facilities, 29.3% from the private sector and 6.9% went to a public facility. Amongst forest goers who sought care, 33% in Cambodia and 52% in Vietnam did so within 24 hours. Conclusions This study is consistent with others that show that early diagnosis and treatment of malaria remains an obstacle to malaria elimination. This study also demonstrates that there are gaps in timeliness of care seeking amongst forest goers. The findings from this study around provider preference and delays in treatment seeking behaviors can be utilized to strengthen the design and targeting of malaria interventions and social behavior change strategies in order to accelerate malaria elimination in Cambodia and Vietnam.

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 ◽  
...  
Keyword(s):  
Health Care ◽  
Ecological Model ◽  
Febrile Illness ◽  
Sub Saharan Africa ◽  
Differential Diagnostics ◽  
Treatment Seeking ◽  
Zoonotic Infections ◽  
Appropriate Treatment ◽  
Seeking Behavior ◽  
Tract Infections

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.

Risk factors for heat-related illnesses during the Hajj mass gathering: an expert review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Saber Yezli
Keyword(s):  
Preventive Measures ◽  
Febrile Illness ◽  
Mass Gatherings ◽  
Expert Review ◽  
Hot Environment ◽  
Increased Risk ◽  
Modifiable Factors ◽  
Life Threatening ◽  
Nutrition And Hydration ◽  
And Behavior

Abstract Human exposure to a hot environment may result in various heat-related illnesses (HRIs), which range in severity from mild and moderate forms to life-threatening heatstroke. The Hajj is one of the largest annual mass gatherings globally and has historically been associated with HRIs. Hajj attracts over two million Muslim pilgrims from more than 180 countries to the holy city of Makkah, Kingdom of Saudi Arabia. Several modifiable and non-modifiable factors render Hajj pilgrims at increased risk of developing HRIs during Hajj. These include characteristics of the Hajj, its location, population, and rituals, as well as pilgrims’ knowledge of HRIs and their attitude and behavior. Makkah is characterized by a hot desert climate and fluctuating levels of relative humidity. Pilgrims are very diverse ethnically and geographically, with different adaptations to heat. Significant proportions of the Hajj population are elderly, obese, and with low levels of fitness. In addition, many have underlying health conditions and are on multiple medications that can interfere with thermoregulation. Other factors are inherent in the Hajj and its activities, including crowding, physically demanding outdoor rituals, and a high frequency of infection and febrile illness. Pilgrims generally lack awareness of HRIs, and their uptake of preventive measures is variable. In addition, many engage in hazardous behaviors that increase their risk of HRIs. These include performing rituals during the peak sunshine hours with no sun protection and with suboptimal sleep, nutrition, and hydration, while neglecting treatment for their chronic conditions. HRIs preventive plans for Hajj should incorporate measures to address the aforementioned factors to reduce the burden of these illnesses in future Hajj seasons. Lessons from the Hajj can be used to inform policy making and HRIs preventive measures in the general population worldwide.

A global perspective on suicides and suicide attempts

2021 ◽  
pp. 93-98
Author(s):  
Elise Paul
Keyword(s):  
Suicide Attempt ◽  
Suicide Attempts ◽  
Global Perspective ◽  
World Health ◽  
Populations At Risk ◽  
Increased Risk ◽  
World Mental Health Survey ◽  
The World ◽  
Health Organization ◽  
Ongoing Monitoring

Specific populations at risk for suicide differ considerably according to region, country, sex, age, and the most common suicide methods used, highlighting the need for ongoing systematic surveillance to inform prevention efforts. The magnitude of the problem is not limited to suicide deaths. It is estimated that for every suicide, there are 20 more persons who have made an attempt. Individuals who have made a suicide attempt are at increased risk for dying by suicide. This chapter explores differences in the suicide and suicide attempt rates in the general population on different continents, by examining data from the World Health Organization (WHO) Global Health Estimates and the World Mental Health Survey Initiative. Differences across contexts in suicidal behaviours and the need for ongoing monitoring are emphasized.

