title: Childhood Illness Prevalence and Health Seeking Behavior Patterns in Rural Tanzania.
abstract: BACKGROUND
  This paper identifies factors influencing differences in the prevalence of diarrhea, fever and acute respiratory infection (ARI), and health seeking behavior among caregivers of children under age five in rural Tanzania.
  
  
  METHODS
  Using cross-sectional survey data collected in Kilombero, Ulanga, and Rufiji districts, the analysis included 1,643 caregivers who lived with 2,077 children under five years old. Logistic multivariate and multinomial regressions were used to analyze factors related to disease prevalence and to health seeking behavior.
  
  
  RESULTS
  One quarter of the children had experienced fever in the past two weeks, 12.0 % had diarrhea and 6.7 % experienced ARI. Children two years of age and older were less likely to experience morbidity than children under one year [ORfever = 0.77, 95 % CI 0.61-0.96; ORdiarrhea = 0.26, 95 % CI 0.18-0.37; ORARI = 0.60 95 % CI 0.41-0.89]. Children aged two and older were more likely than children under one to receive no care or to receive care at home, rather than to receive care at a facility [RRRdiarrhea = 3.47, 95 % CI 1.19-10.17 for "No care"]. Children living with an educated caregiver were less likely to receive no care or home care rather than care at a facility as compared to those who lived with an uneducated caregiver [RRRdiarrhea = 0.28, 95 % CI 1.10-0.79 for "No care"]. Children living in the wealthiest households were less likely to receive no care or home care for fever as compared to those who lived poorest households. Children living more than 1 km from health facility were more likely to receive no care or to receive home care for diarrhea rather than care at a facility as compared to those living less than 1 km from a facility [RRRdiarrhea = 3.50, 95 % CI 1.13-10.82 for "No care"]. Finally, caregivers who lived with more than one child under age five were more likely to provide no care or home care rather than to seek treatment at a facility as compared to those living with only one child under five.
  
  
  CONCLUSIONS
  Our results suggest that child age, caregiver education attainment, and household wealth and location may be associated with childhood illness and care seeking behavior patterns. Interventions should be explored that target children and caregivers according to these factors, thereby better addressing barriers and optimizing health outcomes especially for children at risk of dying before the age of five.
authors.affiliation: Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, 10032, USA. mkante@ihi.or.tz.|Ifakara Health Institute, PO Box 78373, Dar es Salaam, Mikocheni, Tanzania. mkante@ihi.or.tz.|Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, CH-4002, Switzerland. mkante@ihi.or.tz.|University of Basel, Petersplatz 1, Basel, CH-4003, Switzerland. mkante@ihi.or.tz.
authors.forename: Almamy M
authors.initials: AM
authors.lastname: Kanté
authors.affiliation: Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, 10032, USA. hrg2118@columbia.edu.
authors.forename: Hialy R
authors.initials: HR
authors.lastname: Gutierrez
authors.affiliation: Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, 10032, USA. aml2265@columbia.edu.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Larsen
authors.affiliation: Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, 10032, USA. ej2217@columbia.edu.
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Jackson
authors.affiliation: Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. sheller7@jhu.edu.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Helleringer
authors.affiliation: Ifakara Health Institute, PO Box 78373, Dar es Salaam, Mikocheni, Tanzania. aexavery@ihi.or.tz.
authors.forename: Amon
authors.initials: A
authors.lastname: Exavery
authors.affiliation: Ifakara Health Institute, PO Box 78373, Dar es Salaam, Mikocheni, Tanzania. ktani@ihi.or.tz.
authors.forename: Kassimu
authors.initials: K
authors.lastname: Tani
authors.affiliation: Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, 10032, USA. jfp2113@columbia.edu.
authors.forename: James F
authors.initials: JF
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers; D002662:Child Health Services; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003968:Diarrhea, Infantile / Q000453:epidemiology* / Q000517:prevention & control; D005191:Family Characteristics; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000517:prevention & control; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011203:Poverty; D015995:Prevalence; D012424:Rural Population; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult