Healthcare Seeking Behavior and Disease Perception Toward Cholera and Acute Diarrhea Among Populations Living in Cholera High-Priority Hotspots in Shashemene, Ethiopia

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Abstract

Background

Healthcare seeking behavior (HSB) and community perception on cholera can influence its management. We conducted a cross-sectional survey to generate evidence on cholera associated HSB and disease perception in populations living in cholera hotspots in Ethiopia.

Methods

A total of 870 randomly selected households (HHs) in Shashemene Town (ST) and Shashemene Woreda (SW) participated in our survey in January 2022.

Results

Predominant HHs (91.0%; 792/870) responded “primary health center” as the nearest healthcare facility (HCF). Around 57.4% (247/430) of ST HHs traveled <30 minutes to the nearest HCF. In SW, 60.2% (265/440) of HHs travelled over 30 minutes and 25.9% (114/440) over 4 km. Two-thirds of all HHs paid <USD1 travel cost; SW residents had slightly higher cost burden. When cholera symptoms occur, 68.0% (83/122), 75.5% (114/151), 100.0% (52/52), and 100.0% (426/426) of 0–4, 5–14, 15–17, and ≥18 years, respectively, in ST sought healthcare at our sentinel-HCFs. In SW, younger children visited our sentinel-HCFs slightly more (82.6%, 86.7% in 1–4, 5–14 years, respectively) than older age groups (74.4%, 75.6% in 15–17, ≥ 18 years, respectively). Relatively more adults in ST (12.0%; 51/426) sought over-the-counter drugs at pharmacies than those in SW (2.5%; 11/435). Around 73.8% (642/870) of HHs were aware of cholera disease and 66.7% (428/642) of HHs considered eating unclean food as main causes of cholera.

Conclusions

Variations in cholera prevention practices between rural and urban residents were shown. Addressing differences in HSB per age groups is needed for community engagement for early case detection and case management; critical in reducing cholera deaths and transmission.

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Most cited references 31

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Inappropriate Use of Antibiotics and Its Associated Factors among Urban and Rural Communities of Bahir Dar City Administration, Northwest Ethiopia

Endalew Gebeyehu, Laychiluh Bantie, Muluken Azage (2015)

Background Inappropriate use of antibiotics in the community plays a role in the emergence and spread of bacteria resistant to antibiotics which threatens human health significantly. The present study was designed to determine inappropriate use of antibiotics and its associated factors among urban and rural communities of Bahir Dar city administration. Methods A comparative cross sectional study design was conducted in urban and rural kebeles of Bahir Dar city administration from February 1 to March 28, 2014. A total of 1082 participants included in the study using a systematic random sampling technique. Data was collected using pre-tested and structured questionnaire. Data was coded and entered into SPSSS version 16 for statistical analysis. Bivariate and multivariate logistic regression model were used to identify factors associated with inappropriate use of antibiotics. Results Inappropriate use of antibiotics was 30.9% without significant difference between urban (33.1%) and rural (29.2%) communities. From the inappropriate antibiotic use practice, self-medication was 18.0% and the remaining (12.9%) was for family member medication. Respiratory tract symptoms (74.6%), diarrhea (74.4%), and physical injury/wound (64.3%) were the three main reasons that the communities had used antibiotics inappropriately. Factors associated with inappropriate use of antibiotics were low educational status, younger age, unsatisfaction with the health care services, engagement with a job, and low knowledge on the use of antibiotic preparations of human to animals. Conclusions Inappropriate use of antibiotic exists in the study area with no significant difference between urban and rural communities. The study indicated an insight on what factors that intervention should be made to reduce inappropriate use of antibiotics in the community. Interventions that consider age groups, educational status, common health problems and their jobs together with improvement of health care services should be areas of focus to reduce inappropriate use of antibiotics.

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Prevalence and determinants of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis

Animut Alebel, Cheru Tesema, Belisty Temesgen … (2018)

Background Despite remarkable progress in the reduction of under-five mortality, childhood diarrhea is still the leading cause of mortality and morbidity in this highly susceptible and vulnerable population. In Ethiopia, study findings regarding prevalence and determinants of diarrhea amongst under-five children have been inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of diarrhea and its determinants among under-five children in Ethiopia. Methods International databases, including PubMed, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library, were systematically searched. All identified observational studies reporting the prevalence and determinants of diarrhea among under-five children in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. STATA Version 13 statistical software was used. The Cochrane Q test statistics and I 2 test were used to assess the heterogeneity of the studies. A random effects model was computed to estimate the pooled prevalence of diarrhea. Moreover, the associations between determinant factors and childhood diarrhea were examined using the random effect model. Results After reviewing of 535 studies, 31studies fulfilled the inclusion criteria and were included in the meta-analysis. The findings from the 31 studies revealed that the pooled prevalence of diarrhea among under-five children in Ethiopia was 22% (95%CI: 19, 25%). Subgroup analysis of this study revealed that the highest prevalence was observed in Afar region (27%), followed by Somali and Dire Dawa regions (26%), then Addis Abeba (24%). Lack of maternal education (OR: 2.5, 95% CI: 1.3, 2.1), lack of availability of latrine (OR: 2.0, 95%CI: 1.3, 3.2), urban residence (OR: 1.9, 95%CI: 1.2, 3.0), and maternal hand washing (OR: 2.2, 95%CI: 2.0, 2.6) were significantly associated with childhood diarrhea. Conclusion In this study, diarrhea among under-five children in Ethiopia was significantly high. Lack of maternal education, lack of availability of latrine, urban residence, and lack of maternal hand washing were significantly associated with childhood diarrhea.

