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印度五岁以下儿童急性呼吸道感染的流行情况、潜在决定因素及求医行为:2019-2021 年国家家庭健康调查结果。

Prevalence, potential determinants, and treatment-seeking behavior of acute respiratory infection among children under age five in India: Findings from the National Family Health Survey, 2019-21.

机构信息

Indian Institute of Technology (IIT) Delhi, New Delhi, 110016, India.

Department of Family & Generations, International Institute for Population Sciences (IIPS), Mumbai, 400088, Maharashtra, India.

出版信息

BMC Pulm Med. 2023 Jun 6;23(1):195. doi: 10.1186/s12890-023-02487-4.

Abstract

BACKGROUND

Acute respiratory infections (ARI) are a major cause of mortality and morbidity among under-five children worldwide, particularly in developing countries. Current evidence using nationally representative data on determinants and care-seeking behavior for ARI is limited in the Indian context. Hence, the present study complements the existing literature by examining the prevalence, determinants, and health-care-seeking behavior regarding ARI among Indian children under age five.

STUDY DESIGN

Cross-sectional study.

METHODS

The data for the present study were drawn from the fifth round of the National Family Health Survey (NFHS-5) conducted in 28 states and 8 union territories of India in 2019-21. A total of 222,233 children age less than five years were selected to estimate the prevalence and determinants of ARI, and 6198 children having ARI were selected to explore the treatment-seeking behavior. Bivariate analysis and multivariable binary logistic regression analysis were employed.

RESULTS

Among children under five years, 2.8% suffered from ARI in the two weeks preceding the survey, and 56.1% sought treatment for ARI. Younger age, a recent episode of diarrhea, maternal asthmatic history, and tobacco smoke exposure in the household increase the risk of having ARI. Further, having a separate room as a kitchen in the household reduces the likelihood of having ARI by 14% (AOR: 0.86; CI: 0.79-0.93). Female children (AOR: 0.88; CI: 0.77-1.00) and children belonging to households having difficulty in accessing transport to health facility (AOR: 0.83; CI: 0.69-0.99) are less likely to seek treatment.

CONCLUSION

The study identified several socio-demographic, maternal, and household characteristics associated with ARI and treatment seeking for ARI. The study also recommends making health centers more accessible to the people in terms of proximity and cost.

摘要

背景

急性呼吸道感染(ARI)是全球五岁以下儿童死亡和发病的主要原因,在发展中国家尤其如此。目前,在印度背景下,使用关于 ARI 决定因素和寻求医疗行为的全国代表性数据的证据有限。因此,本研究通过检查印度五岁以下儿童 ARI 的流行率、决定因素和医疗保健寻求行为,补充了现有文献。

研究设计

横断面研究。

方法

本研究的数据来自于 2019-2021 年在印度 28 个邦和 8 个联邦属地进行的第五轮国家家庭健康调查(NFHS-5)。总共选择了 222233 名年龄小于五岁的儿童来估计 ARI 的流行率和决定因素,选择了 6198 名患有 ARI 的儿童来探索治疗寻求行为。采用了双变量分析和多变量二项逻辑回归分析。

结果

在五岁以下的儿童中,2.8%的儿童在调查前两周患有 ARI,56.1%的儿童因 ARI 寻求治疗。年龄较小、近期腹泻发作、母亲哮喘史和家庭中暴露于烟草烟雾会增加患 ARI 的风险。此外,家中有单独的房间作为厨房会使患 ARI 的可能性降低 14%(优势比:0.86;置信区间:0.79-0.93)。女童(优势比:0.88;置信区间:0.77-1.00)和家庭难以获得前往医疗机构的交通工具的儿童(优势比:0.83;置信区间:0.69-0.99)不太可能寻求治疗。

结论

该研究确定了与 ARI 和 ARI 治疗寻求相关的一些社会人口学、产妇和家庭特征。该研究还建议在接近度和成本方面使卫生中心更容易为人们所接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c44/10246182/c48e51a4d7e8/12890_2023_2487_Fig1_HTML.jpg

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