Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
J Glob Health. 2024 Nov 1;14:04181. doi: 10.7189/jogh.14.04181.
Estimating the proportion of children with diarrhoea and those who are taken in as inpatients or outpatients is important for policy planning, resource allocation, and to evaluate the effectiveness of diarrhoea prevention and control interventions. We aimed to estimate the proportion of children <2 years of age with diarrhoea, explore their treatment-seeking practices, and identify factors associated with both diarrhoea and treatment seeking.
We designed a longitudinal study based on a sample of children <2 years of age in the Birhan field site from September 2018 to September 2019. The study site collected data on child mortality and morbidity and treatment-seeking practice for those with a history of illness every three months. Mothers/caregivers were asked about signs or symptoms of illnesses for a two-week period prior to each study visit. We estimated the proportion of children <2 years of age with diarrhoea and treatment-seeking practices for each of the four rounds of data collection and identified associated factors through bivariable and multivariable logistic regression.
We enrolled 4678 children <2 years of age. The proportion of children with diarrhoea was the highest from 11 September 2018 to 9 December 2018 (4.47%; 95% confidence interval (CI) = 3.70-5.35) and the lowest from 10 December 2018 to 9 March 2019 (2.48%; 95% CI = 1.90-3.19). Children from households with chlorinated drinking water had a 50% (adjusted odds ratio (aOR) = 0.50; 95% CI = 0.28-0.88) lower odds of developing diarrhoea compared to those who did not. Among 339 children with diarrhoea, 275 (81.12%; 95% CI = 76.54-85.15) were taken to health facilities for treatment. Female children had lower odds of being taken to health facilities for treatment (aOR = 0.37; 95% CI = 0.17-0.80) compared to males.
While the proportion of children with diarrhoea in our study was lower than that observed in prior research conducted in Ethiopia, treatment-seeking practices were higher. Female children and children from the poorest families had lower odds of treatment. We recommend more studies to explore gender-based and socioeconomic differences affecting treatment-seeking practices.
估计腹泻儿童的比例以及住院或门诊儿童的比例对于政策规划、资源分配以及评估腹泻预防和控制干预措施的效果非常重要。我们旨在估计 2 岁以下腹泻儿童的比例，探讨他们的治疗寻求行为，并确定与腹泻和治疗寻求相关的因素。
我们设计了一项基于 2018 年 9 月至 2019 年 9 月在 Birhan 实地研究点的 2 岁以下儿童样本的纵向研究。该研究点每三个月收集一次儿童死亡和发病数据以及有病史儿童的治疗寻求情况。母亲/照顾者在每次研究访问前两周内被问及疾病的迹象或症状。我们估计了每四轮数据收集时 2 岁以下儿童腹泻和治疗寻求行为的比例，并通过单变量和多变量逻辑回归确定了相关因素。
我们招募了 4678 名 2 岁以下儿童。腹泻儿童的比例在 2018 年 9 月 11 日至 12 月 9 日期间最高（4.47%；95%置信区间[CI]：3.70-5.35），在 2018 年 12 月 10 日至 2019 年 3 月 9 日期间最低（2.48%；95%CI：1.90-3.19）。与未使用氯化饮用水的家庭相比，使用氯化饮用水的家庭的儿童腹泻发病几率低 50%（调整后比值比[aOR]：0.50；95%CI：0.28-0.88）。在 339 名腹泻儿童中，275 名（81.12%；95%CI：76.54-85.15）被送往医疗机构治疗。与男性相比，女性儿童接受医疗机构治疗的几率较低（aOR：0.37；95%CI：0.17-0.80）。
虽然我们研究中腹泻儿童的比例低于在埃塞俄比亚进行的先前研究中观察到的比例，但治疗寻求行为较高。贫困家庭的女性儿童和儿童接受治疗的可能性较低。我们建议进行更多研究，以探讨影响治疗寻求行为的性别和社会经济差异。
