Chamany Shadi, Burapat Channawong, Wannachaiwong Yupapan, Limpakarnjanarat Khanchit, Premsri Nakorn, Zell Elizabeth R, Dowell Scott F, Feikin Daniel R, Olsen Sonja J
Epidemic Intelligence Service and Preventive Medicine Residency Program, Office of Workforce and Career Development (OWCD), Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Southeast Asian J Trop Med Public Health. 2008 May;39(3):549-56.
We conducted a household survey among Sa Kaeo residents to characterize self-reported health-seeking behavior for pneumonia and the proportion of individuals who seek care at a hospital to determine the coverage of a surveillance system. A 2-stage cluster sample was used to select households. A case of pneumonia was defined as a self-reported history of cough and difficulty breathing for at least 2 days or being given a diagnosis of pneumonia by a healthcare provider in the 12-month period beginning February 1, 2002, and ending January 31, 2003. Interviewers administered a structured questionnaire that asked about clinical illness and utilization of healthcare services. Among 1,600 households, 5,658 persons were surveyed, of whom 62 persons met the case definition. Of the 59 persons with complete data, 53 (90%, 95% CI: 79-96) sought medical care and 47 (80%, 95% CI: 67-89) sought care at a hospital facility in the province. Neither distance nor cost was reported as a barrier to seeking care. Most individuals with self-reported pneumonia sought care at the hospital level. Population-based surveillance can provide reliable estimates of hospitalized, chest radiograph-confirmed pneumonia in Sa Kaeo if adjustments are made to account for the proportion of individuals who access a hospital where radiologic assessment is available.
我们在沙缴府居民中开展了一项家庭调查，以描述自我报告的肺炎就医行为以及在医院就医的个体比例，从而确定监测系统的覆盖范围。采用两阶段整群抽样方法选取家庭。肺炎病例定义为在2002年2月1日至2003年1月31日这12个月期间，自我报告有至少2天咳嗽和呼吸困难病史，或由医疗服务提供者诊断为肺炎。访员发放了一份结构化问卷，询问临床疾病情况和医疗服务利用情况。在1600户家庭中，对5658人进行了调查，其中62人符合病例定义。在59名数据完整的人中，53人（90%，95%可信区间：79 - 96）寻求了医疗护理，47人（80%，95%可信区间：67 - 89）在该省的医院机构就医。距离和费用均未被报告为就医障碍。大多数自我报告患有肺炎的个体在医院层面寻求护理。如果进行调整以考虑到能够获得放射学评估的医院中就医的个体比例，基于人群的监测可以提供沙缴府住院且经胸部X光片确诊的肺炎的可靠估计值。
