Analysis of care-seeking pathways and factors influencing early and appropriate care-seeking for malaria patients in the Republic of Guinea: a cross-sectional study.

Autor: Diallo EM; African Centre of Excellence for the Prevention and Control of Communicable Diseases, Faculty of Health Sciences and Techniques, University of Conakry, Conakry, Republic of Guinea. elhadjmaroufd@yahoo.fr.; CHU Clermont-Ferrand, UFR Medicine & Paramedical Professions, University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute, Aubière, France. elhadjmaroufd@yahoo.fr., Traore FB; African Centre of Excellence for the Prevention and Control of Communicable Diseases, Faculty of Health Sciences and Techniques, University of Conakry, Conakry, Republic of Guinea., Camara BS; Centre National de Recherche et de Formation en Santé Rurale de Maferinyah Guinée (CNRFSR), Maferenya, Republic of Guinea., Langlet A; CHU Clermont-Ferrand, UFR Medicine & Paramedical Professions, University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute, Aubière, France., Delamou A; African Centre of Excellence for the Prevention and Control of Communicable Diseases, Faculty of Health Sciences and Techniques, University of Conakry, Conakry, Republic of Guinea.; Centre National de Recherche et de Formation en Santé Rurale de Maferinyah Guinée (CNRFSR), Maferenya, Republic of Guinea., Diallo OO; Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, USA., Gerbaud L; CHU Clermont-Ferrand, UFR Medicine & Paramedical Professions, University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute, Aubière, France., Camara A; African Centre of Excellence for the Prevention and Control of Communicable Diseases, Faculty of Health Sciences and Techniques, University of Conakry, Conakry, Republic of Guinea.; National Malaria Control Programme (NMCP), Conakry, Republic of Guinea.
Jazyk: angličtina
Zdroj: Malaria journal [Malar J] 2024 Sep 10; Vol. 23 (1), pp. 273. Date of Electronic Publication: 2024 Sep 10.
DOI: 10.1186/s12936-024-05102-x
Abstrakt: Background: Malaria is a major public health issue in Guinea and care-seeking behaviour is dominated by self-medication and delayed access to appropriate care. However early and appropriate care-seeking are essential to control and reduce complicate forms and mortality, particularly for the most vulnerable. This study was conducted to analyse the diagnostic pathway, and the factors associated with early and appropriate care-seeking for malaria patients in the Republic of Guinea.
Methods: A cross-sectional study was carried out between December 2022 to March 2023 in nine health districts within health facilities and at community level. The study population was confirmed malaria patients with RDT or microscopy. Kroeger's conceptual framework was used to design the questionnaire. Conventional recourse was defined as using a healthcare facility or community services, early and appropriate care-seeking was defined as within 24 h of symptom onset in a conventional recourse, and care pathway as the sequence of recourses followed by each patient. Sankey alluvial plots were used to represent patients' diagnostic pathways, and logistic regression to identify factors associated with early and appropriate care-seeking.
Results: A total of 3300 malaria patients were studied, of which 1632 (49.45%) were female and 1132 (34.30%) were under 5 years of age, with a median age of 23 months. At the time of the survey, 1337 (40.52%), 1423 (43.12%), and 437 (13.85%) of patients were respectively in their first, second and third recourse. A total of 2002 (60.67%) patients had sought care from a conventional recourse as a first line. Of all patients, 1757 (53.25%) had sought care within 24 h, while 28.55% had sought early and appropriate care. In the initial stages of treatment, self-medication was the most common approach, used by 1214 (37.30%). Patients from the health districts of Boffa (Lower Guinea, coastal region) OR = 0.48 95% CI 0.33-0.70, Dabola (Upper Guinea, savanna region) OR = 0.43 95% CI 0.30-0.63 and Labe (Middle Guinea, mountain region) OR = 0.63 CI 95% 0.43-0.91 (p < 0.05) were more likely to delay appropriate care-seeking, when compared to those in Dixinn, (Conakry). However, the under 5-year-old group OR = 1.55 95% CI 1.30-1.85 (p < 0.001) and the availability of a stable monthly household income OR = 4.98 95% CI 3.03, 8.27 (p < 0.001) were positively associated with early and appropriate care seeking.
Conclusion: A low rate of early and appropriate care-seeking was observed. Patients sought care through multiple means, often resulting in a delay in adequate management. The results show the need to deploy strategies adapted to the needs of communities.
(© 2024. The Author(s).)
Databáze: MEDLINE
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