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Determinants of Delayed Treatment-Seeking for Childhood Diarrheal Diseases in Southwest Ethiopia: A Case-Control Study.

ABSTRACT: Background:Although there are low cost and effective interventions to prevent and treat diarrhea, it is one of the leading causes of morbidity and mortality among under-five children in developing countries. Deaths from diarrheal diseases are largely due to lack of prompt seeking of medical care. This study aimed to identify determinants of delayed treatment-seeking for diarrheal diseases among under-five children in Southwest Ethiopia. Methods:Unmatched case-control study was conducted among 324 under-five children paired with their mothers/caregivers from 1st April to 30th May 2019. Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Consecutive sampling was used, and data were collected through interviews and chart reviews. Multivariable binary logistic regression analysis was performed, and variables with a P-value <0.05 were considered statistically significant. Results:A total of 324 (162 cases and 162 controls) under-five children paired with their mothers/caregivers were included in this study. Being rural residents (AOR=1.93, 95% CI: 1.13,3.31), children from households with more than two children (AOR=2.05, 95% CI: 1.15-3.66), preferring traditional healers for the treatment of diarrhea (AOR= 4.78, 95% CI: 1.74,13.12), not having television or radio for the households (AOR=2.05, 95% CI: 1.11-3.66), living in more than 10 km from the nearest health facility (AOR=4.80, 95% CI: 2.61-4.83), and perceiving diarrhea can cure without treatment (AOR=2.11, 95% CI: 1.15-3.87) were significant determinants of delayed treatment-seeking. Conclusion:Being rural residents, larger family size, physical inaccessibility of health facilities, not having access to electronic media (television or radio), preferring traditional healers for the treatment of diarrhea, and having the perception that diarrhea can be cured without treatment were determinants of delayed treatment-seeking for diarrheal diseases among under-five children. Thus, multidimensional approaches that can address accessibility of health facilities and improve caregivers' awareness are necessary to encourage prompt treatment-seeking for diarrheal diseases among under-five children.

SUBMITTER: Asefa A

PROVIDER: S-EPMC7293983 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Determinants of Delayed Treatment-Seeking for Childhood Diarrheal Diseases in Southwest Ethiopia: A Case-Control Study.

Asefa Adane A Qanche Qaro Q Asaye Zufan Z Abebe Lemi L

Pediatric health, medicine and therapeutics 20200610

<h4>Background</h4>Although there are low cost and effective interventions to prevent and treat diarrhea, it is one of the leading causes of morbidity and mortality among under-five children in developing countries. Deaths from diarrheal diseases are largely due to lack of prompt seeking of medical care. This study aimed to identify determinants of delayed treatment-seeking for diarrheal diseases among under-five children in Southwest Ethiopia.<h4>Methods</h4>Unmatched case-control study was con ...[more]

PMID: 32607050

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Project description:BackgroundDelays in seeking timely appropriate care contributes to a large number of deaths from diarrhea in children. This study aimed to identify determinants of delays in seeking timely treatment by mothers/caregivers of under-five children with diarrheal diseases.MethodsWe used an unmatched case-control study from February-March 2017 among 316 children: 158 cases and 158 controls. Cases were mothers/caregivers with under-five children who had signs/symptoms of diarrhea and sought treatment after 24 hours onset of symptom. Controls sought treatment within 24 hours. Field workers collected data using a pre-tested standardized questionnaire. Multivariate logistic regression was conducted to identify determinants of delay in timely diarrhea treatment seeking. Statistical significance was declared by using a p-value<0.05 and 95% of confidence interval (CI) for an adjusted-odds ratio (AOR).ResultsThe determinants of delay in timely treatment seeking of mothers/caregivers of under-five children with diarrheal diseases were children <24months (AOR = 1.9,95%CI:1.1-3.4); fail to attend school (AOR = 2.4, 95%CI:1.2-4.6); being female children (AOR = 1.7,95%CI:1.05-2.9); preferring government health facility for the treatment of children with diarrheal diseases (AOR = 2.9, 95%CI, 1.3-6.7); lack of past history taking children to health facility and lack of counseling (AOR = 4.8, 95%CI:2.0-12.1); being in the15-25 years age (AOR = 1.7, 95%CI:1.1-3.0) and taking children to a health facility as a first response to diarrhea (AOR = 0.1, 95%CI:0.01-0.8).ConclusionsAge of the child, maternal age, and disease related determinants were determinants for seeking timely treatment to diarrheal diseases. Providing skilled based health education and counseling to mothers/caregivers on seeking timely treatment and taking children with diarrheal diseases to a health facility as a first response to diarrhea is a paramount intervention to reduce morbidity and mortality of children.

