Villarreal Iris, Turner Rosario, Jo Hyejin, Park Julie, Gemmen Eric, Pirçon Jean-Yves, Castrejon Maria M, Hausdorff William P
Cromsource for GSK, Avenue Fleming 20, W23 B2-183, 1300, Wavre, Belgium.
Caja de Seguro Social de Panamá, La Chorrera, 507, Panama City, Panama.
BMC Pediatr. 2017 Jan 5;17(1):3. doi: 10.1186/s12887-016-0760-1.
Acute otitis media (AOM) is the most common bacterial childhood infection. However, caregivers with children having mild episodes often do not seek healthcare services, which may lead to an under-appreciation of the disease experienced by the community. The objectives of this survey were to estimate the proportion of primary caregivers who went to a healthcare facility when they suspected that their child aged 6 to <30 months was having an AOM episode during the past 6 months and to assess what factors influenced their decision.
This observational, cross-sectional survey of primary caregivers (≥18 years), with at least one child aged 6 to <30 months was performed in 19 healthcare facilities in Panama (March to May 2013). A 28-item paper questionnaire was administered to assess demographic data, AOM symptoms, as well as potential healthcare-seeking behaviour and factors influencing this behaviour. Potential confounding effects were individually assessed using Chi-squared or Cochran-Mantel-Haenszel tests, and all together in logistic regression models.
The total number of eligible participants was 1330 (mean age 28.5 ± 8.0 years). Of these, 245 participants had at least one child whom they suspected had an AOM episode during the past 6 months. Of the 245 participants, 213 (86.9%) sought healthcare at a facility. Several factors were associated with healthcare usage: perceived severity of illness (p = 0.001), occupational status of the caregiver (p = 0.002), household income (p = 0.016) and length of time since the last suspected AOM episode (p = 0.032).
When confronted with a child with obvious symptoms of AOM, the majority of caregivers reported seeking healthcare. This behaviour appeared to be associated with factors related to the severity of the illness, the length of time since the last episode, as well as with the income and occupational status of the caregivers themselves. As many episodes of AOM present with non-specific respiratory symptoms, our results apply only to caregivers who were confronted with children with an obvious symptom.
急性中耳炎（AOM）是儿童最常见的细菌性感染。然而，孩子症状较轻时，家长往往不寻求医疗服务，这可能导致社区对该疾病的认知不足。本次调查的目的是估计过去6个月中，怀疑6至未满30个月的孩子患有AOM时，带孩子前往医疗机构的主要照顾者的比例，并评估影响他们决策的因素。
2013年3月至5月，在巴拿马的19家医疗机构对至少有一个6至未满30个月孩子的主要照顾者（≥18岁）进行了这项观察性横断面调查。采用一份包含28个条目的纸质问卷，评估人口统计学数据、AOM症状，以及潜在的就医行为和影响该行为的因素。使用卡方检验或Cochran-Mantel-Haenszel检验分别评估潜在的混杂效应，并在逻辑回归模型中一起评估所有效应。
符合条件的参与者总数为1330人（平均年龄28.5±8.0岁）。其中，245名参与者至少有一个孩子，他们怀疑该孩子在过去6个月内患有AOM。在这245名参与者中，213人（86.9%）前往医疗机构就医。有几个因素与就医行为有关：对疾病严重程度的感知（p = 0.001）、照顾者的职业状况（p = 0.002）、家庭收入（p = 0.016）以及自上次怀疑AOM发作以来的时间长度（p = 0.032）。
当面对有明显AOM症状的孩子时，大多数照顾者表示会寻求医疗服务。这种行为似乎与疾病严重程度、自上次发作以来的时间长度，以及照顾者自身的收入和职业状况等因素有关。由于许多AOM发作表现为非特异性呼吸道症状，我们的结果仅适用于面对有明显症状孩子的照顾者。
