Jean Simon David, Kondo Tokpovi Vénunyé Claude, Ouedraogo Adama, Kiragu Ann
Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti.
Institut National de la Statistique et des Etudes Economiques et Démographiques (INSEED), Lomé, Togo.
BMC Pediatr. 2025 Jun 5;25(1):456. doi: 10.1186/s12887-025-05758-7.
In Haiti, childhood diarrhea is one of the leading causes of serious illness and death among children. Factors associated with medical treatment-seeking behaviours for diarrhea illnesses are poorly documented even though diarrhea treatment is key to reduce diarrhea-related child morbidity and mortality. To fill this gap, this study aimed to determine prevalence and identify factors associated with medical treatment-seeking behaviour for childhood diarrhea among Haitian mothers.
The study was based on secondary data, collected from the fifth round of the Haitian Demographic and Health Survey (HDHS 2016-2017). Medical treatment-seeking behaviour for childhood diarrhea was the outcome variable. Various demographic and socio-economic variables were considered as explanatory variables. Descriptive statistics (univariate and bivariate percentage distribution, Pearson's Chi-square test) and multilevel logistic regression were employed to draw inferences from the data.
1,245 children constituted our study population. The prevalence of children who suffered from diarrhea and received treatment (either oral rehydration solution (ORS) or recommended home fluids (RHF)) within two weeks period before the survey was 42.9% (95% CI 40.2-45.6). The results also revealed that children from the "Aire Métropolitaine de Port-au-Prince" region (Ref.), aged 12-23 months (aOR = 1.79; 95% CI: 1.26-2.55), whose mothers were aged 35 and above (aOR = 1.75; 95% CI: 1.15-2.67), whose mothers had secondary and higher levels (aOR = 1.63; 95% CI: 1.02-2.60), whose mothers were in a union (aOR = 2.18; 95% CI: 1.23-3.85), whose mothers did not consider the distance to the health facility a big problem (aOR = 1.35; 95% CI: 1.01-1.84), and children from communities with high access to improved toilet facilities (Ref.) were significantly more likely to receive diarrhea treatment.
To increase the uptake of diarrhea treatment in Haiti, policymakers and stakeholders must give due consideration to those factors. They should educate the population on the causes of childhood diarrhea, its consequences, and the importance of ORS and RHF. The socio-economic vulnerability of some Haitian communities, especially those with low access to improved toilet facilities, could be a major barrier to the use of diarrhea treatments. Consequently, the Haitian government needs to subsidize these products so that they are freely available in public health facilities and pharmacies in these communities.
在海地，儿童腹泻是儿童严重疾病和死亡的主要原因之一。尽管腹泻治疗是降低腹泻相关儿童发病率和死亡率的关键，但与腹泻疾病就医行为相关的因素记录甚少。为填补这一空白，本研究旨在确定海地母亲中儿童腹泻就医行为的患病率并识别相关因素。
本研究基于从海地人口与健康调查第五轮（2016 - 2017年）收集的二手数据。儿童腹泻的就医行为是结果变量。各种人口统计学和社会经济变量被视为解释变量。采用描述性统计（单变量和双变量百分比分布、Pearson卡方检验）和多水平逻辑回归从数据中得出推论。
1245名儿童构成了我们的研究人群。在调查前两周内患有腹泻并接受治疗（口服补液盐（ORS）或推荐的家庭补液（RHF））的儿童患病率为42.9%（95%置信区间40.2 - 45.6）。结果还显示，来自“太子港大都会区”地区（参照组）、年龄在12 - 23个月的儿童（调整后比值比（aOR） = 1.79；95%置信区间：1.26 - 2.55），其母亲年龄在35岁及以上（aOR = 1.75；95%置信区间：1.15 - 2.67），其母亲具有中学及以上学历（aOR = 1.63；95%置信区间：1.02 - 2.60），其母亲处于婚姻关系中（aOR = 2.18；95%置信区间：1.23 - 3.85），其母亲不认为到医疗机构的距离是个大问题（aOR = 1.35；95%置信区间：1.01 - 1.84），以及来自改善厕所设施使用率高的社区的儿童（参照组）更有可能接受腹泻治疗。
为提高海地腹泻治疗的使用率，政策制定者和利益相关者必须充分考虑这些因素。他们应就儿童腹泻的病因、后果以及口服补液盐和推荐的家庭补液的重要性对民众进行教育。一些海地社区的社会经济脆弱性，尤其是那些改善厕所设施使用率低的社区，可能是腹泻治疗使用的主要障碍。因此，海地政府需要对这些产品进行补贴，以便在这些社区的公共卫生设施和药店免费提供。
