A national survey of early treatment seeking behavior among those with incident SARS-CoV-2 infection

Background: Despite effective means to treat SARS-CoV-2 infection, the early treatment seeking behavior of those newly diagnosed with infection is not clear. Methods: We surveyed users of a national SARS-CoV-2 testing company to assess the frequency and correlates of early treatment seeking behavior for a positive test result. We recruited adults (18 years or older) who had tested positive for SARS-CoV-2 by PCR at a large clinical laboratory. To be eligible, individuals had to have a positive test result within 7 days of enrollment. Surveys were anonymous and voluntary. We collected data on demographic characteristics, general health care access and utilization, awareness of treatment for COVID-19, treatment seeking behavior, and treatments received. Descriptive statistics and odds ratios (OR) with 95% confidence intervals (95% CI) were calculated on StataSE. Results: Participants were surveyed from 3-7 January 2022: among the 15,991 who viewed a survey request, 7,647 individuals were eligible and provided responses. The median age of a respondent was 42 years (interquartile range: 32 to 54), 68.9% of respondents were women, and respondents represented 33 different states, districts, and territories. Among respondents, 23.1% reported they had sought treatment or medical advice for their current COVID-19 diagnosis. Of those who were very aware of treatment for COVID-19, 31.0% sought treatment versus 16.7% who were unaware (p-value< 0.001). The odds of treatment seeking behavior were higher for those that were contacted by a medical professional after their diagnosis (OR: 4.57 [95% CI: 3.89 to 5.37]), those with a primary doctor (OR: 2.94 [95% CI: 2.52 to 3.43]), those who self-measured their oxygen saturation (OR: 2.53 [95% CI: 2.25 to 2.84]), and those over 65 years of age (OR: 2.36 [95% CI: 2.02 to 2.76]). There was no difference in those seeking treatment based on heritage, ethnicity, prior COVID-19 diagnosis, state political affiliation, or vaccination status. The odds of seeking treatment were lower among men (OR: 0.88 [95% CI: 0.78 to 0.99]) and those without insurance (OR: 0.62 [95% CI: 0.52 to 0.72]). The most common treatment locations were clinics and most common treatments were Vitamin C, Vitamin D, Zinc, Tylenol, and NSAIDs. Conclusion: More public outreach is needed to raise awareness of the benefits of treatment for COVID-19. We found that people who were more aware about treatment for COVID-19 were more likely to seek medical advice or therapy. Efforts to increase awareness might increase early treatment for SARS-CoV-2 infection. Increased outreach with treatment facilitation from medical professionals and/or public health staff to those with newly detected SARS-CoV-2 infections, particularly among those at higher-risk of complications, might also be helpful.

Early Malaria diagnosis and treatment seeking Behavior among clients attending outpatient department Sekou-Toure regional referral Hospital in Mwanza, Tanzania; A Cross-Sectional Study

Background Early diagnosis of malaria and treatment seeking behavior play key role in controlling and preventing further complication related to malaria disease. Aim of this study was to determine the responses on early malaria diagnosis and treatment seeking behavior among outpatient clients attending at Sekou toure regional referral hospital in Mwanza, Tanzania. Methods A cross-sectional study was conducted among outpatient client at Sekou-Touré regional referral hospital, convenient simple random sampling used and self-administered questionnaire were used to collect data and data was entered into Microsoft excel and then exported to SPSS version 25.0 for further analysis and presented on the percentages and table. The analysis of strength of relationships between categorical variables was conducted using the Chi-square test. A p-value of ≤ 0.05 was considered to be statistically significant. Results A total of 192 respondents completed the study with a response rate of 97.6%. The study revealed that Most of the respondents about 90.6% stated they would seek treatment from health facility when symptoms appear. However, only 6.3% seek treatment within 24 hours of onset of illness (p= 0.017). Half of respondents (50.5%) experienced malaria symptoms in the past six months and only 30% seek for treatment at health facility. Preference of health facility, (51%) respondents were going direct to pharmacy to buy medicine for self-treatment. Overall, cost of service, time consumed and distance of health facility especially health center shows significant with such delay. Conclusion A low proportion of malaria-suspected patients sought treatment within 24 h of fever onset compared to the national target. Distance from the health facility, cost of service and time consumed were found to be predictors of early treatment-seeking behavior for malaria. Strengthening strategies tailored to increasing awareness for communities about malaria, importance of going hospital and early treatment-seeking behavior is essential.

Mental Health Treatment Histories, Recovery, and Well-being

Epidemiological and sociological research on recovery from mental disorder is based on three rarely tested medical model assumptions: (1) recovery without treatment is the result of less severe illness, (2) treatment predicts recovery, and (3) recovery and well–being do not depend on individuals’ treatment histories. I challenge these assumptions using National Comorbidity Survey-Replication data for individuals with any disorder occurring prior to the current year ( N = 2,305). Results indicated that (1) untreated remissions were fully explained by less serious prior illness, (2) treated individuals were less likely to recover due to more serious illness, and (3) people who had past–only treatment were more likely to recover than the never–treated, while those in recurring and recently initiated care were less likely to recover. Treatment histories predicted greater well–being only if recovery had been attained. Histories of care help to explain recovery rates and suggest new directions for treatment–seeking theory and research.

Social Struggles and Treatment Seeking Behaviors of Infertile Women among Different Classes in the Urban Areas of Bangladesh

Background: Infertility is considered a taboo in the society of Bangladesh and is negated in reproductive health programs as well as in the research setting. Yet it is crucial and endemic for social and public health sectors. In Bangladesh, infertile women have to bear the drudgery of dishonor and shame because of their childlessness. The childless women have to shoulder most of the burden of ill-treatment for impotence regardless of who is at fault. Like other social stigmas, this also intersects across class, gender and setting barriers. Objective: The aim of the study is to understand the social struggles, stigmatization and treatment seeking behavior of infertile women of different classes in the urban context of Bangladesh. Methodology: A descriptive qualitative research methodology with in-depth interviews was used to collect data from 20 childless urban women aged between 18 to 45 years. They were urban residents for at least ten years and were aware of their infertile condition for at least one year. Results: The research results showed that childless women, irrespective of their class identities, always live with stigma, accusations and fear of abandonment in their personal lives. It also initiates an arena of violence. Many infertile women face physical and mental abuse due to their childlessness. The treatment seeking behaviors also vary based on financial conditions and the formality of the services among infertile women of different social classes. Conclusion: Infertility is a critical component of reproductive health. When a woman’s worth is measured by her reproductive functions, the childless woman faces humiliation and even abandonment. Attitude towards them is changed due to the societal norms and patriarchal social structures. This affects their treatment seeking behaviors as well. A proper understanding of the social condition of infertile women will facilitate the improved quality of women’s reproductive health care services. J Shaheed Suhrawardy Med Coll 2020; 12(2): 82-86