Wollega University, Nakamte, Ethiopia.
Malar J. 2010 Nov 11;9:320. doi: 10.1186/1475-2875-9-320.
Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia.
A case control study was conducted from March 15 to April 20, 2010. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of developing sign and symptom, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of developing sign and symptom of malaria. Data were collected by trained enumerators using structured questionnaire. Data were entered in to Epi Info version 6.04 and analyzed using SPSS version 16.0. To identify determinants, multiple logistic regression was done.
A total of 155 mothers of cases and 155 mothers of controls were interviewed. Mothers of children who were in a monogamous marriage (OR = 3.41, 95% CI: 1.39, 8.34), who complained about the side effects of anti-malarial drugs (OR = 4.96, 95% CI: 1.21, 20.36), who had no history of child death (OR = 3.50, 95% CI: 1.82, 6.42) and who complained about the higher cost of transportation to reach the health institutions (OR = 2.01, 95% CI: 1.17, 3.45) were more likely to be late for the treatment of malaria in under-five children.
Effective malaria control programmes should address reducing delayed presentation of children for treatment. Efforts to reduce delay should address transport cost, decentralization of services and increasing awareness of the community on early diagnosis and treatment.
在出现首次症状后 24 小时内及时诊断和治疗疟疾，可以减少疾病向严重阶段发展，从而降低死亡率。在埃塞俄比亚，母亲/照顾者为何会延迟对 5 岁以下儿童的疟疾诊断和治疗，这一原因尚未得到充分研究。本研究旨在评估埃塞俄比亚西南部三个地区 5 岁以下儿童疟疾治疗延迟的决定因素。
这是一项病例对照研究，于 2010 年 3 月 15 日至 4 月 20 日进行。病例为出现症状和体征 24 小时后寻求治疗的 5 岁以下患有临床疟疾的儿童，对照为出现疟疾症状和体征 24 小时内寻求治疗的 5 岁以下患有临床疟疾的儿童。培训的计数员使用结构化问卷收集数据。数据输入 Epi Info 版本 6.04 并使用 SPSS 版本 16.0 进行分析。为了确定决定因素，进行了多变量逻辑回归分析。
共访谈了 155 名病例儿童的母亲和 155 名对照儿童的母亲。与处于一夫一妻制婚姻的儿童的母亲（OR = 3.41，95%CI：1.39，8.34）、抱怨抗疟药物副作用的母亲（OR = 4.96，95%CI：1.21，20.36）、无儿童死亡史的母亲（OR = 3.50，95%CI：1.82，6.42）和抱怨前往医疗机构交通费用较高的母亲（OR = 2.01，95%CI：1.17，3.45）相比，更有可能延迟治疗 5 岁以下儿童的疟疾。
有效的疟疾控制计划应致力于减少儿童延迟就诊治疗的情况。减少延迟的努力应针对交通成本、服务的分散化以及提高社区对早期诊断和治疗的认识。
