Tiruneh Melkamu, Gebregergs Gebremedhin Berhe, Birhanu Dereje
Malaria Control and Elimination Partnership in Africa (MACEPA) - PATH: A Catalyst for Global Health, Finote Selam, Ethiopia.
School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Afr Health Sci. 2018 Sep;18(3):552-559. doi: 10.4314/ahs.v18i3.12.
Prompt and effective treatment of malaria is critical because delays increase the risk for serious illness, disability and death.
To assess determinants of delay in seeking treatment among malaria patients at Dera district, NorthWest Ethiopia.
A case control study was conducted from September 01 to October 15, 2014. A total of 318 malaria patients diagnosed using microscopy or rapid diagnostic test, and who sought treatment in health centers were interviewed. Multivariable logistic regression was done to identify determinants of delay.
Delay was high when a patient earned less than 25.0 USD [AOR=15.7, 95% CI: 4.8 - 51.2] and 9.6 times higher if he/she was not a member of community based health insurance [AOR= 9.6, 95% CI: 4.4 - 21.3]. Respondents who travelled for more than 30 minutes to get to a health facility [AOR= 4.4, 95% CI: 1.2 - 15.9] were more likely to be late in seeking treatment for malaria.
Income, community based health insurance, previous history of malaria infection, decision making and distance were determinants of delay in seeking treatment for malaria. To reduce the delay, interventions should focus on outreach malaria services and increase enrollment to community based health insurance.
及时有效地治疗疟疾至关重要，因为延误治疗会增加患重病、残疾和死亡的风险。
评估埃塞俄比亚西北部代拉地区疟疾患者寻求治疗延误的决定因素。
于2014年9月1日至10月15日开展了一项病例对照研究。对总共318名经显微镜检查或快速诊断检测确诊且在卫生中心寻求治疗的疟疾患者进行了访谈。采用多变量逻辑回归分析来确定延误的决定因素。
患者收入低于25.0美元时延误率较高【调整后比值比（AOR）=15.7，95%置信区间（CI）：4.8 - 51.2】，若其未加入社区医疗保险，延误率则高出9.6倍【AOR = 9.6，95% CI：4.4 - 21.3】。前往医疗机构行程超过30分钟的受访者【AOR = 4.4，95% CI：1.2 - 15.9】寻求疟疾治疗时更有可能延误。
收入、社区医疗保险、既往疟疾感染史、决策能力和距离是疟疾患者寻求治疗延误的决定因素。为减少延误，干预措施应侧重于扩大疟疾服务范围并增加社区医疗保险的参保人数。