Project description:BackgroundDiabetic Retinopathy is one of the serious complications patients' diabetic patients suffer from. Little is known about which risk factors are associated with this complication. The aim of this study was therefore to identify determinants of Diabetic Retinopathy in Jimma University Medical Center.MethodsA facility-based case-control study was conducted. Cases were Diabetic patients with diabetic retinopathy and who were on follow up at the Jimma University Medical Center while controls were Diabetic patients but free of diabetic retinopathy and who were on follow up at the Jimma University Medical Center. Cases and controls were identified and 311 of them were recruited using systematic random sampling. Data were entered into the Epi-Data version 4.1 and analyzed using SPSS Version 20. Binary Logistic regression analysis was conducted to identify determinants of diabetic retinopathy.ResultA total of 106 cases and 205 controls diabetic participated in the study. Being ≥60 years of age (AOR = 5.04,95%CI: 1.83,13.87),being illiterate (AOR = 7.17, 95% CI: 2.61,19.7), poor adherence to medication (AOR =3: 95% CI: 1.29,6.95),having high systolic blood pressure (AOR = 3.38:95% CI: 1.26,9.05), having family history of Diabetes Mellitus (AOR = 3.95: 95% CI: 1.64,9.54), having other micro vascular complications (AOR = 3.76,95% CI: 1.33,10.66), poor glycemic control (AOR = 9.08, 95%CI: 3.7,22.29), poor cholesterol control (AOR = 0.21, 95%CI: 0.08,0.51) and being anaemic (AOR = 2.8, 95%CI: 1.05,7.47) were the independent determinants of diabetic retinopathy.ConclusionThis study found that poor adherence to medication, being at the age of 60 years and above, being illiterate patients, having high systolic blood pressure, having a family history of Diabetes Mellitus, having other micro vascular complication, poor glycemic control, poor cholesterol control and being anemic patient were the independent determinants of diabetic retinopathy. Therefore, more attention should be given to older age and illiterate patients. Giving more emphasis for patients poorly adhered to anti-diabetic medications and giving advice for diabetic patients with high systolic blood pressure to follow their blood pressure regularly are also vital. Diabetic patients should also control their Blood sugar and blood cholesterol levels to prevent diabetic retinopathy or reduce its further complications.

