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Individual and contextual factors associated with appropriate healthcare seeking behavior among febrile children in Tanzania

Adinan, Juma ; Damian, Damian J. ; Mosha, Neema R. ; Mboya, Innocent B. LU orcid ; Mamseri, Redempta and Msuya, Sia E. (2017) In PLoS ONE 12(4). p.1-15
Abstract

Introduction: Fever in malaria endemic areas, has been shown to strongly predict malaria infection and is a key symptom influencing malaria treatment. WHO recommended confirmation testing for Plasmodium spp. before initiation of antimalarials due to increased evidence of the decrease of morbidity and mortality from malaria, decreased malaria associated fever, and increased evidence of high prevalence of non-malaria fever. To immediately diagnose and promptly offer appropriate management, caretakers of children with fever should seek care where these services can be offered; in health facilities. Objectives: This study was conducted to describe healthcare seeking behaviors among caretakers of febrile under five years, in Tanzania. And to... (More)

Introduction: Fever in malaria endemic areas, has been shown to strongly predict malaria infection and is a key symptom influencing malaria treatment. WHO recommended confirmation testing for Plasmodium spp. before initiation of antimalarials due to increased evidence of the decrease of morbidity and mortality from malaria, decreased malaria associated fever, and increased evidence of high prevalence of non-malaria fever. To immediately diagnose and promptly offer appropriate management, caretakers of children with fever should seek care where these services can be offered; in health facilities. Objectives: This study was conducted to describe healthcare seeking behaviors among caretakers of febrile under five years, in Tanzania. And to determine children's, household and communitylevel factors associated with parents' healthcare seeking behavior in health facilities. Methods: Secondary data analysis was done using the Tanzania HIV and Malaria Indicator Surveys (THMIS) 2011-2012. Three-level mixed effects logistic regression was used to assess children's, household and community-level factors associated with appropriate healthcare seeking behavior among care takers of febrile children as well as differentiating between household and community variabilities. Results: Of the 8573 children under the age of five years surveyed, 1,675(19.5%) had a history of fever two weeks preceding the survey. Of these, 951 (56.8%) sought appropriate healthcare. Febrile children aged less than a year have 2.7 times higher odds of being taken to the health facilities compared to children with two or more years of age. (OR: 2.7; 95%CI: 1.50-4.88). Febrile children from households headed by female caretakers have almost three times higher odds of being taken to the health facilities (OR: 2.85; 95%CI; 1.41-5.74) compared to households headed by men. Febrile children with caretakers exposed to mass media (radio, television and newspaper) have more than two times higher odds of being taken to health facilities compared to those not exposed to mass media. Febrile children from regions with malaria prevalence above national level have 41% less odds of being taken to health facilities (OR: 0.49; 95%CI: 0.29-0.84) compared to those febrile children coming from areas with malaria prevalence below the national level. Furthermore, febrile children coming from areas with higher community education levels have 57% (OR: 1.57; 95%CI: 1.14-2.15) higher odds of being taken to health facilities compared to their counterparts coming from areas with low levels of community education. Conclusion and recommendation: To effectively and appropriately manage and control febrile illnesses, the low proportion of febrile children taken to health facilities by their caretakers should be addressed through frequent advocacy of the importance of appropriate healthcare seeking behavior, using mass media particularly in areas with high malaria prevalence. Multifaceted approach needs to be used in malaria control and eradication as multiple factors are associated with appropriate healthcare seeking behavior.

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author
; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
in
PLoS ONE
volume
12
issue
4
article number
e0175446
pages
1 - 15
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:28406952
  • scopus:85017549932
ISSN
1932-6203
DOI
10.1371/journal.pone.0175446
language
English
LU publication?
no
additional info
Publisher Copyright: © 2017 Adinan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
id
5feebdfb-c321-4c80-b7f5-4bb6f2ecc3e2
date added to LUP
2022-09-29 10:09:52
date last changed
2024-07-11 22:16:06
@article{5feebdfb-c321-4c80-b7f5-4bb6f2ecc3e2,
  abstract     = {{<p>Introduction: Fever in malaria endemic areas, has been shown to strongly predict malaria infection and is a key symptom influencing malaria treatment. WHO recommended confirmation testing for Plasmodium spp. before initiation of antimalarials due to increased evidence of the decrease of morbidity and mortality from malaria, decreased malaria associated fever, and increased evidence of high prevalence of non-malaria fever. To immediately diagnose and promptly offer appropriate management, caretakers of children with fever should seek care where these services can be offered; in health facilities. Objectives: This study was conducted to describe healthcare seeking behaviors among caretakers of febrile under five years, in Tanzania. And to determine children's, household and communitylevel factors associated with parents' healthcare seeking behavior in health facilities. Methods: Secondary data analysis was done using the Tanzania HIV and Malaria Indicator Surveys (THMIS) 2011-2012. Three-level mixed effects logistic regression was used to assess children's, household and community-level factors associated with appropriate healthcare seeking behavior among care takers of febrile children as well as differentiating between household and community variabilities. Results: Of the 8573 children under the age of five years surveyed, 1,675(19.5%) had a history of fever two weeks preceding the survey. Of these, 951 (56.8%) sought appropriate healthcare. Febrile children aged less than a year have 2.7 times higher odds of being taken to the health facilities compared to children with two or more years of age. (OR: 2.7; 95%CI: 1.50-4.88). Febrile children from households headed by female caretakers have almost three times higher odds of being taken to the health facilities (OR: 2.85; 95%CI; 1.41-5.74) compared to households headed by men. Febrile children with caretakers exposed to mass media (radio, television and newspaper) have more than two times higher odds of being taken to health facilities compared to those not exposed to mass media. Febrile children from regions with malaria prevalence above national level have 41% less odds of being taken to health facilities (OR: 0.49; 95%CI: 0.29-0.84) compared to those febrile children coming from areas with malaria prevalence below the national level. Furthermore, febrile children coming from areas with higher community education levels have 57% (OR: 1.57; 95%CI: 1.14-2.15) higher odds of being taken to health facilities compared to their counterparts coming from areas with low levels of community education. Conclusion and recommendation: To effectively and appropriately manage and control febrile illnesses, the low proportion of febrile children taken to health facilities by their caretakers should be addressed through frequent advocacy of the importance of appropriate healthcare seeking behavior, using mass media particularly in areas with high malaria prevalence. Multifaceted approach needs to be used in malaria control and eradication as multiple factors are associated with appropriate healthcare seeking behavior.</p>}},
  author       = {{Adinan, Juma and Damian, Damian J. and Mosha, Neema R. and Mboya, Innocent B. and Mamseri, Redempta and Msuya, Sia E.}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1--15}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Individual and contextual factors associated with appropriate healthcare seeking behavior among febrile children in Tanzania}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0175446}},
  doi          = {{10.1371/journal.pone.0175446}},
  volume       = {{12}},
  year         = {{2017}},
}