Am J Trop Med Hyg. 2013 Jul;89(1 Suppl):62-68. doi: 10.4269/ajtmh.13-0107. Epub 2013 Apr 29.
We evaluated patterns of health care use for diarrhea among children 0-59 months of age residing in Mirzapur, Bangladesh, using a baseline survey conducted during May-June 2007 to inform the design of a planned diarrheal etiology case/control study. Caretakers of 7.4% of 1,128 children reported a diarrheal illness in the preceding 14 days; among 95 children with diarrhea, 24.2% had blood in the stool, 12.2% received oral rehydration solution, 27.6% received homemade fluids, and none received zinc at home. Caretakers of 87.9% sought care outside the home; 49.9% from a pharmacy, and 22.1% from a hospital or health center. The primary reasons for not seeking care were maternal perception that the illness was not serious enough (74.0%) and the high cost of treatment (21.9%). To improve management of childhood diarrhea in Mirzapur, Bangladesh, it will be important to address knowledge gaps in caretakers' assessment of illness severity, appropriate home management, and when to seek care in the formal sector. In addition, consideration should be given to inclusion of the diverse care-giving settings in clinical training activities for diarrheal disease management.
我们评估了孟加拉国米尔扎布尔地区 0-59 个月龄儿童腹泻的医疗保健使用模式，该研究使用了 2007 年 5 月至 6 月进行的基线调查，为计划中的腹泻病因病例对照研究提供设计依据。1128 名儿童中，有 7.4%的看护者报告其在过去 14 天内患有腹泻病；在 95 名腹泻儿童中，24.2%的粪便中有血，12.2%接受口服补液治疗，27.6%接受家庭自制液体，没有儿童在家中接受补锌治疗。87.9%的看护者选择带儿童到家庭以外的地方寻求治疗；49.9%的人去药店，22.1%的人去医院或卫生中心。不寻求治疗的主要原因是母亲认为病情不够严重（74.0%）和治疗费用高（21.9%）。为改善孟加拉国米尔扎布尔地区儿童腹泻的管理，重要的是要解决看护者在评估疾病严重程度、适当的家庭管理以及何时到正规部门寻求治疗方面的知识差距。此外，还应考虑将不同的护理环境纳入腹泻病管理的临床培训活动中。
