Patterns of care for childhood malaria in Zambia
Patterns of care for childhood malaria in Zambia
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DOI：
10.1016/s0277-9536(00)00049-6
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发表时间：
2000-11-01
影响因子：
5.4
通讯作者：
Kachur, SP
中科院分区：
文献类型：
--
作者：
Baume, C;Helitzer, D;Kachur, SP
在世界许多地方，疟疾是儿童死亡的一个主要原因，尽管存在简单有效的治疗方法。本研究调查了赞比亚患有发烧或抽搐（疟疾的两个主要症状）的儿童的求医模式和获得适当治疗的障碍。该研究侧重于社区对发热性疾病的看法和反应，使用疾病叙述作为主要数据收集工具。154份详细叙述表明，母亲认识到发烧并及时治疗，并认为氯喹与退烧药联合使用是适当的治疗方法。共时性和历时性分析表明，尽管大多数病例也出现在正规卫生系统，但大多数治疗是从家中开始的。然而，无论是在家中治疗还是送到保健中心，大多数儿童都没有得到适当的护理——在本例中，是3天疗程的氯喹——因为难以获得治疗，而且不了解给予全剂量治疗的重要性。此外，尽管接受了氯喹，但仍有发热症状的儿童很少接受推荐的磺胺多辛-乙胺嘧啶二线治疗。大多数有抽搐症状的儿童被带到保健中心，但与单纯的疟疾儿童相比，他们更有可能接受传统治疗。(C) 2000, Elsevier Science Ltd.出版
Malaria is a major cause of death among children in many parts of the world, even though simple and effective treatments exist. This study examines care-seeking patterns and barriers to appropriate treatment for Zambian children with fever or convulsions, two key symptoms of malaria. The study focuses on community perceptions of and response to febrile illness, using illness narratives as the primary data collection vehicle. The 154 detailed narratives indicate that mothers recognize fever and treat promptly, and consider chloroquine in conjunction with anti-pyretics to be the appropriate treatment. Synchronic and diachronic analyses show that most treatment begins at home, although the majority of cases are also seen in the formal health system. However, whether treated at home or taken to the health center, most children do not receive appropriate care - in this case, a 3-day course of chloroquine - because of problems of access and lack of understanding of the importance of giving the full dose. Further, those children who continue to have fever despite receiving chloroquine seldom receive the recommended second-line treatment with sulfadoxine-pyrimethamine. Most children with symptoms of convulsions are taken to the health center, but are more likely than children with simple malaria to receive traditional treatments as well. (C) 2000 Published by Elsevier Science Ltd.