International Center for Diarrheal Disease Research Bangladesh, Mohakhali, Dhaka, Bangladesh.
Malar J. 2012 Mar 5;11:63. doi: 10.1186/1475-2875-11-63.
Malaria treatment-seeking practices vary worldwide and Bangladesh is no exception. Individuals from 88 villages in Rajasthali were asked about their treatment-seeking practices. A portion of these households preferred malaria treatment from the National Control Programme, but still a large number of households continued to use drug vendors and approximately one fourth of the individuals surveyed relied exclusively on non-control programme treatments. The risks of low-control programme usage include incomplete malaria treatment, possible misuse of anti-malarial drugs, and an increased potential for drug resistance.
The spatial patterns of treatment-seeking practices were first examined using hot-spot analysis (Local Getis-Ord Gi statistic) and then modelled using regression. Ordinary least squares (OLS) regression identified key factors explaining more than 80% of the variation in control programme and vendor treatment preferences. Geographically weighted regression (GWR) was then used to assess where each factor was a strong predictor of treatment-seeking preferences.
Several factors including tribal affiliation, housing materials, household densities, education levels, and proximity to the regional urban centre, were found to be effective predictors of malaria treatment-seeking preferences. The predictive strength of each of these factors, however, varied across the study area. While education, for example, was a strong predictor in some villages, it was less important for predicting treatment-seeking outcomes in other villages.
Understanding where each factor is a strong predictor of treatment-seeking outcomes may help in planning targeted interventions aimed at increasing control programme usage. Suggested strategies include providing additional training for the Building Resources across Communities (BRAC) health workers, implementing educational programmes, and addressing economic factors.
疟疾的治疗寻求行为在全球范围内存在差异，孟加拉国也不例外。来自拉贾斯坦利 88 个村庄的居民被问及他们的治疗寻求行为。这些家庭中有一部分人选择国家控制规划的疟疾治疗，但仍有大量家庭继续依赖药物供应商，大约四分之一的受访者完全依赖非控制规划的治疗。低控制规划使用率的风险包括治疗不完整、可能错误使用抗疟药物以及耐药性增加的可能性。
首先使用热点分析（局部 Getis-Ord Gi 统计量）检查治疗寻求行为的空间模式，然后使用回归进行建模。普通最小二乘法（OLS）回归确定了超过 80%的控制规划和供应商治疗偏好变化的关键因素。然后使用地理加权回归（GWR）评估每个因素在何处是治疗寻求偏好的重要预测因素。
发现包括部落归属、住房材料、家庭密度、教育水平和与地区城市中心的距离在内的几个因素是疟疾治疗寻求偏好的有效预测因素。然而，这些因素中的每一个因素的预测强度在研究区域内都有所不同。例如，教育在某些村庄是一个强有力的预测因素，但在其他村庄对预测治疗寻求结果的重要性较低。
了解每个因素在治疗寻求结果中的预测强度可以帮助规划旨在增加控制规划使用率的有针对性的干预措施。建议的策略包括为 BRAC 卫生工作者提供额外的培训、实施教育计划和解决经济因素。
