Determinants of health care seeking for diarrheal illness in young children in urban slums of Kolkata, India.
Determinants of health care seeking for diarrheal illness in young children in urban slums of Kolkata, India.
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DOI：
10.4269/ajtmh.12-0756
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发表时间：
2013-07
期刊：
影响因子：
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通讯作者：
Sur D
中科院分区：
文献类型：
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作者：
Manna B;Nasrin D;Kanungo S;Roy S;Ramamurthy T;Kotloff KL;Levine MM;Sur D
有关儿童保健的产妇做法已被认为是与5岁儿童死亡率有关的一个重要因素。我们重点调查了加尔各答5岁腹泻病儿童的主要照顾者的求医行为。在一次基线调查中，我们采访了1058名儿童的照顾者，在随后的六次调查中，我们采访了6077名儿童。前两周的腹泻患病率在基线调查中为7.9%，在随后的调查中为5.7%(最低3.5%至最高7.8%)。多因素Logistic回归分析显示，初级照顾者受过正规教育与外出就医有关(优势比[OR]=15.5；95%可信区间[CI][2.5~85.7]；P=0.002)。多因素Logistic回归分析显示，与不在家中寻求照顾的儿童相比，初级照顾者的正规教育(OR=21.495%CI[3.2~139.0]；P=0.002)和腹泻时口干(OR=17.3；95%CI[2.7~110.9]；P=0.003)与寻求有执照的照顾者有关。这项卫生保健利用和态度调查(HUAS)可以作为一种工具，用来确定影响加尔各答城市贫民窟更好的卫生保健寻求模式的因素。
Maternal practices regarding children's health care have been recognized as an important factor associated with mortality rates among children < 5 years of age. We focused on health care-seeking practices of primary caretakers of children < 5 years of age with diarrheal disease in Kolkata. We interviewed caretakers of 1,058 children in a baseline survey and 6,077 children on six subsequent surveys. The prevalence of diarrhea during the preceding 2 weeks was 7.9% in the baseline survey and 5.7% (lowest 3.5% to highest 7.8%) in subsequent surveys. Multivariate logistic regression showed that formal education of primary caretakers was associated with seeking care outside the home (odds ratio [OR] = 15.5; 95% confidence interval [CI] [2.5–85.7]; P = 0.002). Multinomial logistic regression showed that formal education of the primary caretaker (OR = 21.4; 95% CI [3.2–139.0]; P = 0.002) and presence of dry mouth during diarrhea (OR = 17.3; 95% CI [2.7–110.9]; P = 0.003) were associated with seeking care from licensed providers compared with the children for whom care was not sought outside of the home. This health care utilization and attitudes survey (HUAS) can serve as a tool to identify the factors that influence a better health care-seeking pattern in urban slums of Kolkata.