scholarly journals Assessing the role of the private sector in surveillance for malaria elimination in Haiti and the Dominican Republic: a qualitative study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Abigail Sidibe ◽  
Alysse Maglior ◽  
Carmen Cueto ◽  
Ingrid Chen ◽  
Arnaud Le Menach ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Health Sector ◽  
Traditional Healers ◽  
Treatment Seeking ◽  
Care Seeking ◽  
Private Providers ◽  
Private Health Sector ◽  
Ongoing Support ◽  
Care Seeking Behaviour

Abstract Background Haiti and the Dominican Republic (DR) are targeting malaria elimination by 2022. The private health sector has been relatively unengaged in these efforts, even though most primary health care in Haiti is provided by non-state actors, and many people use traditional medicine. Data on private health sector participation in malaria elimination efforts are lacking, as are data on care-seeking behaviour of patients in the private health sector. This study sought to describe the role of private health sector providers, care-seeking behaviour of individuals at high risk of malaria, and possible means of engaging the private health sector in Hispaniola’s malaria elimination efforts. Methods In-depth interviews with 26 key informants (e.g. government officials), 62 private providers, and 63 patients of private providers, as well as 12 focus group discussions (FGDs) with community members, were conducted within seven study sites in Haiti and the DR. FGDs focused on local definitions of the private health sector and identified private providers for interview recruitment, while interviews focused on private health sector participation in malaria elimination activities and treatment-seeking behaviour of febrile individuals. Results Interviews revealed that self-medication is the most common first step in the trajectory of care for fevers in both Haiti and the DR. Traditional medicine is more commonly used in Haiti than in the DR, with many patients seeking care from traditional healers before, during, and/or after care in the formal health sector. Private providers were interested in participating in malaria elimination efforts but emphasized the need for ongoing support and training. Key informants agreed that the private health sector needs to be engaged, especially traditional healers in Haiti. The Haitian migrant population was reported to be one of the most at-risk groups by participants from both countries. Conclusion Malaria elimination efforts across Hispaniola could be enhanced by engaging traditional healers in Haiti and other private providers with ongoing support and trainings; directing educational messaging to encourage proper treatment-seeking behaviour; and refining cross-border strategies for surveillance of the high-risk migrant population. Increasing distribution of rapid diagnostic tests (RDTs) and bi-therapy to select private health sector facilities, accompanied by adopting regulatory policies, could help increase numbers of reported and correctly treated malaria cases.

scholarly journals Racial Disparities-Associated COVID-19 Mortality among Minority Populations in the US

2020 ◽  
Vol 9 (8) ◽  
pp. 2442 ◽  
Author(s):  
Donald J. Alcendor
Keyword(s):  
Social Services ◽  
Underserved Populations ◽  
The United States ◽  
Cultural Barriers ◽  
Systems Science ◽  
Minority Populations ◽  
Populations At Risk ◽  
Increased Risk ◽  
The Us ◽  
Novel Coronavirus

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a betacoronavirus that causes the novel coronavirus disease 2019 (COVID-19), is highly transmissible and pathogenic for humans and may cause life-threatening disease and mortality, especially in individuals with underlying comorbidities. First identified in an outbreak in Wuhan, China, COVID-19 is affecting more than 185 countries and territories around the world, with more than 15,754,651 confirmed cases and more than 640,029 deaths. Since December 2019, SARS-CoV-2 transmission has become a global threat, which includes confirmed cases in all 50 states within the United States (US). As of 25 July 2020, the Johns Hopkins Whiting School of Engineering Center for Systems Science and Engineering reports more than 4,112,651 cases and 145,546 deaths. To date, health disparities are associated with COVID-19 mortality among underserved populations. Here, the author explores potential underlying reasons for reported disproportionate, increased risks of mortality among African Americans and Hispanics/Latinos with COVID-19 compared with non-Hispanic Whites. The author examines the underlying clinical implications that may predispose minority populations and the adverse clinical outcomes that may contribute to increased risk of mortality. Government and community-based strategies to safeguard minority populations at risk for increased morbidity and mortality are essential. Underserved populations living in poverty with limited access to social services across the US are more likely to have underlying medical conditions and are among the most vulnerable. Societal and cultural barriers for ethnic minorities to achieve health equity are systemic issues that may be addressed only through shifts in governmental policies, producing long-overdue, substantive changes to end health care inequities.

