title: Utilization and accessibility of healthcare on Pemba Island, Tanzania: implications for health outcomes and disease surveillance for typhoid fever.
abstract: Salmonella enterica serotype Typhi (S. Typhi) was estimated to cause over 200,000 deaths and more than 21 million illnesses worldwide, including over 400,000 illnesses in Africa. The current study was conducted in four villages on Pemba Island, Zanzibar, in 2010. We present data on policy makers', health administrators', and village residents' and leaders' perceptions of typhoid fever, and hypothetical and actual health care use among village residents for typhoid fever. Qualitative data provided descriptions of home-based treatment practices and use of western pharmaceuticals, and actual healthcare use for culture-confirmed typhoid fever. Survey data indicate health facility use was associated with gender, education, residency, and perceptions of severity for symptoms associated with typhoid fever. Data have implications for education of policy makers and health administrators, design and implementation of surveillance studies, and community-based interventions to prevent disease outbreaks, decrease risks of complications, and provide information about disease recognition, diagnosis, and treatment.
authors.affiliation: Wayne State University, Pediatric Prevention Research Center, The Carman and Ann Adams Department of Pediatrics, Detroit, Michigan 48201, USA. lkaljee@med.wayne.edu
authors.forename: Linda M
authors.initials: LM
authors.lastname: Kaljee
authors.forename: Alfred
authors.initials: A
authors.lastname: Pach
authors.forename: Kamala
authors.initials: K
authors.lastname: Thriemer
authors.forename: Benedikt
authors.initials: B
authors.lastname: Ley
authors.forename: Said M
authors.initials: SM
authors.lastname: Ali
authors.forename: Mohamed
authors.initials: M
authors.lastname: Jiddawi
authors.forename: Mahesh
authors.initials: M
authors.lastname: Puri
authors.forename: Lorenz
authors.initials: L
authors.lastname: von Seidlein
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Deen
authors.forename: Leon
authors.initials: L
authors.lastname: Ochiai
authors.forename: Thomas
authors.initials: T
authors.lastname: Wierzba
authors.forename: John
authors.initials: J
authors.lastname: Clemens
mesh_terms: D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D011159:Population Surveillance; D013636:Tanzania / Q000453:epidemiology; D014435:Typhoid Fever / Q000453:epidemiology*