Umuhoza Christian, Karambizi Angelique Charlie, Tuyisenge Lisine, Cartledge Peter
University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
University Teaching Hospital of Kigali, Department of Pediatrics, Kigali, Rwanda.
Pan Afr Med J. 2018 Jun 22;30:160. doi: 10.11604/pamj.2018.30.160.15286. eCollection 2018.
Delay in seeking healthcare contributes significantly to under-five mortality. Multiple socioeconomic and demographic factors have been reported as predictors of such delay. There is no published research in this area in Rwanda. Our aim was to describe the caregivers' delay in seeking healthcare during the acute phase of a childhood illness among under-five children admitted in a tertiary hospital, Rwanda.
This was an analytical, descriptive cross-sectional study conducted at University Teaching Hospital of Kigali. Bivariate analysis and logistic multivariate regression were used to analyze factors associated with delayed care-seeking behavior, defined as seeking care after the first 48 hours of illness onset.
Among 275 admitted children under age five, care-seeking delay occurred in 35% (97/275) of cases. The most significant predictors of delay in seeking care were use of traditional healers (AOR = 14.87, 95% CI: 3.94-56.12), the recognition of illness as mild (AOR = 8.20, 95% CI: 4.08-16.47), use of un-prescribed medicine at home (AOR = 2.00, 95% CI: 1.01-3.91), use of special prayers provided by ministers of God before seeking healthcare (AOR = 6.42, 95% CI: 2.50, 16.48), and first consultation at public institutions (AOR = 4.00, 95% CI:1.54-10.39).
Even though Rwanda has made tremendous achievements in strengthening the community-based health systems, delayed care-seeking is a reality. Health education and behavior change communication interventions are needed at the community level to address the factors that lead to delay in seeking healthcare.
就医延迟是导致五岁以下儿童死亡的重要因素。据报道,多种社会经济和人口因素是此类延迟的预测指标。卢旺达在这一领域尚无已发表的研究。我们的目的是描述卢旺达一家三级医院收治的五岁以下儿童在患儿童疾病急性期时,其照料者就医延迟的情况。
这是一项在基加利大学教学医院开展的分析性、描述性横断面研究。采用双变量分析和逻辑多元回归分析与延迟就医行为相关的因素,延迟就医行为定义为在疾病发作首48小时后才寻求治疗。
在275名五岁以下入院儿童中,35%(97/275)的病例出现了就医延迟。延迟就医的最显著预测因素包括寻求传统治疗师治疗(比值比=14.87,95%置信区间:3.94 - 56.12)、认为病情较轻(比值比=8.20,95%置信区间:4.08 - 16.47)、在家使用非处方药(比值比=2.00,95%置信区间:1.01 - 3.91)、在就医前使用神职人员提供的特殊祈祷(比值比=6.42,95%置信区间:2.50,16.48)以及首次在公共机构就诊(比值比=4.00,95%置信区间:1.54 - 10.39)。
尽管卢旺达在加强社区卫生系统方面取得了巨大成就,但就医延迟仍是现实情况。需要在社区层面开展健康教育和行为改变沟通干预措施,以解决导致就医延迟的因素。