Defining and surveying key populations at risk of HIV infection: Towards a unified approach to eligibility criteria for respondent-driven sampling HIV biobehavioral surveys

2018 ◽  
Vol 29 (9) ◽  
pp. 895-903 ◽  
Author(s):  
Avi J Hakim ◽  
Lisa G Johnston ◽  
Samantha Dittrich ◽  
Dimitri Prybylski ◽  
Janet Burnett ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Risk Behavior ◽  
Respondent Driven Sampling ◽  
Key Populations ◽  
Unified Approach ◽  
Common Multiple ◽  
Eligibility Criteria ◽  
Populations At Risk ◽  
Immunodeficiency Virus ◽  
Less Common Multiple

Substantial resources are invested in human immunodeficiency virus biobehavioral surveys using respondent-driven sampling for measuring progress towards the UNAIDS 90–90–90 goals and to obtain other essential data on key populations. Survey data are used to meet country needs as well those of development partners, whose data needs may sometimes diverge. Surveys using differing eligibility criteria impede comparisons across surveys. With scant literature and guidelines on how to approach eligibility criteria, diverse criteria are used within and across countries. We conducted a review of peer-reviewed human immunodeficiency virus respondent-driven sampling biobehavioral survey literature published through December 2013. We describe eligibility criteria of 137 articles representing 214 surveys. Reporting on age, risk behavior, and reference period of risk behavior was nearly universal; however, reporting on gender, geography, and language was less common. Multiple definitions were used for each criterion, making comparisons challenging. We provide a framework for how to approach defining eligibility to improve consistency and comparability across surveys.

scholarly journals Malaria and associated co-morbidity in children admitted with fever manifestation in Western Ghana: A retrospective study

2015 ◽  
Vol 9 (11) ◽  
pp. 1257-1263 ◽  
Author(s):  
Verner N Orish ◽  
Joseph Y Ansong ◽  
Isaac B Anagi ◽  
Onyekachi S Onyeabor ◽  
Adekunle O Sanyaolu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Febrile Illness ◽  
Malaria Prevalence ◽  
Control Measures ◽  
Malaria Morbidity ◽  
Increased Risk ◽  
Co Morbidity ◽  
Mild Malaria ◽  
The Mean ◽  
One Year

Introduction: Children under five years of age are highly vulnerable to malaria infection and often face dire consequences such as severe malaria if they are not promptly and adequately treated with effective anti-malarial medications. We set out to evaluate malaria and associated co-morbidity among children admitted with febrile illness in Sekondi-Takoradi, Ghana. Methodology: This retrospective study focused on children admitted with fever over a three-year period at the pediatric unit of Effia-Nkwanta Regional Hospital. The children were identified, and the medical records of those who were successfully treated and discharged were searched, retrieved, and reviewed. Results: A total of 1,193 children were identified and selected for analysis. The mean duration of admission increased from 2.17 days in 2010 to 3.36 in 2012. Conversely, the mean age decreased from 3.85 years in 2010 to 2.74 in 2012. Overall, laboratory-confirmed malaria prevalence decreased; however, this decrease was only observed among children five years of age or younger, while malaria prevalence increased among children one year of age or younger. The proportion of children with severe malarial anemia significantly increased, while the proportion of those with mild malaria decreased significantly. Conclusions: Despite the general decrease in malaria morbidity seen in this study, children younger than one year of age remain at increased risk of malaria morbidity. With an increase in malaria prevalence among children younger than one year of age over the three years of study, integrated and targeted control measures are highly needed for this age group.

scholarly journals Redefining typhoid diagnosis: what would an improved test need to look like?

