Dataset Information

Healthcare seeking patterns of families of infants with circumcision-related morbidities from two population-based cohort studies in Ghana.

ABSTRACT:

Objective

This study assessed healthcare seeking patterns of families of infants with circumcision-related morbidities and families of infants with acute illnesses in rural Ghana.

Design

Two population-based cohort studies.

Setting

Brong Ahafo Region of central rural Ghana.

Participants

A total of 22?955 infants enrolled in a large population-based trial (Neovita trial) from 16 August 2010 to 7 November 2011 and 3141 infants in a circumcision study from 21 May 2012 to 31 December 2012.

Primary outcome

Care seeking for circumcision-related morbidities and acute illnesses unrelated to circumcision.

Results

Two hundred and thirty (8.1%) infants from the circumcision study had circumcision-related morbidities and 6265 (27.3%) infants from the Neovita study had acute illnesses unrelated to circumcision. A much lower proportion (35, 15.2%) of families of infants with circumcision-related morbidities sought healthcare compared with families of infants with acute illnesses in the Neovita study (5520, 88.1%). More families sought care from formal providers (24, 69%) compared with informal providers (11, 31%) for circumcision-related morbidities. There were no obvious determinants of care seeking for acute illnesses or circumcision-related morbidities in the population.

Conclusions

Government and non-government organisations need to improve awareness about the complications and care seeking needed for circumcision-related morbidities.

SUBMITTER: Gyan T

PROVIDER: S-EPMC5724066 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Publications

Healthcare seeking patterns of families of infants with circumcision-related morbidities from two population-based cohort studies in Ghana.

Gyan Thomas T McAuley Kimberley K O'Leary Maureen M Strobel Natalie A NA Edmond Karen M KM

BMJ open 20170829 8

<h4>Objective</h4>This study assessed healthcare seeking patterns of families of infants with circumcision-related morbidities and families of infants with acute illnesses in rural Ghana.<h4>Design</h4>Two population-based cohort studies.<h4>Setting</h4>Brong Ahafo Region of central rural Ghana.<h4>Participants</h4>A total of 22 955 infants enrolled in a large population-based trial (Neovita trial) from 16 August 2010 to 7 November 2011 and 3141 infants in a circumcision study from 21 May 2012 t ...[more]

PMID: 28851802

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Project description:BackgroundOver half of under-five deaths occur in sub-Saharan Africa and appropriate, timely, quality care is critical for saving children's lives. This study describes the context surrounding children's deaths from the time the illness was first noticed, through the care-seeking patterns leading up to the child's death, and identifies factors associated with care-seeking for these children in rural Rwanda.MethodsSecondary analysis of a verbal and social autopsy study of caregivers who reported the death of a child between March 2013 to February 2014 that occurred after discharge from the child's birth facility in southern Kayonza and Kirehe districts in Rwanda. Bivariate analyses using Fisher's exact tests were conducted to identify child, caregiver, and household factors associated with care-seeking from the formal health system (i.e., community health worker or health facility). Factors significant at α = 0.10 significance level were considered for backwards stepwise multivariate logistic regression, stopping when remaining factors were significantly associated with care-seeking at α = 0.05 significance level.ResultsAmong the 516 eligible deaths among children under-five, 22.7% (n = 117) did not seek care from the health system. For those who did, the most common first point of contact was community health workers (45.8%). In multivariate logistic regression, higher maternal education (OR = 3.36, 95% CI: 1.89, 5.98), having diarrhea (OR = 4.21, 95%CI: 1.95, 9.07) or fever (OR = 2.03, 95%CI: 1.11, 3.72), full household insurance coverage (3.48, 95%CI: 1.79, 6.76), and longer duration of illness (OR = 22.19, 95%CI: 8.88, 55.48) were significantly associated with formal care-seeking.ConclusionInterventions such as community health workers and insurance promote access to care, however a gap remains as many children had no contact with the health system prior to death and those who sought formal care still died. Further efforts are needed to respond to urgent cases in communities and further understand remaining barriers to accessing appropriate, quality care.

