Determinants of delay in care-seeking for febrile children in eastern Uganda.
OBJECTIVE
To explore factors associated with delay in seeking treatment outside the home for febrile children under five.


METHODS
Using a pre-tested structured questionnaire, all 9176 children below 5 years in Iganga-Mayuge Demographic Surveillance Site were enumerated. Caretakers of children who had been ill within the previous 2 weeks were asked about presenting symptoms, type of home treatment used, timing of seeking treatment and distance to provider. Children who sought care latest after one night were compared with those who sought care later.


RESULTS
Those likely to delay came from the lowest socio-economic quintile (OR 1.45; 95% CI 1.06-1.97) or had presented with pallor (OR 1.58; 95% CI 1.10-2.25). Children less likely to delay had gone to drug shops (OR 0.70; 95% CI 0.59-0.84) or community medicine distributors (CMDs) (OR 0.33; 95% CI 0.15-0.74), had presented with fast breathing (OR 0.75; 95% CI 0.60-0.87), used tepid sponging at home (OR 0.43; 95% CI 0.27-0.68), or perceived the distance to the provider to be short (OR 0.72; 95% CI 0.60-0.87).


CONCLUSIONS
Even in the presence of 'free services', poverty is associated with delay to seek care. Drug shops and CMDs may complement government efforts to deliver timely treatment. Health workers need to sensitize caretakers to take children for care promptly. Methods to elucidate time in population-surveys in African settings need to be evaluated.
Rutebemberwa
Elizeus
E
Makerere University School of Public Health, Kampala, Uganda. ellie@musph.ac.ug
Kallander
Karin
K
Tomson
Goran
G
Peterson
Stefan
S
Pariyo
George
G
D000328:Adult; D000368:Aged; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005334:Fever / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult