Am J Trop Med Hyg. 2013 Jul;89(1 Suppl):29-40. doi: 10.4269/ajtmh.12-0755. Epub 2013 Apr 29.
We interviewed caretakers of 1,043 children < 5 years old in a baseline cross-sectional survey (April to May 2007) and > 20,000 children on five separate subsequent occasions (May of 2009 to December 31, 2010) to assess healthcare seeking patterns for diarrhea. Diarrhea prevalence during the preceding 2 weeks ranged from 26% at baseline to 4-11% during 2009-2010. Caretakers were less likely to seek healthcare outside the home for infants (versus older children) with diarrhea (adjusted odds ratio [aOR] = 0.33, confidence interval [CI] = 0.12-0.87). Caretakers of children with reduced food intake (aOR = 3.42, CI = 1.37-8.53) and sunken eyes during their diarrheal episode were more likely to seek care outside home (aOR = 4.76, CI = 1.13-8.89). Caretakers with formal education were more likely to provide oral rehydration solution (aOR = 3.01, CI = 1.41-6.42) and visit a healthcare facility (aOR = 3.32, CI = 1.56-7.07). Studies calculating diarrheal incidence and healthcare seeking should account for seasonal trends. Improving caretakers' knowledge of home management could prevent severe diarrhea.
我们在基线横断面调查（2007 年 4 月至 5 月）中采访了 1043 名 < 5 岁的儿童的照顾者，并在随后的五个单独时间点（2009 年 5 月至 2010 年 12 月 31 日）对 > 20000 名儿童进行了采访，以评估腹泻的就医模式。在过去 2 周内，腹泻的患病率在基线时为 26%，在 2009-2010 年期间为 4-11%。对于有腹泻症状的婴儿（与年龄较大的儿童相比），照顾者在家外寻求医疗保健的可能性较低（调整后的优势比 [aOR] = 0.33，置信区间 [CI] = 0.12-0.87）。在腹泻发作期间，照顾者如果发现孩子食量减少（aOR = 3.42，CI = 1.37-8.53）和眼睛凹陷，更有可能在家外寻求医疗护理（aOR = 4.76，CI = 1.13-8.89）。接受过正规教育的照顾者更有可能提供口服补液溶液（aOR = 3.01，CI = 1.41-6.42）并前往医疗机构（aOR = 3.32，CI = 1.56-7.07）。计算腹泻发病率和医疗服务利用率的研究应该考虑季节性趋势。提高照顾者对家庭管理的认识可能有助于预防严重腹泻。
