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缅甸农村疟疾流行地区五岁以下儿童照料者的就医行为:一项横断面研究。

Caregivers' treatment-seeking behaviour for children under age five in malaria-endemic areas of rural Myanmar: a cross-sectional study.

作者信息

Thandar Moe Moe, Kyaw Myat Phone, Jimba Masamine, Yasuoka Junko

机构信息

Community and Global Health Department, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.

出版信息

Malar J. 2015 Jan 5;14:1. doi: 10.1186/1475-2875-14-1.

Abstract

BACKGROUND

A community-based malaria intervention was introduced through fixed and mobile clinics in rural Myanmar. This study attempted to identify treatment-seeking behaviour of caregivers for children under five and the determinants of appropriate treatment-seeking behaviour in mobile clinic villages (MV) and non-mobile clinic villages (NMV) in malaria-endemic rural areas in Myanmar.

METHODS

A cross-sectional study was conducted in 23 MV and 25 NMV in Ingapu Township, Myanmar. Appropriate treatment-seeking behaviour was operationally defined as seeking treatment from trained personnel or at a health facility within 24 hours after the onset of fever. Multiple logistic regression analyses were conducted to identify the determinants of appropriate treatment-seeking behaviour.

RESULTS

Among the 597 participants in both types of villages, 166 (35.3%) caregivers sought appropriate treatment. No significant difference in appropriate treatment-seeking behaviour was found between the two types of villages (adjusted odds ratio (AOR), 0.80; 95% confidence interval (CI), 0.51-1.24). Determinants of behaviour include proximity to public health facilities (AOR, 5.86; 95% CI, 3.43-10.02), knowledge of malaria (AOR, 1.90; 95% CI, 1.14-3.17), malaria prevention behaviour (AOR, 1.76; 95% CI, 1.13-2.76), treatment at home (AOR, 0.26; 95% CI, 0.15-0.45), and treatment and transportation costs (AOR, 0.52; 95% CI, 0.33-0.83).

CONCLUSIONS

Caregivers' treatment-seeking behaviour was poor for fever cases among children under age five, and did not differ significantly between MV and NMV. It is necessary to educate caregivers, particularly for early treatment seeking and appropriate use of health care options for fever, and catering to their medical needs. These findings can help promote awareness and prevention, and improve the quality of interventions at the community level.

摘要

背景

通过缅甸农村地区的固定诊所和流动诊所引入了一项基于社区的疟疾干预措施。本研究试图确定五岁以下儿童看护者的就医行为,以及缅甸疟疾流行农村地区流动诊所村(MV)和非流动诊所村(NMV)中适当就医行为的决定因素。

方法

在缅甸因加普镇的23个MV村和25个NMV村进行了一项横断面研究。适当就医行为在操作上被定义为在发烧开始后24小时内从受过培训的人员处或在医疗机构寻求治疗。进行了多项逻辑回归分析以确定适当就医行为的决定因素。

结果

在两类村庄的597名参与者中,166名(35.3%)看护者寻求了适当治疗。两类村庄之间在适当就医行为方面未发现显著差异(调整优势比(AOR),0.80;95%置信区间(CI),0.51 - 1.24)。行为的决定因素包括与公共卫生设施的距离(AOR,5.86;95%CI,3.43 - 10.02)、疟疾知识(AOR,1.90;95%CI,1.14 - 3.17)、疟疾预防行为(AOR,1.76;95%CI,1.13 - 2.76)、在家治疗(AOR,0.26;95%CI,0.15 - 0.45)以及治疗和交通成本(AOR,0.52;95%CI,0.33 - 0.83)。

结论

五岁以下儿童发烧病例中看护者的就医行为较差,MV村和NMV村之间没有显著差异。有必要对看护者进行教育,特别是关于早期就医以及对发烧适当使用医疗保健选项,并满足他们的医疗需求。这些发现有助于提高认识和预防水平,并改善社区层面干预措施的质量。

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