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FACTORS INFLUENCING HEALTH-SEEKING BEHAVIOUR AMONG CIVIL SERVANTS IN IBADAN, NIGERIA

O.O. Latunji, O.O. AKINYEMI (2018)

Background: Health-seeking behaviours (HSB) are closely linked with the health status of a nation and thus its economic development. Several studies have described HSB within the context of various diseases. However, knowledge of HSB among population sub-groups is still scanty. This study aims to determine factors most important to civil servants when seeking health care. Methods: A descriptive cross-sectional study was conducted among 337 civil servants working in the Federal Secretariat, Ibadan, Nigeria. An intervieweradministered semi-structured questionnaire was used to collect information. Chi-square tests were used to test for associations while binary logistic regression test was used for determining predictors. All data analysis were done at 5% level of significance. Results: Members of the poorest quartile were 6 times more likely to have inappropriate HSB than the richest quartile (Q4:Q1= 5.83;O.R: 16.12, 95% C.I: 2.61-11.03). Visits to the hospital or clinic (62.2%) was the most common source of healthcare sought. This was followed by visits to the chemist (33.0%), traditional healers (4.3%). A little more than one-third (34.5%) of respondents considered good service delivery as the most important factor affecting HSB. This was followed by proximity (23.9%), affordability (20.4%), prompt attention (8.8%) and readily-available drugs (7.1%). Completing only basic education [O.R: 0.24 (0.06, 0.96)] and out of pocket payment [O.R: 0.04 (9.16, 82.45)] were associated with a reduction in the likelihood of seeking healthcare from formal sources. Conclusion: Appropriate health-seeking behaviour was found to be high among civil servants. However, lower cadre workers and those with lower levels of education need to be targeted during policy formulation to improve health-seeking behaviour. In addition, health insurance schemes should be extended to cover more of the population in order to improve health-seeking behaviour.

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Author and article information

Contributors

Tomas Getahun

Dejene Hailu

Ondari D Mogeni

Edlawit Mesfin Getachew

Biruk Yeshitela

Yeonji Jeon

Abel Gedefaw

Samuyel Ayele Abebe

Ermiyas Hundito

David Mukasa

Geun Hyeog Jang

Gi Deok Pak

Deok Ryun Kim

Yeshambel Worku Demlie

Mukemil Hussen

Mekonnen Teferi

Se Eun Park:

ORCID: https://orcid.org/0000-0002-1632-3045

Journal

Journal ID (nlm-ta): Clin Infect Dis

Journal ID (iso-abbrev): Clin Infect Dis

Journal ID (publisher-id): cid

Title: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

Publisher: Oxford University Press (US )

ISSN (Print): 1058-4838

ISSN (Electronic): 1537-6591

Publication date Collection: 15 July 2024

Publication date (Electronic): 12 July 2024

Publication date PMC-release: 12 July 2024

Volume: 79

Issue: Suppl 1 , Ethiopia Cholera Control and Prevention (ECCP): Evidence-Generation Towards Global Roadmap to Ending Cholera

Pages: S43-S52

Affiliations

Clinical Trials Directorate, Armauer Hansen Research Institute , Addis Ababa, Ethiopia

Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute , Seoul, Republic of Korea

School of Public Health, Hawassa University , Hawassa, Ethiopia

Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute , Seoul, Republic of Korea

Clinical Trials Directorate, Armauer Hansen Research Institute , Addis Ababa, Ethiopia

Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute , Addis Ababa, Ethiopia

Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute , Seoul, Republic of Korea

College of Medicine and Health Sciences, Hawassa University , Hawassa, Ethiopia

Statistics and Data Management Department, Armauer Hansen Research Institute , Addis Ababa, Ethiopia

Clinical Trials Directorate, Armauer Hansen Research Institute , Addis Ababa, Ethiopia

Biostatistics and Data Management (BDM) Department, International Vaccine Institute , Seoul, Republic of Korea

Public Health Emergency Management, Ethiopia Public Health Institute , Addis Ababa, Ethiopia

Clinical Trials Directorate, Armauer Hansen Research Institute , Addis Ababa, Ethiopia

Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute , Seoul, Republic of Korea

Department of Global Health and Disease Control, Yonsei University Graduate School of Public Health , Seoul, Republic of Korea

Author notes

M. T. and S. E. P. contributed equally to this work.

Correspondence: S. E. Park, DPhil in Clinical Medicine. Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute. SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 Korea; Yonsei University Graduate School of Public Health, Seoul, Korea ( SeEun.Park@ 123456ivi.int ).

Potential conflicts of interest . The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Author information

Se Eun Park https://orcid.org/0000-0002-1632-3045

Article

Publisher ID: ciae232

DOI: 10.1093/cid/ciae232

PMC ID: 11244153

PubMed ID: 38996036

SO-VID: 3f1a8ace-2f5a-44f9-9566-96ae5379b1c2

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 25 September 2023

Date: 23 April 2024

Page count

Pages: 10

Funding

Funded by: Korea Support Committee;

Funded by: International Vaccine Institute;

Award ID: CHMTD05083-010

Funded by: LG Electronics, DOI 10.13039/501100017634;

Award ID: CHMTD05083-020

Funded by: Community Chest of Korea, DOI 10.13039/100021024;

Award ID: CHMTD05083-030

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Healthcare Seeking Behavior and Disease Perception Toward Cholera and Acute Diarrhea Among Populations Living in Cholera High-Priority Hotspots in Shashemene, Ethiopia

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Abstract

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Novel Coronavirus Disease COVID-19

Most cited references 31

Inappropriate Use of Antibiotics and Its Associated Factors among Urban and Rural Communities of Bahir Dar City Administration, Northwest Ethiopia

Prevalence and determinants of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis

FACTORS INFLUENCING HEALTH-SEEKING BEHAVIOUR AMONG CIVIL SERVANTS IN IBADAN, NIGERIA

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