Project description:Background:Worldwide, 10-20% of women experience depression during pregnancy. In sub-Saharan countries, depression during pregnancy is estimated to be 15-57%. Even though there is a high burden of depression during pregnancy, little attention has been given to identify sociodemographic and obstetric determinants in diverse populations like Ethiopia. Objective:To identify sociodemographic and obstetric determinants of antenatal depression among women attending an antenatal clinic at Jimma Medical Center, southwest Ethiopia. Patients and Methods:A case-control study was conducted among 246 pregnant mothers (82 cases and 164 controls) attending an antenatal clinic in Jimma Medical Center from June 1 to August 30, 2019. Antenatal depression was assessed using the Beck Depression Inventory-II. Epidata 3.1 and SPSS v24 were used for data entry and analysis, respectively. Adjusted odds ratios (AOR) and 95%CIs were estimated using logistic regression models. Statistical significance was set at P<0.05. Results:Married mothers were 67% (AOR=0.33, 95%CI: 0.15-0.75), housewives were 97% (AOR=0.03, 95%CI: 0.01-0.14), private workers were 87% (AOR=0.13, 95%CI: 0.04-0.44), and government employees were 84% (AOR=0.16, 95%CI: 0.05-0.46), less likely to develop antenatal depression. Multigravida were 88% (AOR=0.12, 95%CI: 0.04-0.37) less likely to develop antenatal depression. Third trimester pregnancy was four times (AOR=4.04, 95%CI: 1.51-10.81) more likely to have depression. Mothers who having wanted pregnancy were 83% (AOR=0.17, 95%CI: 0.04-0.81) less likely to develop antenatal depression compared with mothers having unwanted pregnancy. Conclusion and Recommendation:Being married, multigravida, having wanted pregnancy and occupation status (housewives, private workers and government employees) can protect mothers from developing antenatal depression. Mothers with third trimester pregnancy were four times more likely to have depression. Designing a screening and intervention strategy for antenatal depression must consider the aforementioned protective and risk factors.

Project description:BACKGROUND:Timely and appropriate health care seeking for diarrhea of under-five children is important to reduce severe and life-threatening complications. However, different findings indicate that mothers of under-five children often delay in seeking care which in turn contributes to the death of large number of children without ever reaching a health facility. Therefore, a proper pinpointing of determinants of delay in seeking care informs intervention strategies for health service planners. OBJECTIVES:Of this study was to identify the determinants of delay in care seeking for diarrheal disease among mothers/caregivers of under-five children in public health facilities of Arba Minch town, South Ethiopia, 2019. METHODS:Facility based case control study was conducted from March 4 to April 30, 2019. Total sample size was 400. Cases were selected by systematic random sampling technique while controls were mothers of under-five children with signs and symptoms of diarrhea who came to the same health facility within 24 hours following cases. Data was collected by using pretested structured questionnaire by three data collectors and entered into EpiData V4 and exported to SPSS V23 for further analysis. Bivariable logistic regression was done to identify variables candidate for Multivariable LR at p-value<0.25. Multivariable logistic regression was done and p-value <0.05 and 95%CI of AOR was used to declare statistical significance. RESULT:Female sex[AOR = 1.93, (95%CI: 1.11,3.36)], child age <24 months[AOR = 4.47,95%CI:2.51,7.97)], mothers'/caregivers without formal education[AOR = 6.90, (95%CI:3.10,15.37)], and attended primary school [AOR = 3.12,(95%CI:1.44,6.73)], poorest household wealth index category[AOR = 2.81, (95%CI:1.20,6.58) and poor household wealth index category [AOR = 2.61,(95%CI: 1.12, 6.09)], mothers/caregivers who did not visit health facility to first episode diarrhea [AOR = 4.55, (95%CI:2.41,8.59)], mothers/caregivers who were satisfied in the last six month visit [AOR = 0.29, (95%CI:0.15,0.55)], and poor perceived health care professionals respect[AOR = 4.91, (95%CI:2.64,9.15)] were important determinants of delay in seeking care. CONCLUSIONS:Sex and age of the child, educational status of the mother/caregiver, poor wealth index category, not visiting health facility at first response, satisfaction with the care and examination, and respect of health care professionals were important determinants of delay in seeking care among mothers/caregivers of under-five children with diarrhea illness. All concerned body should focus interventions on poor and less educated mothers/caregivers with emphasis on female children and <24 months. Health workers are needed to provide respectful service to promote satisfaction level of clients.