2019 ◽  
Author(s):  
Richard Mather ◽  
Heidi Hopkins ◽  
Christopher M. Parry ◽  
Sabine Dittrich
Keyword(s):  
Typhoid Fever ◽  
Diagnostic Test ◽  
Clinical Medicine ◽  
Point Of Care ◽  
Treatment Algorithm ◽  
Febrile Illness ◽  
Diagnosis And Treatment ◽  
Acute Febrile Illness ◽  
Next Generation ◽  
Antibiotic Overuse

IntroductionTyphoid fever is one of the most common bacterial causes of acute febrile illness in the developing world, with an estimated 10.9 million new cases and 116.8 thousand deaths in 2017. Typhoid point-of-care (POC) diagnostic tests are widely used but have poor sensitivity and specificity, resulting in antibiotic overuse that has led to the emergence and spread of multidrug resistant strains. With recent advances in typhoid surveillance and detection, this is the ideal time to produce a target product profile (TPP) that guides product development and ensure that a next-generation test meets the needs of users in the resource-limited settings where typhoid is endemic.MethodsA structured literature review was conducted to develop a draft TPP for a next-generation typhoid diagnostic test with minimal and optimal desired characteristics for 36 test parameters. The TPP was refined using feedback collected from a Delphi survey of key stakeholders in clinical medicine, microbiology, diagnostics and public and global health.ResultsA next-generation typhoid diagnostic test should improve patient management through the diagnosis and treatment of infection with acute Salmonella enterica serovars Typhi or Paratyphi with a sensitivity ≥90% and specificity ≥95%. The test would ideally be used at the lowest level of the healthcare system in settings without a reliable power or water supply and provide results in less than 15 minutes at a cost of <$1.00 USD.ConclusionThis report outlines the first comprehensive TPP for typhoid fever and is intended to guide the development of a next-generation typhoid diagnostic test. An accurate POC test will reduce the morbidity and mortality of typhoid fever through rapid diagnosis and treatment and will have the greatest impact in reducing antimicrobial resistance if it is combined with diagnostics for other causes of acute febrile illness in a treatment algorithm.

scholarly journals Care-seeking delay of imported malaria to China: Implications for improving post-travel healthcare for migrant workers

2021 ◽  
Author(s):  
Guangyu Lu ◽  
Yuanyuan Cao ◽  
Qi Chen ◽  
Guoding Zhu ◽  
Olaf Müller ◽  
...  
Keyword(s):  
Decision Tree ◽  
Symptom Onset ◽  
Migrant Workers ◽  
Imported Malaria ◽  
Sub Saharan Africa ◽  
Care Seeking ◽  
Healthcare Facilities ◽  
Healthcare Seeking ◽  
Factors Influencing ◽  
Populations At Risk

Abstract Background: Imported malaria cases continue to pose major challenges in China as well as in other countries having achieved elimination. Our study aims to identify the factors influencing the timing of care-seeking after symptom onset among migrant workers with imported malaria, in order to develop innovative interventions to improve access and provision of post-travel healthcare for returning migrants. Methods: We analysed the timing and types of healthcare service utilization after symptom onset among patients with imported malaria between 2012 and 2019 in Jiangsu Province, China. Moreover, decision tree models were used to explore the factors influencing the care seeking timing after symptom onset among patients with imported malaria. Results: A total of 2255 cases of imported malaria were identified from 1 June 2012 through 31 December 2019. Patients with malaria imported into China were mainly male migrant labourers returning from sub-Saharan Africa (96.8%). A substantial number of patients with imported malaria sought healthcare more than 3 days after symptom onset, which clearly represented delayed healthcare-seeking behaviour. According to the decision tree analysis, initial healthcare seeking from healthcare facilities at higher administrative levels, infection with Plasmodium vivax, and absence of malaria infection history were significantly associated with delayed healthcare seeking in patients with imported malaria. Conclusion: The delay in seeking of medical care among migrant workers with imported malaria should be considered and addressed by specific interventions. In addition to increasing awareness about these issues among health care professionals, improved access to healthcare facilities at higher administrative levels as well as improved diagnostic capacity of healthcare facilities at lower administrative levels should be developed.. Moreover, education programs targeting populations at risk of malaria importation and delayed healthcare seeking should be improved to facilitate early healthcare seeking and service use.

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