Association between caregivers’ knowledge and care seeking behaviour for children with symptoms of pneumonia in six sub-Saharan African Countries

Noordam, Aaltje Camielle; Sharkey, Alyssa; Hinssen, Paddy; Dinant, Geert-Jan; Cals, Jochen

doi:10.1186/s12913-017-2060-3

Cited by 32 publications

(36 citation statements)

References 26 publications

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“…One qualitative study 25 revealed demandside barriers to healthcare utilisation in Nigeria, suggesting that costs, physical distance, cultural considerations, and knowledge of symptoms and warning signs might all play a role in delayed careseeking and could explain behaviours in other locations. In one study 26 of six countries in sub Saharan Africa, only 30% of care givers recognised fast breathing or difficulty in breathing as a symptom of LRI. Among several countries in western subSaharan Africa, the proportion of care givers who reported seeking treatment for symptoms of pneumonia ranged from 27·4% in Chad to 73·2% in Sierra Leone and was 41·9% in Nigeria.…”

Section: Discussionmentioning

confidence: 99%

“…Among several countries in western subSaharan Africa, the proportion of care givers who reported seeking treatment for symptoms of pneumonia ranged from 27·4% in Chad to 73·2% in Sierra Leone and was 41·9% in Nigeria. 26 Appropriate care and treatment to protect against LRI mortality are important but the two risk factors responsible for the largest reduction in LRI mortality at the global level and for the largest prevention of incident episodes of LRI are Hib vaccine coverage and household air pollution. Vaccines have been an important part of LRI prevention in many countries.…”

Section: Discussionmentioning

confidence: 99%

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Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years: an analysis for the Global Burden of Disease Study 2017

Troeger¹,

Khalil²,

Blacker³

et al. 2020

The Lancet Infectious Diseases

115

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Background Despite large reductions in under-5 lower respiratory infection (LRI) mortality in many locations, the pace of progress for LRIs has generally lagged behind that of other childhood infectious diseases. To better inform programmes and policies focused on preventing and treating LRIs, we assessed the contributions and patterns of risk factor attribution, intervention coverage, and sociodemographic development in 195 countries and territories by drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) LRI estimates. MethodsWe used four strategies to model LRI burden: the mortality due to LRIs was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive ensemble modelling tool; the incidence of LRIs was modelled using population representative surveys, health-care utilisation data, and scientific literature in a compartmental meta-regression tool; the attribution of risk factors for LRI mortality was modelled in a counterfactual framework; and trends in LRI mortality were analysed applying changes in exposure to risk factors over time. In GBD, infectious disease mortality, including that due to LRI, is among HIV-negative individuals. We categorised locations based on their burden in 1990 to make comparisons in the changing burden between 1990 and 2017 and evaluate the relative percent change in mortality rate, incidence, and risk factor exposure to explain differences in the health loss associated with LRIs among children younger than 5 years.Findings In 2017, LRIs caused 808 920 deaths (95% uncertainty interval 747 286-873 591) in children younger than 5 years. Since 1990, there has been a substantial decrease in the number of deaths (from 2 337 538 to 808 920 deaths; 65·4% decrease, 61·5-68·5) and in mortality rate (from 362·7 deaths [330·1-392·0] per 100 000 children to 118·9 deaths [109·8-128·3] per 100 000 children; 67·2% decrease, 63·5-70·1). LRI incidence declined globally (32·4% decrease, 27·2-37·5). The percent change in under-5 mortality rate and incidence has varied across locations. Among the risk factors assessed in this study, those responsible for the greatest decrease in under-5 LRI mortality between 1990 and 2017 were increased coverage of vaccination against Haemophilus influenza type b (11·4% decrease, 0·0-24·5), increased pneumococcal vaccine coverage (6·3% decrease, 6·1-6·3), and reductions in household air pollution (8·4%, 6·8-9·2).Interpretation Our findings show that there have been substantial but uneven declines in LRI mortality among countries between 1990 and 2017. Although improvements in indicators of sociodemographic development could explain some of these trends, changes in exposure to modifiable risk factors are related to the rates of decline in LRI mortality. No single intervention would universally accelerate reductions in health loss associated with LRIs in all settings, but emphasising the most dominant risk factors, particularly in countries with high case fatality, can contribut...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years: an analysis for the Global Burden of Disease Study 2017

Troeger¹,

Khalil²,

Blacker³

et al. 2020

The Lancet Infectious Diseases

115

View full text Add to dashboard Cite

show abstract

“…Out of 596 diarrheic children, only 196 (32.9%) were taken by their caregivers to health facilities. Parents with poor knowledge are unlikely to go to hospitals because there is a positive association between knowledge and care-seeking behavior [ 40 ]. The percentage of caregivers who knew home-based fluids for treating diarrhea was very low in similar studies from other developing countries [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Caregivers’ knowledge and attitudes about childhood diarrhea among refugee and host communities in Gambella Region, Ethiopia

