莫桑比克 5 岁以下儿童疟疾护理寻求的相关因素：对 2018 年疟疾指标调查的二次分析。
Factors associated with malaria care seeking among children under 5 years of age in Mozambique: a secondary analysis of the 2018 Malaria Indicator Survey.
机构信息
Instituto Nacional de Saúde, Maputo, Mozambique.
Observatório Nacional de Saúde, Maputo, Mozambique.
出版信息
Malar J. 2022 Mar 24;21(1):100. doi: 10.1186/s12936-022-04128-3.
BACKGROUND
Mozambique is ranked fourth in a list of the 29 countries that accounted for 95% of all malaria cases globally in 2019. The aim of this study was to identify factors associated with care seeking for fever, to determine the association between knowledge about malaria and care seeking and to describe the main reasons for not seeking care among children under five years of age in Mozambique.
METHODS
This is a quantitative, observational study based on a secondary data analysis of the 2018 Malaria Indicator Survey. This weighted analysis was based on data reported by surveyed mothers or caregivers of children aged 0-59 months who had fever in the two weeks prior to the survey.
RESULTS
Care was reportedly sought for 69.1% [95% CI 63.5-74.2] of children aged 0-59 months old with fever. Care-seeking was significantly higher among younger children, < 6 months old (AOR = 2.47 [95% CI 1.14-5.31]), 6-11 months old (AOR = 1.75 [95% CI 1.01-3.04]) and 12-23 months old (AOR = 1.85 [95% CI 1.19-2.89]), as compared with older children (48-59 months old). In adjusted analysis, mothers from the middle (AOR = 1.66 [95% CI 0.18-3.37]) and richest (AOR = 3.46 [95% CI 1.26-9.49]) wealth quintiles were more likely to report having sought care for their febrile children than mothers from the poorest wealth quintile. Additionally, mothers with secondary or higher education level were more likely to seek care (AOR = 2.16 [95% CI 1.19-3.93]) than mothers with no education. There was no association between maternal malaria knowledge or reported exposure to malaria messages and care-seeking behaviours. The main reasons reported for not seeking care included distance to health facility (46.3% of respondents), the perception that the fever was not severe (22.4%) and the perception that treatment was not available at the health facility (15%).
CONCLUSION
Health facility access and socioeconomic barriers continue to be important constraints to malaria service utilization in Mozambique.
背景
莫桑比克在 2019 年全球疟疾病例占比 95%的 29 个国家中排名第四。本研究旨在确定与发热就诊相关的因素，确定疟疾知识与就诊之间的关联，并描述莫桑比克五岁以下儿童未就诊的主要原因。
方法
这是一项基于 2018 年疟疾指标调查的二次数据分析的定量观察性研究。这项加权分析基于接受调查的 0-59 个月大的儿童的母亲或照顾者报告的在调查前两周内有发热的儿童的数据。
结果
据报告，69.1%（95%CI 63.5-74.2）的 0-59 个月大的发热儿童接受了治疗。在较年幼的儿童（<6 个月龄，AOR=2.47[95%CI 1.14-5.31]）、6-11 个月龄（AOR=1.75[95%CI 1.01-3.04]）和 12-23 个月龄（AOR=1.85[95%CI 1.19-2.89]）中，就诊的比例明显更高，而在年龄较大的儿童（48-59 个月龄）中则不然。在调整分析中，来自中（AOR=1.66[95%CI 0.18-3.37]）和最富有（AOR=3.46[95%CI 1.26-9.49]）财富五分位数的母亲比来自最贫穷财富五分位数的母亲更有可能报告为发热的孩子寻求治疗。此外，具有中学或以上教育水平的母亲比没有受过教育的母亲更有可能寻求治疗（AOR=2.16[95%CI 1.19-3.93]）。母亲对疟疾的认识或报告的疟疾信息暴露与就诊行为之间没有关联。未寻求治疗的主要原因包括距离医疗机构远（46.3%的受访者）、认为发热不严重（22.4%）和认为医疗机构无法提供治疗（15%）。
结论
在莫桑比克，医疗机构的可及性和社会经济障碍仍然是利用疟疾服务的重要限制因素。
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