Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

Panzner, Ursula

Pak, Gi Deok

Aaby, Peter

Adu-Sarkodie, Yaw

Ali, Mohammad

Aseffa, Abraham

Baker, Stephen

Bjerregaard-Andersen, Morten

Crump, John A

Deerin, Jessica

Cruz Espinoza, Ligia Maria

Gasmelseed, Nagla

Heriniaina, Jean Noël

Hertz, Julian T

Im, Justin

von Kalckreuth, Vera

Keddy, Karen H

Lankoande, Bruno

Løfberg, Sandra

Meyer, Christian G

Oresto, Michael Munishi

Park, Jin Kyung

Park, Se Eun

Rakotozandrindrainy, Raphaël

Sarpong, Nimako

Soura, Abdramane Bassiahi

Gassama Sow, Amy

Tall, Adama

Teferi, Mekonnen

Worku, Alemayehu

Yeshitela, Biruk

Wierzba, Thomas F

Marks, Florian

United States

2017-03-02T18:54:51Z

2017-03-02T18:54:51Z

2016-03-15

BACKGROUND: Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. METHODS: A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility-based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined. RESULTS: Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion-namely, 20%-45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania-sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites. CONCLUSIONS: Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever.

https://www.ncbi.nlm.nih.gov/pubmed/26933023

civ891

1537-6591

https://hdl.handle.net/10161/13758

eng

Oxford University Press (OUP)

Clin Infect Dis

10.1093/cid/civ891

healthcare utilization

sub-Saharan Africa

typhoid fever

Adolescent

Adult

Africa South of the Sahara

Aged

Aged, 80 and over

Child

Child, Preschool

Cross-Sectional Studies

Female

Humans

Infant

Infant, Newborn

Male

Middle Aged

Patient Acceptance of Health Care

Typhoid Fever

Young Adult

Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

Journal article

Hertz, Julian T|0000-0002-7396-4789

https://www.ncbi.nlm.nih.gov/pubmed/26933023

S56

S68

Clinical Science Departments

Duke

Medicine

Medicine, Infectious Diseases

Pathology

School of Medicine

Surgery

Surgery, Emergency Medicine

Published

62 Suppl 1