Afolabi B M, Brieger W R, Salako L A
Nigerian Institute of Medical Research, 6 Edmond Crescent, Yaba, Lagos, Nigeria.
J Health Popul Nutr. 2004 Mar;22(1):46-51.
Parents and caregivers often try various treatment modalities for their sick children before bringing them to clinic. Many community-based studies have documented home and self-treatment practices, often with the aid of patent medicine vendors, but less is known about prior treatment behaviour of caregivers who actually reach a government clinic. This study, therefore, aimed at documenting the treatment provided by caregivers prior to their attendance at a public hospital. Beginning in April 1996, a year-long study was conducted among 1,943 sick children and their caregivers who attended the largest government-owned paediatric hospital in Lagos, Nigeria. The major complaints mentioned by the caregivers included fever, cough, and diarrhoea. Most (89%) caregivers had administered some form of medicine to the child prior to the clinic visit, and on average, 2.5 medications had been given. Associations were found between major complaint and type of medicine given: fevers were associated with antimalarial drugs and analgesics (antipyretics), cough was associated with cough syrup and analgesics, while diarrhoea was associated with antidiarrhoeal drugs. Although one-fifth of the children had received an antibiotic, provision of antibiotics was not associated with a particular complaint/illness. Since caregivers appeared to use perceived complaints/illnesses as a treatment guide, this can form the basis of safer and more appropriate recognition of illness and home management. In addition, the information obtained in this study can be used for training clinicians to inquire about home management and, thus, for making more informed decisions about their own treatment and prescribing practices.
家长和护理人员在带生病的孩子去诊所之前，常常会尝试各种治疗方法。许多基于社区的研究记录了家庭和自我治疗行为，这些行为通常借助成药小贩，但对于那些最终前往政府诊所的护理人员之前的治疗行为，我们了解得较少。因此，本研究旨在记录护理人员在前往公立医院就诊之前所提供的治疗。从1996年4月开始，对1943名在尼日利亚拉各斯最大的政府儿科医院就诊的患病儿童及其护理人员进行了为期一年的研究。护理人员提到的主要症状包括发烧、咳嗽和腹泻。大多数（89%）护理人员在带孩子就诊前已给孩子服用了某种形式的药物，平均每人给孩子服用了2.5种药物。研究发现主要症状与所服用药物的类型之间存在关联：发烧与抗疟药和镇痛药（退烧药）有关，咳嗽与止咳糖浆和镇痛药有关，而腹泻与止泻药有关。虽然五分之一的儿童接受了抗生素治疗，但抗生素的使用与特定的症状/疾病并无关联。由于护理人员似乎将所察觉到的症状/疾病作为治疗指导，这可以成为更安全、更恰当的疾病识别和家庭护理的基础。此外，本研究中获得的信息可用于培训临床医生询问家庭护理情况，从而使其在自身治疗和开处方时做出更明智的决策。
