Determination of cut-off and correlates of delay in treatment-seeking of febrile illness: a retrospective analysis
Open Access
- 28 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Public Health
- Vol. 20 (1), 1-9
- https://doi.org/10.1186/s12889-020-08660-2
Abstract
Early diagnosis and treatment of malaria symptoms reduces the risk of severe complication and malaria transmission. However, delay in malaria diagnosis and treatment is a major public health problem in India. The primary aim of the study was to determine cut-off for the delay in seeking treatment of fever, and the secondary aim was to identify the factors associated with delay in malaria-endemic areas of Assam, Northeast India. The present study analysed data from two prior cross-sectional surveys (community- and hospital-based) that was conducted to study the health-seeking behaviour of people residing in high malaria-endemic areas of Assam, Northeast India. The hospital-based survey data were used to determine optimal cut-off for the delay in reporting, and further, used to identify the factors associated with delay using community-based data. Mean age of fever cases was similar in both community- and hospital-based surveys (23.1 years vs 24.2 years, p = 0.229). Delay in reporting fever was significantly higher among hospital inpatients compared to community-based fever cases (3.6 ± 2.1 vs 4.0 ± 2.6 days; p = 0.006). Delay of > 2 days showed higher predictive ability (sensitivity: 96.4%, and ROC area: 67.5%) compared to other cut-off values (> 3, > 4, and > 5 days). Multivariable logistic regression analysis revealed that the adjusted odds ratio (aOR) of delay was significantly higher for people living in rural areas (1.52, 95%CI: 1.11–2.09), distance (> 5 km) to health facility (1.93, 95%CI: 1.44–2.61), engaged in agriculture work (2.58, 95%CI: 1.97–3.37), and interaction effect of adult male aged 20–40 years (1.71, 95%CI: 1.06–2.75). The delay (> 2 days) in seeking treatment was likely to be twice among those who live in rural areas and travel > 5 km to assess health care facility. The findings of the study are useful in designing effective intervention programmes for early treatment of febrile illness to control malaria.This publication has 24 references indexed in Scilit:
- Optimal Cutoff and Accuracy of an IgM Enzyme-Linked Immunosorbent Assay for Diagnosis of Acute Scrub Typhus in Northern Thailand: an Alternative Reference Method to the IgM Immunofluorescence AssayJournal of Clinical Microbiology, 2016
- Determinants of delay in care seeking among children under five with fever in Dodoma region, central Tanzania: a cross-sectional studyMalaria Journal, 2014
- Risk of malaria among febrile patients: retrospective analysis of a hospital-based study in an endemic area of northeast IndiaInternational Health, 2014
- The Inconsistency of “Optimal” Cutpoints Obtained using Two Criteria based on the Receiver Operating Characteristic CurveAmerican Journal of Epidemiology, 2006
- Assessment of knowledge about malaria among patients reported with fever: a hospital-based study.2004
- Transmission of malaria and its control in the northeastern region of India.2003
- Complications and mortality patterns due to Plasmodium falciparum malaria in hospitalized adults and children, Rourkela, Orissa, IndiaTransactions of the Royal Society of Tropical Medicine and Hygiene, 2003
- Clinical review: Severe malariaCritical Care, 2003
- The influence of healthcare facilities on malarial mortality in and around Rourkela, IndiaPathogens and Global Health, 2002
- Barriers to prompt and effective treatment of malaria in northern Sri LankaTropical Medicine & International Health, 2002