TY - JOUR
T1 - Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program
AU - Panzner, Ursula
AU - Pak, Gi Deok
AU - Aaby, Peter
AU - Adu-Sarkodie, Yaw
AU - Ali, Mohammad
AU - Aseffa, Abraham
AU - Baker, Stephen
AU - Bjerregaard-Andersen, Morten
AU - Crump, John A.
AU - Deerin, Jessica
AU - Cruz Espinoza, Ligia Maria
AU - Gasmelseed, Nagla
AU - Heriniaina, Jean Noël
AU - Hertz, Julian T.
AU - Im, Justin
AU - Von Kalckreuth, Vera
AU - Keddy, Karen H.
AU - Lankoande, Bruno
AU - Løfberg, Sandra
AU - Meyer, Christian G.
AU - Oresto, Michael Munishi
AU - Park, Jin Kyung
AU - Park, Se Eun
AU - Rakotozandrindrainy, Raphaël
AU - Sarpong, Nimako
AU - Soura, Abdramane Bassiahi
AU - Gassama Sow, Amy
AU - Tall, Adama
AU - Teferi, Mekonnen
AU - Worku, Alemayehu
AU - Yeshitela, Biruk
AU - Wierzba, Thomas F.
AU - Marks, Florian
N1 - Publisher Copyright:
© 2016 The Author.
PY - 2016/3/15
Y1 - 2016/3/15
N2 - 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.
AB - 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.
KW - healthcare utilization
KW - sub-Saharan Africa
KW - typhoid fever
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U2 - 10.1093/cid/civ891
DO - 10.1093/cid/civ891
M3 - Article
C2 - 26933023
AN - SCOPUS:84959888226
SN - 1058-4838
VL - 62
SP - s56-s68
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
ER -