School of Health Service Management, Anhui Medical University, Meishan Road 81, Hefei, Anhui, 230032, China.
Library Department of Literature Retrieval and Analysis, Anhui Medical University, Meishan Road 81, Hefei, Anhui, 230032, China.
J Infect Public Health. 2020 Dec;13(12):1939-1945. doi: 10.1016/j.jiph.2020.09.022. Epub 2020 Oct 21.
Respiratory tract infections (RTIs) are important health problems with high incidence and consequent economic costs. The study aimed to analyze trajectories of experienced RTI symptoms and use of healthcare and antibiotics.
The study adopted a cross-sectional design and face-face interview using a structured questionnaire. The questionnaire comprised: a) social demographics; b) last episode of symptomatic RTIs; c) responses to the RTIs; d) antibiotics obtained from clinics and medicine shops for the RTIs. The study subjects were residents in randomly selected villages in Anhui, China. The study settings were the residents households. Descriptive analyses were conducted to draw symptoms trajectory and identify relationship between healthcare seeking and symptoms and common sociodemographic variables.
A total 91.1% (1968) of 2160 eligible residents completed the interview who reported 1.83 episodes of RTIs in the pass year on average. Over half (54.8%) of these RTI episodes had led to visit to clinics for professional care and 51.9%, to use of antibiotics. The trajectories of common RTI symptoms featured a sharp increase and peak followed by a long tail along the days after onset of the infection. Over 60.5% of healthcare-seeking happened between two days before and one day after the symptoms peak. The study also revealed interesting pattern in the timing of different type of treatment following, e.g., taking leftover medicine and antibiotics happened the earliest and seeking professional help and getting antibiotics from clinics, the latest.
RTIs incur a large volume of healthcare-seeking and antibiotics use and there is an urgent need for effective education measures on proper service especially antibiotics use. Patients' reported RTI symptoms manifest peculiar trajectories and their retrospective recall of the course of prior RTI episodes and associated actions may guide their future responses to similar infections. Knowledge of these may help inform doctors about patient expectations, enabling them better manage shared decision- making around antibiotic treatment.
呼吸道感染（RTI）是发病率高、经济成本高的重要健康问题。本研究旨在分析经历 RTI 症状的轨迹以及使用医疗保健和抗生素的情况。
该研究采用横断面设计和面对面访谈，使用结构化问卷。问卷包括：a）社会人口统计学；b）最近一次有症状的 RTI 发作；c）对 RTI 的反应；d）从诊所和药店获得的治疗 RTI 的抗生素。研究对象为中国安徽随机抽取的村庄居民。研究地点为居民家中。进行描述性分析以绘制症状轨迹，并确定医疗保健寻求与症状之间的关系以及常见的社会人口统计学变量。
在符合条件的 2160 名居民中，共有 91.1%（1968 名）完成了访谈，他们报告过去一年平均发生了 1.83 次 RTI。这些 RTI 发作中有一半以上（54.8%）导致去诊所寻求专业护理，51.9%使用了抗生素。常见 RTI 症状的轨迹特征是在感染发作后的几天内急剧增加并达到峰值，然后是长尾。超过 60.5%的就医发生在症状高峰期前两天至一天内。研究还揭示了不同类型的治疗时间安排的有趣模式，例如，服用剩余药物和抗生素的时间最早，而寻求专业帮助和从诊所获得抗生素的时间最晚。
RTI 导致大量的医疗保健和抗生素使用，迫切需要采取有效的教育措施来规范服务，特别是抗生素的使用。患者报告的 RTI 症状表现出独特的轨迹，他们对先前 RTI 发作过程和相关治疗措施的回顾性回忆可能会指导他们未来对类似感染的反应。了解这些情况可能有助于医生了解患者的期望，使他们能够更好地管理围绕抗生素治疗的共同决策。
