title: Health care use patterns for diarrhea in children in low-income periurban communities of Karachi, Pakistan.
abstract: Diarrhea causes 16% of all child deaths in Pakistan. We assessed patterns of healthcare use among caretakers of a randomly selected sample of 959 children ages 0-59 months in low-income periurban settlements of Karachi through a cross-sectional survey. A diarrheal episode was reported to have occurred in the previous 2 weeks among 298 (31.1%) children. Overall, 280 (80.3%) children sought care. Oral rehydration solution and zinc were used by 40.8% and 2%, respectively; 11% were admitted or received intravenous rehydration, and 29% sought care at health centers identified as sentinel centers for recruiting cases of diarrhea for a planned multicenter diarrheal etiology case-control study. Odds ratios for independent predictors of care-seeking behavior were lethargy, 4.14 (95% confidence interval = 1.45-11.77); fever, 2.67 (1.27-5.59); and stool frequency more than six per day, 2.29 (1.03-5.09). Perception of high cost of care and use of home antibiotics were associated with reduced care seeking: odds ratio = 0.28 (0.1-0.78) and 0.29 (0.11-0.82), respectively. There is a need for standardized, affordable, and accessible treatment of diarrhea as well as community education regarding appropriate care in areas with high diarrheal burden.
authors: Farheen
authors: F
authors: Quadri
authors: Dilruba
authors: D
authors: Nasrin
authors: Asia
authors: A
authors: Khan
authors: Tabassum
authors: T
authors: Bokhari
authors: Shiyam Sunder
authors: SS
authors: Tikmani
authors: Muhammad Imran
authors: MI
authors: Nisar
authors: Zaid
authors: Z
authors: Bhatti
authors: Karen
authors: K
authors: Kotloff
authors: Myron M
authors: MM
authors: Levine
authors: Anita K M
authors: AKM
authors: Zaidi
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology*; D002675:Child, Preschool; D003968:Diarrhea, Infantile / Q000191:economics / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011203:Poverty; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D012720:Severity of Illness Index; D014505:Urban Population
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