Field Epidemiology Program, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Malar J. 2018 Nov 3;17(1):406. doi: 10.1186/s12936-018-2556-2.
As malaria is among the leading public health problems globally, early diagnosis and treatment of cases is one of the key interventions for its control and elimination. Nevertheless, little is known about early treatment-seeking behaviour for malaria of people in Ethiopia. This study was conducted to investigate early treatment-seeking behaviour and associated factors among febrile patients in Dera district, one of the malaria hotspot districts in Ethiopia.
An institution-based, cross-sectional study was conducted among malaria-suspected febrile patients in Dera district, Amhara Regional State, Ethiopia from September to December 2017. The study used the lottery method to select sample health facilities, and participant allocation to facilities was done in proportion to client flow to the respective health facilities. Data were collected by interview. Thus, binary logistic regression model was fitted to the data. Crude and adjusted odds ratios with the respective confidence intervals and p-values were computed. An explanatory variable with a p-value ≤ 0.05 was considered statistically significant. SPSS version 20 was used for the analysis.
A total of 680 respondents completed the study with a response rate of 96.6%. The study revealed that 356 (52.4%) participants sought treatment within 24 h of fever onset, and patients who: knew the advantage of sleeping under nets [AOR 95% CI 2.8 (1.70-4.60)]; knew mosquito breeding sites [AOR 95% CI 1.9 (1.10-3.30)]; had good, overall knowledge about malaria [AOR 95% CI 2.7 (1.56-4.76)]; had previous history of malaria [AOR 95% CI 3.26 (1.64-6.49)]; were at a distance of < 6 km from a health centre [AOR 95% CI 2.5 (1.72-3.60)]; and, had family size < 5 [AOR 95% CI 2.1 (1.43-3.20)], were more likely to seek treatment within 24 hof fever onset.
A low proportion of malaria-suspected patients sought treatment within 24 h of fever onset compared to the national target. Awareness about the advantage of sleeping under nets, knowledge about mosquito breeding sites and malaria itself, previous history of malaria, distance from the health centres, and family size were found to be predictors of early treatment-seeking behaviour for malaria. Strengthening strategies tailored to increasing awareness for communities about malaria prevention methods and early treatment-seeking behaviour is essential.
疟疾是全球主要的公共卫生问题之一，因此对病例进行早期诊断和治疗是控制和消除疟疾的关键干预措施之一。然而，人们对于埃塞俄比亚发热患者的疟疾早期治疗寻求行为知之甚少。本研究旨在调查埃塞俄比亚疟疾热点地区之一的德拉地区发热患者的早期治疗寻求行为及其相关因素。
本研究为 2017 年 9 月至 12 月在埃塞俄比亚阿姆哈拉州德拉区疑似疟疾发热患者中进行的基于机构的横断面研究。该研究采用彩票法选择样本医疗机构，根据各医疗机构的患者流量按比例分配给医疗机构。数据通过访谈收集。因此，对数据进行了二元逻辑回归模型拟合。计算了具有相应置信区间和 p 值的粗比值比和调整比值比。p 值≤0.05 的解释变量被认为具有统计学意义。使用 SPSS 版本 20 进行分析。
共有 680 名受访者完成了研究，应答率为 96.6%。研究表明，356 名（52.4%）参与者在发热后 24 小时内寻求治疗，以下患者更有可能在发热后 24 小时内寻求治疗：知道睡在蚊帐下的好处[比值比 95%置信区间 2.8（1.70-4.60）]；知道蚊子滋生地[比值比 95%置信区间 1.9（1.10-3.30）]；对疟疾有很好的总体认识[比值比 95%置信区间 2.7（1.56-4.76）]；有疟疾既往史[比值比 95%置信区间 3.26（1.64-6.49）]；距离卫生中心<6 公里[比值比 95%置信区间 2.5（1.72-3.60）]；家庭规模<5[比值比 95%置信区间 2.1（1.43-3.20）]。
与国家目标相比，疑似疟疾患者中只有一小部分在发热后 24 小时内寻求治疗。对睡在蚊帐下的好处、蚊子滋生地和疟疾本身的认识、疟疾既往史、离卫生中心的距离以及家庭规模是疟疾早期治疗寻求行为的预测因素。制定针对社区的强化策略，提高对疟疾预防方法和早期治疗寻求行为的认识至关重要。
