Kassile Telemu, Lokina Razack, Mujinja Phares, Mmbando Bruno P
Faculty of Science, Sokoine University of Agriculture, PO Box 3038, Morogoro, Tanzania.
Malar J. 2014 Sep 3;13:348. doi: 10.1186/1475-2875-13-348.
BACKGROUND: Early diagnosis and timely treatment of malaria is recognized as a fundamental element to the control of the disease. Although access to health services in Tanzania is improved, still many people seek medical care when it is too late or not at all. This study aimed to determine factors associated with delay in seeking treatment for fever among children under five in Tanzania. METHODS: A three-stage cluster sampling design was used to sample households with children under five in Dodoma region, central Tanzania between October 2010 and January 2011. Information on illness and health-seeking behaviours in the previous four weeks was collected using a structured questionnaire. A multivariable logistic regression was used to investigate determinants of delay in treatment-seeking behaviour while accounting for sample design. RESULTS: A total of 287 under-five children with fever whose caretakers sought medical care were involved in the study. Of these, 55.4% were taken for medical care after 24 hours of onset of fever. The median time of delay in fever care seeking was two days. Children who lived with both biological parents were less likely to be delayed for medical care compared to those with either one or both of their biological parents absent from home (OR = 0.42, 95% CI: 0.24, 0.74). Children from households with two to three under-five children were more likely to be delayed for medical care compared to children from households with only one child (OR = 1.54, 95% CI: 1.04, 2.26). Also, children living in a distance ≥5 kilometres from the nearest health facility were about twice (95% CI: 1.11, 2.72) as likely to delay to be taken for medical care than those in the shorter distances. CONCLUSION: Living with non-biological parents, high number of under-fives in household, and long distance to the nearest health facility were important factors for delay in seeking healthcare. Programmes to improve education on equity in social services, family planning, and access to health facilities are required for better healthcare and development of children.
背景：疟疾的早期诊断和及时治疗被认为是控制该疾病的基本要素。尽管坦桑尼亚的医疗服务可及性有所改善，但仍有许多人在病情太晚时才寻求医疗护理，或者根本不寻求医疗护理。本研究旨在确定坦桑尼亚五岁以下儿童发热后延迟就医的相关因素。 方法：2010年10月至2011年1月期间，采用三阶段整群抽样设计，对坦桑尼亚中部多多马地区有五岁以下儿童的家庭进行抽样。使用结构化问卷收集前四周内的疾病和就医行为信息。在考虑样本设计的情况下，采用多变量逻辑回归来调查延迟就医行为的决定因素。 结果：共有287名五岁以下发热儿童的照料者寻求了医疗护理并参与了本研究。其中，55.4%的儿童在发热24小时后才接受医疗护理。发热后延迟就医的中位时间为两天。与亲生父母一方或双方不在家的儿童相比，与亲生父母双方一起生活的儿童延迟就医的可能性较小（比值比=0.42，95%置信区间：0.24，0.74）。与只有一个五岁以下儿童的家庭中的儿童相比，有两到三个五岁以下儿童的家庭中的儿童延迟就医的可能性更大（比值比=1.54，95%置信区间：1.04，2.26）。此外，居住在距离最近的医疗机构≥5公里处的儿童延迟就医的可能性是居住在较近距离处儿童的两倍左右（95%置信区间：1.11，2.72）。 结论：与非亲生父母一起生活、家庭中五岁以下儿童数量多以及距离最近的医疗机构远是延迟就医的重要因素。需要开展相关项目，以改善社会服务公平性、计划生育和医疗设施可及性方面的教育，从而为儿童提供更好的医疗保健并促进其发展。
BMC Public Health. 2015-9-23
J Health Popul Nutr. 2011-10
Trop Med Int Health. 2020-12
Tanzan J Health Res. 2012-7
J Health Popul Nutr. 2011-10
Zotero 插件