Mekonnen

Mengistie

Sahilu

et al. 2018

J Health Popul Nutr

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BackgroundMaternal knowledge, attitudes, and practices related to hygiene, breastfeeding, sanitary food preparation, and appropriate weaning practices are potentially important determinants in the occurrence of diarrhea in children. However, few studies have been carried out about the knowledge and attitudes about childhood diarrhea among parents in refugee camps and host communities.ObjectiveThis study aims at assessing the caregivers’ knowledge and attitudes regarding acute diarrhea in under-five children among refugee and host communities in Gambella Region, Ethiopia.MethodologyThis cross-sectional study, employing multistage sampling, was carried out from September to December 2016. Data was collected by a questionnaire-based interview, and 1667 caregivers were included in this study. A composite knowledge score was calculated, and a five-point Likert type of attitude scale was developed to assess the attitudes of the caregivers towards childhood diarrhea. Appropriate descriptive statistics and logistic regression models were used. Odds ratios (ORs) are presented with their 95% confidence intervals (CIs), and all analyses were performed at the 5% significance level (p < 0.05).ResultThe study indicates that 633 (28.0%) of the caregivers had poor knowledge, while 393 (23.6%) of them had unfavorable attitudes towards childhood diarrhea. Knowledge of the caregivers was significantly associated with formal education (AOR, 1.3; 95% CI, 1.03–1.5) and health information obtained from a health care institution (AOR, 1.8; 95% CI, 1.28–2.3). Caregivers’ knowledge is a single predictor of their attitude (p < 0.001), and Pearson’s correlation coefficient revealed that there was a significant positive correlation (r = 0.2, p < 0.001) between knowledge and attitude scores.ConclusionThe study indicates that significant numbers of caregivers had inadequate knowledge and unfavorable attitudes about diarrhea in under-five children. Designing and implementing an inclusive health education intervention focusing on uneducated child caregivers may be beneficial for improving knowledge and attitudes towards reducing the incidence of acute childhood diarrhea in the region.

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“…A systematic review found recognition of pneumonia by caregivers in low income countries to be poor [7]. Caregivers’ poor knowledge of the symptoms and danger signs of childhood pneumonia can also contribute to delays or failure to seek care [8,9]. Other factors such as distance to health care facilities and economic status can affect caregivers’ ability to seek care.…”

mentioning

confidence: 99%

Care seeking behaviour and aspects of quality of care by caregivers for children under five with and without pneumonia in Ibadan, Nigeria

Kirolos¹,

Ayede²,

Williams³

et al. 2018

Journal of Global Health

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BackgroundThis study aimed to investigate the differences in reported care seeking behaviour and treatment between children with pneumonia and children without pneumonia with cough and/or difficult breathing.MethodsThree hundred and two children aged 0-59 months with fast breathing pneumonia were matched with 302 children seeking care for cough and/or difficult breathing at four outpatient clinics in Ibadan, Nigeria. After follow up at home, Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) questionnaires were administered in the community by trained field workers to gather information around care seeking delay, patterns of care seeking, appropriateness of care seeking and treatment provided once care was sought. Multivariable analysis was carried out to determine significant factors associated with care seeking delay.ResultsChildren with pneumonia had a significantly longer delay (median = 3d) before seeking care than those without pneumonia (median = 2d; P = 0.001). The length of the delay was 21% (95% confidence interval (CI) = 1%-42%) greater in those aged 0-1 month and 11% (95% CI = 5%-42%) greater in those aged 2-11 months compared to those aged 12-59 months. The length of delay was 17% (95% CI = 5%-30%) greater in rural locations than urban ones, and 33% (95% CI = 7%-51%) shorter in fathers with only primary education compared to higher education, adjusted for covariates. The range of places where care was sought showed the same distribution in those with and without pneumonia. Twenty two per cent of those with pneumonia sought care first from inappropriate providers. The number of children for whom caregivers reported having received antibiotic treatment was 92% for those with pneumonia and 84% for those without pneumonia.ConclusionsGiven that children with pneumonia and cough/cold had similar patterns of reported care seeking information gathered on care seeking (type of provider visited) from DHS and MICS surveys on those with ‘symptoms of acute respiratory infection’ in this setting provide a reasonably valid indication of care seeking behaviours in children with pneumonia. There are high levels of antibiotic overuse for children with cough/cold in this setting which risks worsening antibiotic resistance.

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Association between caregivers’ knowledge and care seeking behaviour for children with symptoms of pneumonia in six sub-Saharan African Countries

Cited by 32 publications

References 26 publications

Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years: an analysis for the Global Burden of Disease Study 2017

Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years: an analysis for the Global Burden of Disease Study 2017

Caregivers’ knowledge and attitudes about childhood diarrhea among refugee and host communities in Gambella Region, Ethiopia

Care seeking behaviour and aspects of quality of care by caregivers for children under five with and without pneumonia in Ibadan, Nigeria

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