Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program

作者：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 Noel; Hertz Julian T; Im Justin; von Kalckreuth Vera; Keddy Karen H; Lankoande Bruno; Lofberg Sandra; Meyer Christian G; Oresto Michael Munishi; Park Jin Kyung; Park Se Eun; Rakotozandrindrainy Raphael; Sarpong Nimako; Soura Abdramane Bassiahi

来源：Clinical Infectious Diseases, 2016, 62(suppl 1): S56-S68.

DOI：10.1093/cid/civ891

• healthcare utilization
• typhoid fever
• sub-Saharan Africa

Methods.aEuro integral 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.aEuro integral 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.aEuro integral 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.

• 出版日期2016-3-15