Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Department of Microbiology, Faculty of Life Sciences, University of Benin, P.M.B. 1154, Benin City, Nigeria.
J Public Health (Oxf). 2020 May 26;42(2):353-361. doi: 10.1093/pubmed/fdaa015.
Lay diagnosis is a widely used diagnostic approach for home management of common illnesses in Nigeria. This study aimed to explore the perspectives of caregivers and healthcare professionals on lay diagnosis of childhood malaria and pneumonia. Aligned to this, the study sought to explore the feasibility of training caregivers in the Integrated Management of Childhood Illness (IMCI) guidelines for improved recognition and treatment of these diseases.
A qualitative study using individual face-to-face semi-structured interviews was conducted in Benin City, Nigeria. Participants included 13 caregivers with children under 5 years and 17 healthcare professionals (HPs). An inductive approach to thematic analysis was used to generate themes and analyses.
Caregivers relied on lay diagnosis but recognised its limitations. The perceived severity of malaria and pneumonia significantly influenced caregivers' preference for reliance on lay diagnosis practices, health-seeking behaviour and willingness to undertake training in IMCI guidelines for home management of diseases. Safety and potential unintended misuse of medications were recognised by caregivers and HPs as the main challenges.
The high level of acceptance among caregivers to receive IMCI training could help improve effective management of childhood malaria and pneumonia at the community level through early recognition and prompt treatment.
在尼日利亚，居家治疗常见疾病的一种广泛应用的诊断方法是由非专业人员进行诊断。本研究旨在探讨照料者和医疗保健专业人员对儿童疟疾和肺炎的非专业诊断的看法。为此，本研究旨在探索培训照料者掌握《儿童疾病综合管理》（IMCI）指南以提高对这些疾病的识别和治疗的可行性。
本研究在尼日利亚贝宁城采用了个体面对面半结构式访谈的定性研究方法。参与者包括 13 名有 5 岁以下儿童的照料者和 17 名医疗保健专业人员（HPs）。采用归纳式主题分析方法来生成主题和分析。
照料者依赖于非专业诊断，但认识到其局限性。疟疾和肺炎的感知严重程度显著影响照料者对依赖非专业诊断实践、寻求医疗服务的行为以及接受 IMCI 指南培训以进行居家疾病管理的意愿。安全和潜在的药物误用是照料者和 HPs 认识到的主要挑战。
照料者对接受 IMCI 培训的高度接受程度可能有助于通过早期识别和及时治疗，提高社区层面儿童疟疾和肺炎的有效管理。