Project description:Ethiopia is rapidly increasing insecticide-treated nets (ITNs) coverage to combat malaria, but adequate follow-up and factors affecting use of ITNs is lacking. The aim of this study was to assess determinants of the use of ITNs in a southwest area of Ethiopia.This cross-sectional survey was conducted in the Chewaka district settlement area of southwest Oromia from March to May, 2013. Kebeles were stratified by degree of urbanization (rural, peri-urban, or urban). Randomly selected households, which had been freely supplied with at least one ITN, were surveyed using a pre-tested, structured questionnaire administered through household interviews. Logistic regression analysis was used to examine the association between use of ITNs and determinant factors.Of 574 households surveyed, 72.6 % possessed ITNs and 80 % of these had been used the night before the survey. The most common reasons for the absence ITNs in the household identified in this study were ITNs were old and therefore discarded and that households use ITNs for purposes other than their intended use. The multivariate analysis found that knowledge of malaria transmission by mosquito bites (Adjusted OR = 3.44, 95 % CI: 1.80-6.59), and washing of ITNs at least once by households (Adjusted OR = 2.66, 95 % CI: 1.35-5.26) were significantly associated with an ITN being used by households. The mean possession was 1.59 ITN per household (3.57 persons per an ITN). One hundred fifty four (36.9 %) of ITNs had at least one hole/tear. Among these, 108 (70.1 %) ITNs had at least one hole/tear with greater than 2 cm and 29 (18.8 %) had greater than seven holes/tears.This study in Southwest Ethiopia showed a high proportion of net ownership compared to a household survey from Ethiopia which included in the World Malaria Report. Despite somewhat high percentages ITN ownership, the study demonstrated there was still a gap between ownership and use of ITNs. Use of ITNs was affected by knowledge of malaria transmission by mosquito bite and washing of ITNs at least once by households. Intensive health education and community mobilization efforts should be employed to attempt to influence these factors that significantly affect ITN use.

Project description:BackgroundEctopic pregnancy is an abnormal condition in which implantation of the blastocyst occurs outside the endometrium of the uterus. It is gynecological important, particularly in the developing world, because of associated with enormous rate of high morbidity, during the first trimester of pregnancy. A better understanding of its risk factors can help to prevent its prevalence. However, the determinants of ectopic pregnancy are not well understood and few researches conducted in our country were based on secondary data covering small scale area. This study aimed to identify determinants of ectopic pregnancy among pregnant women attending referral hospitals in Southwestern part of Oromia regional state, Southwest Ethiopia.MethodsHospital-based case control study was employed from June 1 to September 30, 2019. The study was conducted in five referral hospitals in Southwestern part of Oromia regional state. Final sample size includes 59 cases and 118 controls. Data were entered by using Epidata version 3.1 and analyzed using SPSS version 23. Descriptive statistics were used to explore the data. All explanatory variables with p-value of < 0.25 in bi-variable analysis, then entered into multivariable logistic regression. Associated factors were identified at 95% confidence interval (p < 0.05).ResultsOut of 177 (59 cases and 118 controls) participants, 174 (58 cases and 116 controls) were participating in the study. Prior two or more induced abortions [AOR = 3.95:95% CI: 1.22-13.05], previous history of caesarean section [AOR = 3.4:95% CI: 1.11-10.94], marital status (being single) [AOR = 4.04:95%CI: 1.23-13.21], reporting prior recurrent sexual transmitted infection [AOR = 2.25:95%CI: 1.00-5.51], prior history of tubal surgery [AOR = 3.32:95%CI: 1.09-10.13], were more likely to have an ectopic pregnancy with their respective AOR with 95%CI.ConclusionIt was found that having a history of more than two induced abortions during previous pregnancies, marital status (single), recurrent sexual transmitted infection, prior history of tubal surgery and experiencing prior caesarean section were found to be determinants of ectopic pregnancy. Hospitals should give emphasis on prevention and early detection of risks of ectopic pregnancy and create awareness in order to reduce the burden of ectopic pregnancy.

Dataset Information

Determinants of Delayed Treatment-Seeking for Childhood Diarrheal Diseases in Southwest Ethiopia: A Case-Control Study.

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Determinants of Delayed Treatment-Seeking for Childhood Diarrheal Diseases in Southwest Ethiopia: A Case-Control Study.

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