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

Abstract 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.
PMID
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Authors

Mayor MeshTerms

Delivery of Health Care

Keywords
Journal Title plos one
Publication Year Start




PMID- 28406952
OWN - NLM
STAT- MEDLINE
DA  - 20170413
DCOM- 20170428
LR  - 20170504
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 4
DP  - 2017
TI  - Individual and contextual factors associated with appropriate healthcare seeking 
      behavior among febrile children in Tanzania.
PG  - e0175446
LID - 10.1371/journal.pone.0175446 [doi]
AB  - 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 community-level 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.
FAU - Adinan, Juma
AU  - Adinan J
AUID- ORCID: http://orcid.org/0000-0002-7964-2879
AD  - Assistant Medical Officer (AMO)-General Teaching College, KCMC Hospital, Moshi,
      Tanzania.
AD  - Institute of Public Health, Department of Community Health, Kilimanjaro Christian
      Medical University College (KCMU Co), Moshi, Tanzania.
AD  - Department of Community Health, Kilimanjaro Christian Medical Centre (KCMC)
      Hospital, Moshi, Tanzania.
AD  - Institute of Public Health, Department of Epidemiology and Biostatistics,
      Kilimanjaro Christian Medical University College (KCMU Co), Moshi, Tanzania.
FAU - Damian, Damian J
AU  - Damian DJ
AD  - Institute of Public Health, Department of Community Health, Kilimanjaro Christian
      Medical University College (KCMU Co), Moshi, Tanzania.
AD  - Department of Community Health, Kilimanjaro Christian Medical Centre (KCMC)
      Hospital, Moshi, Tanzania.
AD  - Institute of Public Health, Department of Epidemiology and Biostatistics,
      Kilimanjaro Christian Medical University College (KCMU Co), Moshi, Tanzania.
FAU - Mosha, Neema R
AU  - Mosha NR
AD  - Institute of Public Health, Department of Community Health, Kilimanjaro Christian
      Medical University College (KCMU Co), Moshi, Tanzania.
AD  - Department of Community Health, Kilimanjaro Christian Medical Centre (KCMC)
      Hospital, Moshi, Tanzania.
AD  - Institute of Public Health, Department of Epidemiology and Biostatistics,
      Kilimanjaro Christian Medical University College (KCMU Co), Moshi, Tanzania.
FAU - Mboya, Innocent B
AU  - Mboya IB
AD  - Institute of Public Health, Department of Community Health, Kilimanjaro Christian
      Medical University College (KCMU Co), Moshi, Tanzania.
AD  - Department of Community Health, Kilimanjaro Christian Medical Centre (KCMC)
      Hospital, Moshi, Tanzania.
AD  - Institute of Public Health, Department of Epidemiology and Biostatistics,
      Kilimanjaro Christian Medical University College (KCMU Co), Moshi, Tanzania.
FAU - Mamseri, Redempta
AU  - Mamseri R
AD  - Institute of Public Health, Department of Community Health, Kilimanjaro Christian
      Medical University College (KCMU Co), Moshi, Tanzania.
AD  - Department of Community Health, Kilimanjaro Christian Medical Centre (KCMC)
      Hospital, Moshi, Tanzania.
AD  - Institute of Public Health, Department of Epidemiology and Biostatistics,
      Kilimanjaro Christian Medical University College (KCMU Co), Moshi, Tanzania.
FAU - Msuya, Sia E
AU  - Msuya SE
AD  - Institute of Public Health, Department of Community Health, Kilimanjaro Christian
      Medical University College (KCMU Co), Moshi, Tanzania.
AD  - Department of Community Health, Kilimanjaro Christian Medical Centre (KCMC)
      Hospital, Moshi, Tanzania.
AD  - Institute of Public Health, Department of Epidemiology and Biostatistics,
      Kilimanjaro Christian Medical University College (KCMU Co), Moshi, Tanzania.
LA  - eng
PT  - Journal Article
DEP - 20170413
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - *Delivery of Health Care
MH  - Female
MH  - Humans
MH  - Malaria/*epidemiology/*therapy
MH  - Male
MH  - Prevalence
MH  - Socioeconomic Factors
MH  - Tanzania/epidemiology
PMC - PMC5391017
EDAT- 2017/04/14 06:00
MHDA- 2017/04/30 06:00
CRDT- 2017/04/14 06:00
PHST- 2016/03/26 [received]
PHST- 2017/03/27 [accepted]
AID - 10.1371/journal.pone.0175446 [doi]
AID - PONE-D-16-07629 [pii]
PST - epublish
SO  - PLoS One. 2017 Apr 13;12(4):e0175446. doi: 10.1371/journal.pone.0175446.
      eCollection 2017.

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