Treatment-seeking for febrile illness in north-east India: an epidemiological study in the malaria endemic zone

Abstract

BackgroundThis paper studies the determinants of utilization of health care services, especially for treatment of febrile illness in the malaria endemic area of north-east India.MethodsAn area served by two districts of Upper Assam representing people living in malaria endemic area was selected for household survey. A sample of 1,989 households, in which at least one member of household suffered from febrile illness during last three months and received treatment from health service providers, were selected randomly and interviewed by using the structured questionnaire. The individual characteristics of patients including social indicators, area of residence and distance of health service centers has been used to discriminate or group the patients with respect to their initial and final choice of service providers.ResultsOf 1,989 surveyed households, initial choice of treatment-seeking for febrile illness was self-medication (17.8%), traditional healer (Vaidya)(39.2%), government (29.3%) and private (13.7%) health services. Multinomial logistic regression (MLR) analysis exhibits the influence of occupation, area of residence and ethnicity on choice of health service providers. The traditional system of medicine was commonly used by the people living in remote areas compared with towns. As all the febrile cases finally received treatment either from government or private health service providers, the odds (Multivariate Rate Ratio) was almost three-times higher in favour of government services for lower households income people compared to private.ConclusionThe study indicates the popular use of self-medication and traditional system especially in remote areas, which may be the main cause of delay in diagnosis of malaria. The malaria training given to the paramedical staff to assist the health care delivery needs to be intensified and expanded in north-east India. The people who are economically poor and living in remote areas mainly visit the government health service providers for seeking treatment. So, the improvement of quality health services in government health sector and provision of health education to people would increase the utilization of government health services and thereby improve the health quality of the people.

Do community health workers perceive mechanisms associated with the success of community case management of malaria? A qualitative study from Burkina Faso

“…Selling paracetamol alone is prohibited because, while attenuating the fever, it delays the administration of appropriate antimalarial treatments e which can increase lethality (Chaturvedi et al, 2009;McCombie, 1996).…”

Health care seeking behavior of parents of under five in District Kanga, Himachal Pradesh

“…Easy availability, less fees and better responsiveness were probably in favor of visiting nonqualified practitioners. [13][14][15] Multiple studies from Nepal reported that 26% of people visited traditional healers exclusively while only 19% first visited formal health care institutions, medical shops without consultation were common source of medicines, and around half of episodes of childhood illnesses were treated by pharmacists. [16][17][18] In a study by Gera et al, from on women of Uttarakhand all respondents went for traditional/home remedies/other remedy initially and only 6.5% opted allopathic medicine as the first choice.…”

Etiological Spectrum and Prevalence of Acute Undifferentiated Febrile Illness (AUFI) in Fever Cases Attending our Tertiary Care Centre

“…In limited resource settings fever may be treated empirically or self treated due to lack of access to diagnostic tests. Thus knowledge of local prevalence of infections is critical in order to target clinical work up and treatment as shown in Mittal et al, (2015) and Chaturvedi et al, (2009). Studies from Tamilnadu by Anugrah Chrispal et al, (2010), Rani et al, (2016), Gopalakrishnan et al, (2013) and Kerala by Andrews et al, (2014) showed most of the AUFI are treatable and reduction in mortality if they were diagnosed earlier.…”