Asefa Adane, Qanche Qaro, Asaye Zufan, Abebe Lemi
Department of Public Health, College of Health Science, Mizan-Tepi University, Mizan Aman, Ethiopia.
Department of Statistics, College of Natural Science, Mizan-Tepi University, Tepi, Ethiopia.
Pediatric Health Med Ther. 2020 Jun 10;11:171-178. doi: 10.2147/PHMT.S257804. eCollection 2020.
Although there are low cost and effective interventions to prevent and treat diarrhea, it is one of the leading causes of morbidity and mortality among under-five children in developing countries. Deaths from diarrheal diseases are largely due to lack of prompt seeking of medical care. This study aimed to identify determinants of delayed treatment-seeking for diarrheal diseases among under-five children in Southwest Ethiopia.
Unmatched case-control study was conducted among 324 under-five children paired with their mothers/caregivers from 1st April to 30th May 2019. Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Consecutive sampling was used, and data were collected through interviews and chart reviews. Multivariable binary logistic regression analysis was performed, and variables with a P-value <0.05 were considered statistically significant.
A total of 324 (162 cases and 162 controls) under-five children paired with their mothers/caregivers were included in this study. Being rural residents (AOR=1.93, 95% CI: 1.13,3.31), children from households with more than two children (AOR=2.05, 95% CI: 1.15-3.66), preferring traditional healers for the treatment of diarrhea (AOR= 4.78, 95% CI: 1.74,13.12), not having television or radio for the households (AOR=2.05, 95% CI: 1.11-3.66), living in more than 10 km from the nearest health facility (AOR=4.80, 95% CI: 2.61-4.83), and perceiving diarrhea can cure without treatment (AOR=2.11, 95% CI: 1.15-3.87) were significant determinants of delayed treatment-seeking.
Being rural residents, larger family size, physical inaccessibility of health facilities, not having access to electronic media (television or radio), preferring traditional healers for the treatment of diarrhea, and having the perception that diarrhea can be cured without treatment were determinants of delayed treatment-seeking for diarrheal diseases among under-five children. Thus, multidimensional approaches that can address accessibility of health facilities and improve caregivers' awareness are necessary to encourage prompt treatment-seeking for diarrheal diseases among under-five children.
尽管有低成本且有效的腹泻防治干预措施,但腹泻仍是发展中国家五岁以下儿童发病和死亡的主要原因之一。腹泻疾病导致的死亡很大程度上是由于未能及时就医。本研究旨在确定埃塞俄比亚西南部五岁以下儿童腹泻疾病延迟就医的决定因素。
2019年4月1日至5月31日,在324名五岁以下儿童及其母亲/照料者中开展了非匹配病例对照研究。病例为五岁以下儿童及其母亲/照料者,他们在腹泻疾病症状和体征出现24小时后才寻求治疗,对照为五岁以下儿童及其母亲/照料者,他们在腹泻疾病症状和体征出现24小时内就寻求治疗。采用连续抽样,通过访谈和病历审查收集数据。进行多变量二元逻辑回归分析,P值<0.05的变量被认为具有统计学意义。
本研究共纳入324名(162例病例和162名对照)五岁以下儿童及其母亲/照料者。农村居民(比值比=1.93,95%置信区间:1.13,3.31)、来自有两个以上孩子家庭的儿童(比值比=2.05,95%置信区间:1.15 - 3.66)、更喜欢找传统治疗师治疗腹泻(比值比=4.78,95%置信区间:1.74,13.12)、家庭没有电视或收音机(比值比=2.05,95%置信区间:1.11 - 3.66)、居住在距离最近卫生设施10公里以上的地方(比值比=4.80,95%置信区间:2.61 - 4.83)以及认为腹泻无需治疗就能痊愈(比值比=2.11,95%置信区间:1.15 - 3.87)是延迟就医的重要决定因素。
农村居民身份、家庭规模较大、卫生设施难以到达、无法使用电子媒体(电视或收音机)、更喜欢找传统治疗师治疗腹泻以及认为腹泻无需治疗就能痊愈是五岁以下儿童腹泻疾病延迟就医的决定因素。因此,需要采取多维度方法来解决卫生设施可达性问题并提高照料者的意识,以鼓励五岁以下儿童腹泻疾病的及时就医。