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Determinants and pa...
Determinants and pathways of healthcare-seeking behaviours in under-5 children for common childhood illnesses and antibiotic prescribing : a cohort study in rural India
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- Khare, Shweta (författare)
- Karolinska Inst, Dept Global Publ Hlth, Hlth Syst & Policy HSP Med Focusing Antibiot, S-17177 Stockholm, Sweden.;Ruxmaniben Deepchand Gardi Med Coll, Dept Publ Hlth & Environm, Ujjain 456006, Madhya Pradesh, India.
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- Pathak, Ashish, 1973- (författare)
- Karolinska Institutet,Uppsala universitet,Internationell barnhälsa och nutrition,Karolinska Inst, Dept Global Publ Hlth, Hlth Syst & Policy HSP Med Focusing Antibiot, S-17177 Stockholm, Sweden; Ruxmaniben Deepchand Gardi Med Coll, Dept Pediat, Ujjain 456006, Madhya Pradesh, India
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- Purohit, Manju Raj (författare)
- Karolinska Inst, Dept Global Publ Hlth, Hlth Syst & Policy HSP Med Focusing Antibiot, S-17177 Stockholm, Sweden.;Ruxmaniben Deepchand Gardi Med Coll, Dept Pathol, Ujjain 456006, Madhya Pradesh, India.
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- Sharma, Megha (författare)
- Karolinska Institutet
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- Marrone, Gaetano (författare)
- Karolinska Institutet
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- Tamhankar, Ashok J. (författare)
- Karolinska Institutet
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- Stålsby Lundborg, Cecilia (författare)
- Karolinska Institutet
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- Diwan, Vishal (författare)
- Karolinska Institutet
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Karolinska Inst, Dept Global Publ Hlth, Hlth Syst & Policy HSP Med Focusing Antibiot, S-17177 Stockholm, Sweden;Ruxmaniben Deepchand Gardi Med Coll, Dept Publ Hlth & Environm, Ujjain 456006, Madhya Pradesh, India. Internationell barnhälsa och nutrition (creator_code:org_t)
- 2021-12-03
- 2021
- Engelska.
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:12
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://bmjopen.bmj....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Objectives To explore the healthcare-seeking pathways, antibiotic prescribing and determine the sociodemographic factors associated with healthcare-seeking behaviour (HSB) of caregivers for common illnesses in under-5 (U-5) children in rural Ujjain, India.Study design Prospective cohort study.Study setting and study sample The cohort included 270 U-5 children from selected six villages in rural demographic surveillance site, of the R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India. A community-based cohort was visited two times weekly for over 113 weeks (August 2014 to October 2016) to record the HSB of caregivers using HSB diaries. Sociodemographic information was also solicited.Primary and secondary outcome measures Primary outcomes: first point of care, healthcare-seeking pathway and quantify antibiotic prescribing for the common acute illnesses.Secondary outcome HSB risk factors were determined using mixed-effects multinomial logistic regression.Results A total of 60 228 HSB follow-up time points for 270 children were recorded with a total of 2161 acute illness episodes. The most common illnesses found were respiratory tract infections (RTI) (69%) and gastrointestinal tract infections (8%). No healthcare was sought in 33% of illness episodes, mostly for RTIs. The most common healthcare-seeking pathway was to informal healthcare providers (IHCPs, 49% of illness episodes). The adjusted relative risk for obtaining no treatment, home treatment and treatment by IHCPs was higher for RTIs (aRR=11.54, 1.82 and 1.29, respectively), illiterate mothers (aRR=2.86, 2.38 and 1.93, respectively), and mothers who were homemakers (aRR=2.90, 4.17 and 2.10, respectively). Socioeconomic status was associated with HSB, with the highest aRR for no treatment in the lowest two socioeconomic quintiles (aRR=6.59 and 6.39, respectively). Antibiotics were prescribed in 46% (n=670/1450) illness episodes and the majority (85%, n=572/670) were broad spectrum.Conclusion In our rural cohort for many acute episodes of illnesses, no treatment or home treatment was done, which resulted in overall reduced antibiotic prescribing. The most common healthcare-seeking pathway was to visit IHCPs, which indicates that they are major healthcare providers in rural areas. Most of the antibiotics were prescribed by IHCPs and were commonly prescribed for illnesses where they were not indicated.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Nyckelord
- quality in health care
- public health
- community child health
- primary care
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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