Am J Trop Med Hyg. 2013 Jul;89(1 Suppl):21-28. doi: 10.4269/ajtmh.12-0753. Epub 2013 Apr 29.
Diarrhea is a leading cause of child mortality worldwide. Early recognition of symptoms and referral to medical treatment are essential. In 2007, we conducted a Healthcare Utilization and Attitudes Survey (HUAS) of 1,000 children randomly selected from a population census to define care-seeking patterns for diarrheal disease in Bamako, Mali, in preparation for the Global Enteric Multicenter Study (GEMS). We found that 57% of caretakers sought care for their child's diarrheal illness from traditional healers, and 27% of caretakers sought care from the government health center (GHC). Weighted logistic regression showed that seeking care from a traditional healer was associated with more severe reported diarrheal disease, like decreased urination (odds ratio [OR] = 3.35, 95% confidence interval [95% CI] = 1.19-9.41) and mucus or pus in stool (OR = 4.42, 95% CI = 1.35-14.51), along with other indicators of perceived susceptibility. A locally designed traditional healer referral system was, therefore, created that emphasized more severe disease. This system may serve as a model for health systems in West Africa.
腹泻是全球儿童死亡的主要原因。早期识别症状并转至医疗机构进行治疗至关重要。2007 年，我们对从人口普查中随机抽取的 1000 名儿童进行了医疗保健利用和态度调查（HUAS），以便在为全球肠道疾病研究（GEMS）做准备的同时，明确马里巴马科腹泻病的求医模式。我们发现，57%的照顾者带孩子去看传统治疗师治疗腹泻，27%的照顾者带孩子去政府保健中心（GHC）就诊。加权逻辑回归显示，寻求传统治疗师的治疗与更严重的报告腹泻病有关，如排尿减少（比值比[OR] = 3.35，95%置信区间[95%CI] = 1.19-9.41）和粪便中有粘液或脓液（OR = 4.42，95%CI = 1.35-14.51），以及其他感知易感性的指标。因此，创建了一个当地设计的传统治疗师转诊系统，该系统强调更严重的疾病。该系统可以作为西非卫生系统的一个模式。
