Tune Samiun Nazrin Kamal, Kibria Gulam Muhammed Al, Islam Mohammad Zahirul, Billah Md Arif, Vandenent Maya, Talukder Md Shamim Hayder, Sultana Ummay Ferhin, Majlish Maliha Khan, Shimul Shafiun Nahin, Jahangir Margub Aref, Khan Jahangir A M, Akter Shahin, Salahin Kazi Fayzus, Chowdhury Md Razib, Razzaque Abdur, Joarder Taufique
International Development Division (IDD), Abt Global, Dhaka, 1212, Bangladesh.
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
Sci Rep. 2025 Mar 29;15(1):10928. doi: 10.1038/s41598-024-80979-x.
Childhood pneumonia affects an estimated 18% of under-five children in Bangladesh. Urban slum-dwellers face challenges in healthcare-seeking. This study examined the factors influencing the healthcare-seeking for childhood pneumonia among under-two children in urban slums in Bangladesh. The study examined influence of children's characteristics (age, sex, number of ARI/pneumonia symptoms, and duration of symptoms), maternal factors (age, education, and working status), and household characteristics (number of household members, wealth quintile, sex of household heads, age of household heads). The outcome variable was receiving care from a qualified medical provider for childhood pneumonia or pneumonia-like symptoms within 14 days before the collection of surveillance data. The research utilized data from the Urban Health and Demographic Surveillance System, which included 155,000 people from five slums in Dhaka and Gazipur City Corporation areas. Overall, 753 out of 4,679 (16%) children under two years of age were included in this study, all of whom had ARI/pneumonia-like symptoms. The mean age of these children was 11.4 months, and 50% were boys. Of them, 350 (46%) sought care from local pharmacies, while 37% sought care from medically trained providers. Logistic regression analyses indicated that children with multiple symptoms (AOR: 2.32, 95% CI: 1.71-3.14) and illness duration over seven days (AOR: 2.61, 95% CI: 1.51-4.51) had higher odds of receiving care from a medically trained provider. Higher maternal education compared to no formal education, having five or more household members compared to four or fewer, household heads aged 40-49 years compared to those under 25 years, a longer duration of living in the slum (more than 10 years compared to less than five years), and belonging to the richest wealth quintile compared to the poorest were protective factors for care-seeking from qualified providers. Further research is required to understand the context for designing appropriate interventions and comprehensive policies for improved child health regarding ARI/pneumonia-like symptoms.
据估计，孟加拉国18%的五岁以下儿童受到儿童肺炎的影响。城市贫民窟居民在寻求医疗服务方面面临挑战。本研究调查了影响孟加拉国城市贫民窟两岁以下儿童寻求儿童肺炎医疗服务的因素。该研究考察了儿童特征（年龄、性别、急性呼吸道感染/肺炎症状数量和症状持续时间）、母亲因素（年龄、教育程度和工作状况）以及家庭特征（家庭成员数量、财富五分位数、户主性别、户主年龄）的影响。结果变量是在收集监测数据前14天内从合格医疗服务提供者处获得针对儿童肺炎或肺炎样症状的治疗。该研究利用了城市卫生和人口监测系统的数据，该系统涵盖了达卡和加济布尔市公司地区五个贫民窟的15.5万人。总体而言，4679名两岁以下儿童中有753名（16%）被纳入本研究，他们都有急性呼吸道感染/肺炎样症状。这些儿童的平均年龄为11.4个月，50%为男孩。其中，350名（46%）从当地药店寻求治疗，37%从受过医学培训的提供者处寻求治疗。逻辑回归分析表明，有多种症状的儿童（调整后比值比：2.32，95%置信区间：1.71 - 3.14）和病程超过七天的儿童（调整后比值比：2.61，95%置信区间：1.51 - 4.51）从受过医学培训的提供者处获得治疗的几率更高。与未接受正规教育相比，母亲受教育程度较高；与家庭成员为四人或更少相比，家庭成员为五人或更多；与25岁以下的户主相比，户主年龄在40 - 49岁；在贫民窟居住时间较长（与居住时间少于五年相比，居住时间超过十年）；与最贫困的五分位数相比，属于最富有的财富五分位数，这些都是从合格提供者处寻求治疗的保护因素。需要进一步开展研究，以了解针对急性呼吸道感染/肺炎样症状设计适当干预措施和全面政策以改善儿童健康状况的背景情况。
