Health care seeking for childhood diarrhea in developing countries: evidence from seven sites in Africa and Asia.
Health care seeking for childhood diarrhea in developing countries: evidence from seven sites in Africa and Asia.
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DOI：
10.4269/ajtmh.12-0749
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Kotloff KL
中科院分区：
文献类型：
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作者：
Nasrin D;Wu Y;Blackwelder WC;Farag TH;Saha D;Sow SO;Alonso PL;Breiman RF;Sur D;Faruque ASG;Zaidi AKM;Biswas K;Van Eijk AM;Walker DG;Levine MM;Kotloff KL
我们对参与全球肠道多中心研究（GEMS）的0-59个月儿童的看护人进行了系列卫生保健利用和态度调查（HUASs）， GEMS是一项在7个发展中国家进行的中度至重度腹泻（MSD）病例对照研究。调查的目的是估计到哨点卫生中心（SHCs）就诊的MSD儿童的比例，这些哨点卫生中心将招募GEMS病例，并为调整疾病发病率提供基础，以包括在SHCs未见的病例。每个地点报告在调查前7天内发生MSD事件的儿童比例，婴儿（0-11个月）为0.7%至4.4%，幼儿（12-23个月）为0.4%至4.7%，学龄前儿童（24-59个月）为0.3%至2.4%。在三个年龄层中，每个地点在腹泻发病后7天内发生MSD的比例分别为15-56%、17-64%和7 - 33%。高昂的护理费用和对危险信号的认识不足与在家庭之外缺乏任何寻求护理的行为有关。大多数儿童在家中没有得到建议的补液和持续喂养。我们已经展示了系列HUASs作为优化与大型病例对照研究性能相关的操作和方法问题的工具的效用，并得出了基于人群的MSD发病率。此外，调查还提出了教育干预的关键目标，这些干预可能会改善低资源环境中腹泻疾病的预后。
We performed serial Health Care Utilization and Attitudes Surveys (HUASs) among caretakers of children ages 0–59 months randomly selected from demographically defined populations participating in the Global Enteric Multicenter Study (GEMS), a case-control study of moderate-to-severe diarrhea (MSD) in seven developing countries. The surveys aimed to estimate the proportion of children with MSD who would present to sentinel health centers (SHCs) where GEMS case recruitment would occur and provide a basis for adjusting disease incidence rates to include cases not seen at the SHCs. The proportion of children at each site reported to have had an incident episode of MSD during the 7 days preceding the survey ranged from 0.7% to 4.4% for infants (0–11 months of age), from 0.4% to 4.7% for toddlers (12–23 months of age), and from 0.3% to 2.4% for preschoolers (24–59 months of age). The proportion of MSD episodes at each site taken to an SHC within 7 days of diarrhea onset was 15–56%, 17–64%, and 7–33% in the three age strata, respectively. High cost of care and insufficient knowledge about danger signs were associated with lack of any care-seeking outside the home. Most children were not offered recommended fluids and continuing feeds at home. We have shown the utility of serial HUASs as a tool for optimizing operational and methodological issues related to the performance of a large case-control study and deriving population-based incidence rates of MSD. Moreover, the surveys suggest key targets for educational interventions that might improve the outcome of diarrheal diseases in low-resource settings.
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影响因子：
3.5
作者：
Filmer, D;Pritchett, LH
通讯作者：
Pritchett, LH
影响因子：
5.4
作者：
Nyamongo, IK
通讯作者：
Nyamongo, IK
影响因子：
5.4
作者：
Ellis, Amy A.;Winch, Peter;Swedberg, Eric
通讯作者：
Swedberg, Eric
影响因子：
7.7
作者：
ALAM, N;HENRY, FJ;RAHAMAN, MM
通讯作者：
RAHAMAN, MM
DOI：
10.1093/cid/cis755
发表时间：
2012-12
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Biswas K;Carty C;Horney R;Nasrin D;Farag TH;Kotloff KL;Levine MM
通讯作者：
Levine MM