title: Respiratory illness healthcare-seeking behavior assessment in the Lao People's Democratic Republic (Laos).
abstract: BACKGROUND
  Respiratory illness (RI) remains a public health problem in Laos, but little is known about the overall burden and people's healthcare-seeking behavior for RI. Understanding the burden of RI and community patterns of healthcare-seeking behavior would provide better guidance for Lao public health program and policy planners to improve RI public health practice, surveillance systems, and prevention strategies.
  
  
  METHODS
  A quantitative and qualitative survey was conducted in 14 randomly selected villages of two purposively selected peri-urban and two rural provinces in Laos. A pre-designed and pre-tested questionnaire was used to collect information on RI in household members (defined as new fever with cough and/or sore-throat in the absence of other diagnoses during the preceding 30 days) from all heads of household in each village. Sixteen focus group discussions were conducted to obtain more information to support the quantitative survey.
  
  
  RESULTS
  Among 1,751 households (9,114 people) studied, 3.5% (317/9,114) had experienced RI (fever, cough, and/or sore-throat) in the 30 days before the survey [6.2% in rural and 2.4% in peri-urban areas (p<0.001)]. The percentage of RI among persons aged≥15 years was 2.7%, 3.7% for those aged 5-14 years, and 8.2% for children<5 years (p<0.001). Of all sick persons, 71% sought treatment [94% in peri-urban and 48% in rural areas (p<0.001)] and 31.5% of them self-medicated [55.5% in peri-urban and 29% in rural areas (p<0.001)]. Sick people in peri-urban areas preferred to chose private clinics and pharmacies as their first treatment option while in rural areas they frequently consulted with village health volunteers and visited health centres as their first choice. The qualitative study suggests that distance, costs of care, and service availability are the most important determinants of seeking healthcare.
  
  
  CONCLUSIONS
  The RI burden and healthcare-seeking behavior are different between rural and peri-urban areas of Laos and this is probably due to the differences in environmental and hygienic conditions, health service availability and socio-economic status between the two areas. Therefore strategies for healthcare service improvement may also need to differ between the two areas.
authors: Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao PDR. mayfong@tropmedres.ac
authors: Mayfong
authors: M
authors: Mayxay
authors: Visanou
authors: V
authors: Hansana
authors: Bouachanh
authors: B
authors: Sengphilom
authors: Latsamy
authors: L
authors: Oulay
authors: Vatsana
authors: V
authors: Thammavongsa
authors: Vatsana
authors: V
authors: Somphet
authors: Chansathit
authors: C
authors: Taykeophithoune
authors: Soudavanh
authors: S
authors: Nathavong
authors: Johnly
authors: J
authors: Phanthady
authors: Kongmany
authors: K
authors: Chareunvong
authors: Phetsavanh
authors: P
authors: Chanthavilay
authors: Vanphanom
authors: V
authors: Sychareun
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D017281:Cost of Illness; D005260:Female; D006801:Humans; D007812:Laos / Q000453:epidemiology; D008297:Male; D010342:Patient Acceptance of Health Care; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D012424:Rural Population; D012959:Socioeconomic Factors; D014505:Urban Population; D055815:Young Adult
references: Soc Sci Med. 1996 Aug;43(4):429-39
references: 8844944
references: Lancet. 2005 Mar 26-Apr 1;365(9465):1147-52
references: 15794969
references: Health Policy Plan. 2005 Sep;20(5):319-27
references: 16076933
references: Southeast Asian J Trop Med Public Health. 2008 May;39(3):526-41
references: 18564695
references: Soc Sci Med. 2001 Nov;53(10):1363-72
references: 11676406
references: BMC Int Health Hum Rights. 2006 May 23;6:7
references: 16719911
references: Niger J Med. 2005 Jan-Mar;14(1):65-71
references: 15832646
references: Health Educ Q. 1988 Summer;15(2):175-83
references: 3378902
references: Soc Sci Med. 2000 Feb;50(3):345-64
references: 10626760
references: Soc Sci Med. 2003 Mar;56(6):1173-82
references: 12600356
references: Bull World Health Organ. 2002;80(2):97-105
references: 11953787
references: ScientificWorldJournal. 2003 Aug 19;3:721-30
references: 12941972
references: Southeast Asian J Trop Med Public Health. 1997 Mar;28(1):99-106
references: 9322291
references: J Rural Health. 1992 Winter;8(1):13-26
references: 10118045
references: Soc Sci Med. 2003 Aug;57(3):513-27
references: 12791493
references: Soc Sci Med. 1984;19(4):441-50
references: 6435252
references: Southeast Asian J Trop Med Public Health. 2006 May;37(3):488-93
references: 17120968