Health Seeking in People Later Diagnosed as Having Dengue Fever during the Epidemic of 2018 in Kerala, India

Abstract

BACKGROUND Dengue Fever is a major contributor to morbidity and mortality among all communicable diseases in Kerala. Delay in seeking care is significantly associated with complications. Understanding health seeking behaviour of persons with risk of infection, helps in improving health care delivery. METHODS A cross sectional study was done among 100 dengue fever patients listed under Integrated Disease Surveillance Programme (IDSP) of Thiruvananthapuram district, Kerala state. Data regarding their health seeking behaviour during the course of the disease was collected using a structured questionnaire. RESULTS Inappropriate health seeking behaviour indicated by delay in seeking care and self medication was found in 22 % (95 % CI; 13.9 - 30.1) of subjects. Mean (SD) of delay in seeking health care was 3.01 (1.3) days. Treatment was initiated from government health facility by 63 % of patients. Primary level health care facility was sought by 61 % patients whereas 30 % opted for a secondary level facility. Proximity of the location of health facility to the patient’s dwelling was the factor influencing choice of treatment facility in 70 % of patients, followed by perceived quality of facility (15 %) and patient perceived competency of the physician (9 %). Male gender (p = 0.03) and educational status less than secondary level (p = 0.008) were significant risk factors for self-medication and delay in seeking health care. CONCLUSIONS Inappropriate health seeking behaviour in patients with suspected Dengue Fever is comparatively less in Kerala. Majority are seeking care from Government facilities and access to health care is influencing health seeking behaviour. Awareness generation in general and specific interventions targeting those with lower education status can further improve health seeking behaviour and reduce complications of dengue. KEYWORDS Health Seeking Behaviour, Dengue Fever, Self-Medication, Delay in Seeking Care, Healthcare Access, Kerala

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“…This could be attributed to gender-related differences in healthseeking behavior. Awareness generation in general and specific interventions targeting those with lower education status can further improve the health-seeking behavior and reduce complications of dengue 27 .…”