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埃塞俄比亚疟疾患者寻求医疗服务的延误及其决定因素:一项系统评价和荟萃分析。

Delays in seeking healthcare and its determinants among malaria patients in Ethiopia: A systematic review and meta-analysis.

作者信息

Tadesse Abebe Moges, Tafere Tesfahun Zemene, Tegegne Kaleab Tesfaye, Shiferaw Dessie Alemnew, Gonete Yosef Aragaw, Wudu Tadele Kassahun, Takele Getnet Azanaw, Agimas Muluken Chanie

机构信息

Department of Pediatric and Child Health Nursing, College of Health Science, Debark University, Debark, Ethiopia.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

PLoS One. 2025 Apr 8;20(4):e0320149. doi: 10.1371/journal.pone.0320149. eCollection 2025.

Abstract

METHODS

PubMed, Cochrane Library, Scopus, Web of Science, Google Scholar and Google were searched. Cross-sectional and case-control studies about delays in seeking healthcare for more than 24 hours were included. STATA 17 was used to analyze the data. Heterogeneity across studies was assessed via the I2 test. A funnel plot and Egger's test were used to assess publication bias. Subgroup analyses were performed by region and study setting. Sensitivity analysis was performed to determine the influence of individual studies.

RESULTS

A total of 18 articles with 7371 participants were included in this review. The pooled prevalence of delay in seeking healthcare was 67% (95% CI: 51%-84%). Age less than 15 years (OR: 2.27, 95% CI: 1.34-3.85), inability to read and write (OR: 3.36, 95% CI: 1.18-9.69), travel to health institutions on foot (OR: 2.77, 95% CI: 1.71-4.49), and by horse (OR: 2.76, 95% CI: 1.57-4.84), living far from a health institution (OR: 2.65, CI: 1.37-5.13), not having a family history of death (OR: 3.04, 95% CI: 2.14-4.33), and not being a member of community-based health insurance (OR: 7.14, 95% CI: 1.09-46.63) were significant determinants of delays in seeking healthcare.

CONCLUSION

The pooled prevalence of delays in seeking healthcare was high, and most of the determinants were modifiable. These findings underscore the need for targeted interventions to address these barriers and improve timely access to healthcare for affected populations.

摘要

方法

检索了PubMed、Cochrane图书馆、Scopus、科学网、谷歌学术和谷歌。纳入了关于寻求医疗保健延迟超过24小时的横断面研究和病例对照研究。使用STATA 17分析数据。通过I2检验评估研究间的异质性。使用漏斗图和Egger检验评估发表偏倚。按地区和研究背景进行亚组分析。进行敏感性分析以确定个别研究的影响。

结果

本综述共纳入18篇文章,涉及7371名参与者。寻求医疗保健延迟的合并患病率为67%(95%CI:51%-84%)。年龄小于15岁(OR:2.27,95%CI:1.34-3.85)、读写能力不足(OR:3.36,95%CI:1.18-9.69)、步行(OR:2.77,95%CI:1.71-4.49)或骑马(OR:2.76,95%CI:1.57-4.84)前往医疗机构、居住在远离医疗机构的地方(OR:2.65,CI:1.37-5.13)、没有家族死亡史(OR:3.04,95%CI:2.14-4.33)以及不是社区医疗保险成员(OR:7.14,95%CI:1.09-46.63)是寻求医疗保健延迟的重要决定因素。

结论

寻求医疗保健延迟的合并患病率很高,且大多数决定因素是可改变的。这些发现强调了需要有针对性的干预措施来消除这些障碍,并改善受影响人群及时获得医疗保健的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef51/11977998/1c263bf7cfa4/pone.0320149.g001.jpg

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