Background
Methods
Study setting
Study design
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Pneumonia within the last year diagnosed by a healthcare worker, or defined by sudden onset or worsening fever (temperature [T] > 38 °C or subjective) and cough and difficult breathing lasting 2–30 days, in a person of any age
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Influenza-like illness [ILI] within the last 30 days defined as sudden onset fever or worsening fever (T > 38 °C or subjective) with cough and/or sore throat in a person of any age
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Chronic febrile respiratory illness within the last year defined by fever and cough and either difficult breathing or weight loss lasting ≥30 days in a person of any age
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Diarrhea within the last 14 days defined by ≥3 loose or watery stools within a 24 h period in a child < 5 years of age
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Meningitis in a person of any age within the last year, defined by fever or headache, and one of the following: stiff neck, confusion, new weakness in arm or leg, or double vision.
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Pneumonia: Sudden onset or worsening fever and difficult or fast breathing
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ILI: Sudden onset or worsening fever with cough or sore throat
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Chronic febrile respiratory illness: Cough with fever or weight loss lasting > 30 days
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Diarrhea in a child < 5 years old: 3 or more loose stools per day
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Meningitis: Sudden onset of fever and stiff neck
Statistical analysis
Results
Subset surveyed about hypothetical healthcare utilization | Main survey of healthcare utilization, excluding subset | P-value | |
---|---|---|---|
Number of geographic coordinates sampled, N | 300 | 3082 | NA |
Number of invalid coordinates, n (%) | 23 (8) | 225 (7) | n.s. |
Households visited, n (%) | 277 (92) | 2857 (93) | n.s. |
Declined main survey, n (%) | 24 (9) | 234 (8) | n.s. |
Declined additional survey only, n (%) | 22 (8) | NA | NA |
Primary caregiver unavailable, n (%) | 41 (15) | 420 (15) | n.s. |
Completed survey(s), n (%) | 190 (69) | 2203 (77) | < 0.01 |
Primary caregiver age, median years (IQR) | 37 (28–52) | 39 (29–52) | n.s. |
Primary caregiver female, n (%) | 138 (73) | 1536 (70) | n.s. |
Site | |||
Klerksdorp, n (%) | 114 (60) | 1318 (60) | n.s. |
Soweto, n (%) | 76 (40) | 885 (40) | n.s. |
Monthly income <ZAR 2000, n (%) | 116 (69) | 1307 (68) | n.s. |
First provider consulted for illness | ILI | Pneumonia | Chronic respiratory | Meningitis | Diarrhea in child <5y | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n (%)b | Intended, n = 172 | Actual, n = 268 |
P
| Intended, n = 172 | Actual, n = 231 |
P
| Intended, n = 187 | Actual, n = 16 |
P
| Intended, n = 186 | Actual, n = 21 |
P
| Intended, n = 182 | Actual, n = 41 |
P
|
Would not /did not seek care | (0) | 55 (21) | <.01 | 0 | 34 (15) | <.01 | 0 | 1 (6) | ns | 1 (1) | 0 | ns | 2 (1) | 9 (22) | ns |
Would seek / sought care | 170 (99) | 213 (79) | <.01 | 172 (100) | 197 (85) | <.01 | 187 (100) | 15 (94) | 0.01 | 185 (99) | 21 (100) | ns | 180 (99) | 32 (78) | <.01 |
Licensed medical provider | 168 (98) | 147 (55) | <.01 | 171 (99) | 151 (65) | <.01 | 187 (100) | 15 (94) | 0.01 | 181 (97) | 20 (95) | ns | 177 (97) | 27 (66) | <.01 |
Public clinic or health center | 133 (77) | 90 (34) | <.01 | 122 (71) | 98 (42) | <.01 | 139 (74) | 9 (56) | 0.1 | 133 (72) | 12 (57) | ns | 146 (80) | 20 (49) | 0.06 |
Private clinic | 19 (11) | 9 (3) | <.01 | 19 (11) | 8 (3) | <.01 | 14 (7) | 0 | ns | 18 (10) | 0 | ns | 17 (9) | 2 (5) | <.01 |
Public hospital | 11 (6) | 5 (2) | ns | 24 (14) | 14 (6) | <.01 | 28 (15) | 5 (31) | 0.1 | 21 (11) | 7 (33) | 0.01 | 9 (5) | 0 | ns |
Private hospital | 3 (2) | 9 (3) | ns | 4 (2) | 7 (3) | ns | 4 (2) | 0 | 1 | 6 (3) | 0 | ns | 2 (1) | 0 | ns |
Private Doctor | 2 (1) | 34 (13) | <.01 | 2 (1) | 24 (10) | <.01 | 2 (1) | 1 (6) | ns | 3 (2) | 1 (5) | ns | 3 (2) | 5 (12) | ns |
Other provider | 2 (1) | 66 (25) | <.01 | 1 (1) | 46 (20) | <.01 | 0 (0) | 0 | 0.01 | 4 (2) | 1 (5) | ns | 3 (2) | 5 (12) | 0.007 |
Pharmacy | 2 (1) | 59 (22) | <.01 | (0) | 43 (19) | <.01 | (0) | 0 | 0.01 | 3 (2) | 0 | ns | 3 (2) | 2 (5) | 0.007 |
Traditional healer | (0) | 1 | ns | 1 (1) | 1 | ns | (0) | 0 | 0.1 | (0) | 0 | ns | (0) | 1 (2) | ns |
Religious leader | (0) | 0 | ns | (0) | 1 | ns | (0) | 0 | ns | (0) | 0 | ns | (0) | 0 | ns |
Friend or relative | (0) | 4 (1) | ns | (0) | 0 | ns | (0) | 0 | 0.1 | (0) | 1 (5) | ns | (0) | 1 (2) | ns |
Health volunteer | (0) | 1 | ns | (0) | 1 | ns | (0) | 0 | 1 | (0) | 0 | ns | (0) | 0 | ns |
Other | (0) | 1 | ns | (0) | 0 | ns | (0) | 0 | ns | 1 (1) | 0 | ns | (0) | 1 (2) | ns |