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促进及时治疗:揭示坦桑尼亚五岁以下发热儿童及时寻求疟疾治疗行为的决定因素。

Towards promoting timely treatment: Uncovering the determinants of prompt malaria care seeking behavior among febrile children under-five years in Tanzania.

作者信息

Omary Huda, Chombo Suleiman, Luoga Pankras, Mbishi Jackline Vicent, Paulo Heavenlight A, Andrew John, Zacharia Abdallah, Addo Isaac Y

机构信息

Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

出版信息

PLoS One. 2025 Apr 10;20(4):e0319913. doi: 10.1371/journal.pone.0319913. eCollection 2025.

Abstract

BACKGROUND

Prompt diagnosis and effective treatment within 24 hours of fever onset is crucial for reducing malaria-related morbidity and mortality in under five children. However, research on the prompt care-seeking behaviors and their determinants in this demographic is limited. This study examined the prevalence of prompt care-seeking behaviors among under five febrile children in Tanzania and the associated determinants.

METHODS

This cross-sectional study analyzed data from the 2022 Tanzania Demographic and Health Survey (TDHS), including a nationally representative and weighted sample of 1,050 under-five children who experienced fever within two weeks prior to the survey. A weighted univariable and multivariable modified Poisson regression model with robust estimator was used to examine the association between prompt care seeking behaviors and explanatory variables, including child and caregivers' factors.

RESULTS

The prevalence of prompt care seeking for febrile children was 43.2%. Caregivers of female children had 18% less prevalences of seeking prompt care (95% CI 0.68-0.98) compared to caregivers with their male children. Caregivers aged 25-34 and 35-49 years had 36% (95% CI 1.05-1.78) and 61% (95% CI 1.16-2.23) higher prevalences of seeking prompt care for their children respectively, compared to younger caregivers aged 15-24 years. Caregivers with at least primary education had 50% (95% CI 1.12-2.02) higher prevalences of seeking prompt care compared to those with no formal education. Additionally, an increase in one household member was associated with a 3% increase in the prevalence of seeking prompt malaria care (95% CI 1.01-1.05).

CONCLUSION

In Tanzania, female children under five experience delays in care-seeking for malaria, whereas older and more educated caregivers are more likely to seek timely treatment for their children. To enhance health outcomes in this vulnerable group, targeted interventions should prioritize raising awareness among caregivers, particularly younger ones and prompting equitable care seeking to all children regardless of sex.

摘要

背景

发热开始后24小时内的及时诊断和有效治疗对于降低五岁以下儿童疟疾相关的发病率和死亡率至关重要。然而,关于这一人群及时就医行为及其决定因素的研究有限。本研究调查了坦桑尼亚五岁以下发热儿童及时就医行为的患病率及其相关决定因素。

方法

这项横断面研究分析了2022年坦桑尼亚人口与健康调查(TDHS)的数据,包括1050名五岁以下儿童的全国代表性加权样本,这些儿童在调查前两周内曾发烧。采用加权单变量和多变量修正泊松回归模型及稳健估计量来检验及时就医行为与解释变量之间的关联,包括儿童和照料者的因素。

结果

发热儿童及时就医的患病率为43.2%。与有男童的照料者相比,有女童的照料者及时就医的患病率低18%(95%可信区间0.68 - 0.98)。与15 - 24岁的年轻照料者相比,25 - 34岁和35 - 49岁的照料者为其子女及时就医的患病率分别高36%(95%可信区间1.05 - 1.78)和61%(95%可信区间1.16 - 2.23)。与未接受正规教育的照料者相比,至少接受过小学教育的照料者及时就医的患病率高50%(95%可信区间1.12 - 2.02)。此外,家庭中每增加一名成员,及时寻求疟疾治疗的患病率就增加3%(95%可信区间1.01 - 1.05)。

结论

在坦桑尼亚,五岁以下女童在寻求疟疾治疗方面存在延迟,而年龄较大且受教育程度较高的照料者更有可能为其子女寻求及时治疗。为改善这一弱势群体的健康状况,有针对性的干预措施应优先提高照料者的意识,尤其是年轻照料者,并促使对所有儿童不论性别都能公平就医。

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