Project description:ObjectiveTo determine the effect of implementation of the Integrated Management of Neonatal and Childhood Illness strategy on treatment seeking practices and on neonatal and infant morbidity.DesignCluster randomised trial.SettingHaryana, India.Participants29,667 births in nine intervention clusters and 30,813 births in nine control clusters.Main outcome measuresThe pre-specified outcome was the effect on treatment seeking practices. Post hoc exploratory analyses assessed morbidity, hospital admission, post-neonatal infant care, and nutritional status outcomes.InterventionsThe Integrated Management of Neonatal and Childhood Illness intervention included home visits by community health workers, improved case management of sick children, and strengthening of health systems. Outcomes were ascertained through interviews with randomly selected caregivers: 6204, 3073, and 2045 in intervention clusters and 6163, 3048, and 2017 in control clusters at ages 29 days, 6 months, and 12 months, respectively.ResultsIn the intervention cluster, treatment was sought more often from an appropriate provider for severe neonatal illness (risk ratio 1.76, 95% confidence interval 1.38 to 2.24), for local neonatal infection (4.86, 3.80 to 6.21), and for diarrhoea at 6 months (1.96, 1.38 to 2.79) and 12 months (1.22, 1.06 to 1.42) and pneumonia at 6 months (2.09, 1.31 to 3.33) and 12 months (1.44, 1.00 to 2.08). Intervention mothers reported fewer episodes of severe neonatal illness (risk ratio 0.82, 0.67 to 0.99) and lower prevalence of diarrhoea (0.71, 0.60 to 0.83) and pneumonia (0.73, 0.52 to 1.04) in the two weeks preceding the 6 month interview and of diarrhoea (0.63, 0.49 to 0.80) and pneumonia (0.60, 0.46 to 0.78) in the two weeks preceding the 12 month interview. Infants in the intervention clusters were more likely to still be exclusively breast fed in the sixth month of life (risk ratio 3.19, 2.67 to 3.81).ConclusionImplementation of the Integrated Management of Neonatal and Childhood Illness programme was associated with timely treatment seeking from appropriate providers and reduced morbidity, a likely explanation for the reduction in mortality observed following implementation of the programme in this study.Trial registration Clinical trials NCT00474981; ICMR Clinical Trial Registry CTRI/2009/091/000715.

Project description:Background Parasitic infections among human immunodeficiency virus (HIV)-infected patients are common in various regions and populations across the world and have since remained a persistent public health challenge. Sub-Saharan Africa harbors the greatest burden of the infections due to sociodemographic and behavioral factors. However, the prevalence of gastrointestinal parasitic infections among HIV-infected persons has been poorly investigated in Ghana. Aim This study sought to determine the prevalence of gastrointestinal parasitic infections and associated factors in HIV-infected individuals attending the antiretroviral therapy (ART) clinic in St. Mary Theresa Hospital, Dodi Papase. Methods A cross-sectional study was conducted from June 2021 to September 2021 among three hundred and thirty-five HIV-infected individuals in the study area. Sociodemographic and behavioral factors were collected with the aid of a close-ended structured questionnaire. Furthermore, stool samples were collected from each participant and examined for the presence of intestinal parasites by microscopy using direct wet mount, formol-ether concentration, and modified Ziehl–Neelsen (Zn) techniques. Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 22.0 and Graphpad Prism version 8. Results The prevalence of gastrointestinal parasitic infections was 5.97%. Species-specific prevalence was found to be 2.99% for Giardia lamblia, 1.19% for Ascaris lumbricoides, and 0.90% each for Entamoeba histolytica/dispar and Trichuris trichiura. There was a significant association between participants' educational level and intestinal parasitic infection. In addition, gastrointestinal parasitic infections were not found to be associated with age. Unemployed participants, those with a lower frequency of deworming, and those who do not use water closet toilet facilities were at a higher risk of getting infected. Conclusion The lower infection rate recorded in this study suggests that public health interventions put in place are yielding significant results. Even though the prevalence is low, routine screening of all HIV-infected patients for parasitic infection is recommended to ensure timely, effective treatment and comprehensive care.

Project description:BackgroundIn spite of the strong role of traditional medicine in childcare in the pluralistic healthcare system in Western Africa, little information is known on mothers' domestic plant knowledge. Identifying local perspectives and treatments of children's illnesses, including folk illnesses, is essential to having a comprehensive understanding of how mothers make healthcare treatment decisions. We aimed to identify which infant illnesses Beninese and Gabonese mothers knew to treat with medicinal plants and for which illnesses they sought biomedical care or traditional healers.MethodsWe conducted 81 questionnaires with mothers in Bénin and Gabon and made 800 botanical specimens of cited medicinal plants. We calculated the number of species cited per illness and the proportion of participants knowledgeable on at least one herbal remedy per illness. Using qualitative data, we described folk illnesses in each country and summarized responses on preferences for each of the three healthcare options.ResultsParticipants from both countries were most knowledgeable on plants to treat respiratory illnesses, malaria, diarrhea, and intestinal ailments. Mothers also frequently mentioned the use of plants to encourage children to walk early, monitor the closure of fontanels, and apply herbal enemas. Major folk illnesses were atita and ka in Bénin and la rate and fesses rouges in Gabon. Traditional healers were reported to have specialized knowledge of cultural bound illnesses. Malaria was frequently cited as an illness for which mothers would directly seek biomedical treatment.ConclusionMothers largely saw the three systems as complementary, seamlessly switching between different healing options until a remedy was found. Folk illnesses were found to give insight into local treatments and may reveal important neglected diseases. Due to high reported levels of knowledge on treating top statistical causes of infant mortality and folk illnesses, mothers' medicinal plant knowledge should be included in the analysis of healthcare-seeking behavior for childcare.

Dataset Information

Healthcare seeking patterns of families of infants with circumcision-related morbidities from two population-based cohort studies in Ghana.

Objective

Design

Setting

Participants

Primary outcome

Results

Conclusions

Publications

Healthcare seeking patterns of families of infants with circumcision-related morbidities from two population-based cohort studies in Ghana.

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