title: Health care preferences for children with typhoid fever in two slum communities in Karachi, Pakistan.
abstract: This study examined health care preferences and influences in response to initial and persistent symptoms of typhoid fever among children in two slum communities in Karachi, Pakistan. Typhoid fever in this area is endemic and has a high rate of multi-drug resistantce. The study involved a household survey of 502 respondents. Private practitioners, including qualified medical specialists, were the preferred providers for initial symptoms, with government and private hospitals preferred for continuing symptoms. A number of cases continued to select initial health care choices regardless of the severity of symptoms. The findings point to factors of cost, access to care, previous use of a provider and perceived quality of care as key influences regarding health care choices. These findings suggest that cases of typhoid fever in these communities are at risk for not receiving appropriate diagnoses and treatment for children who are at risk for severe cases of multi-drug resistant disease. Suggestions are made for improving the care of children with typhoid in this context.
authors.affiliation: Department of Pediatrics, Aga Khan University, Karachi, Pakistan.
authors.forename: Zahid Ali
authors.initials: ZA
authors.lastname: Memon
authors.forename: Alfred
authors.initials: A
authors.lastname: Pach
authors.forename: Marina
authors.initials: M
authors.lastname: Rifkin
authors.forename: Oak Pil
authors.initials: OP
authors.lastname: Han
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
authors.forename: John
authors.initials: J
authors.lastname: Clemens
authors.forename: Zulfiqar
authors.initials: Z
authors.lastname: Bhutta
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000145:classification*; D006801:Humans; D008297:Male; D010154:Pakistan; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011204:Poverty Areas; D011787:Quality of Health Care; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014435:Typhoid Fever / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology