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National and sub-national variation in patterns of febrile case management in sub-Saharan Africa

National and sub-national variation in patterns of febrile case management in sub-Saharan Africa
National and sub-national variation in patterns of febrile case management in sub-Saharan Africa
Given national healthcare coverage gaps, understanding treatment-seeking behaviour for fever is crucial for the management of childhood illness and to reduce deaths. We conducted a modelling study by triangulating household survey data for fever in children under the age of five years with georeferenced public health facility databases (n=86,442 facilities) in 29 countries across sub-Saharan Africa, to estimate the probability of seeking treatment for fever at public facilities. A Bayesian item response theory framework was used to estimate this probability based on reported fever episodes, treatment choice, residence, and estimated travel-time to the nearest public-sector health facility. Findings showed inter- and intra-country variation, with the likelihood of seeking treatment for fever less than 50% in 16 countries. Results highlight the need to invest in public healthcare and related databases. The variation in public sector use illustrates the need to include such modelling in future infectious disease burden estimation.
1-7
Alegana, Victor
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Maina, Joseph
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Ouma, Paul
f66781f7-ddc4-41ea-b138-9f87b81e8294
Macharia, Peter
9e88c6b8-5c52-40a6-889d-4849cba446fd
Wright, James
94990ecf-f8dd-4649-84f2-b28bf272e464
Atkinson, Peter
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Okiro, Emelda
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Snow, Robert
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Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Alegana, Victor
6fdaa47e-c08c-48bc-b881-1dc7b89085e4
Maina, Joseph
71ff9280-cb38-4259-ae35-cf63f4a08cc9
Ouma, Paul
f66781f7-ddc4-41ea-b138-9f87b81e8294
Macharia, Peter
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Wright, James
94990ecf-f8dd-4649-84f2-b28bf272e464
Atkinson, Peter
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Okiro, Emelda
3174a4d7-b9a8-4e64-a0cb-668c2c194227
Snow, Robert
0792eb8a-6d13-4ac4-beef-03301e1c0c27
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e

Alegana, Victor, Maina, Joseph, Ouma, Paul, Macharia, Peter, Wright, James, Atkinson, Peter, Okiro, Emelda, Snow, Robert and Tatem, Andrew (2018) National and sub-national variation in patterns of febrile case management in sub-Saharan Africa. Nature Communications, 9, 1-7. (doi:10.1038/s41467-018-07536-9).

Record type: Article

Abstract

Given national healthcare coverage gaps, understanding treatment-seeking behaviour for fever is crucial for the management of childhood illness and to reduce deaths. We conducted a modelling study by triangulating household survey data for fever in children under the age of five years with georeferenced public health facility databases (n=86,442 facilities) in 29 countries across sub-Saharan Africa, to estimate the probability of seeking treatment for fever at public facilities. A Bayesian item response theory framework was used to estimate this probability based on reported fever episodes, treatment choice, residence, and estimated travel-time to the nearest public-sector health facility. Findings showed inter- and intra-country variation, with the likelihood of seeking treatment for fever less than 50% in 16 countries. Results highlight the need to invest in public healthcare and related databases. The variation in public sector use illustrates the need to include such modelling in future infectious disease burden estimation.

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Accepted/In Press date: 7 November 2018
e-pub ahead of print date: 26 November 2018
Published date: 26 November 2018

Identifiers

Local EPrints ID: 426483
URI: https://eprints.soton.ac.uk/id/eprint/426483
PURE UUID: cba689e7-f63e-4231-8f2b-dc6e9f7fe1b1
ORCID for James Wright: ORCID iD orcid.org/0000-0002-8842-2181
ORCID for Andrew Tatem: ORCID iD orcid.org/0000-0002-7270-941X

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Date deposited: 28 Nov 2018 17:30
Last modified: 14 Mar 2019 01:43

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Contributors

Author: Victor Alegana
Author: Joseph Maina
Author: Paul Ouma
Author: Peter Macharia
Author: James Wright ORCID iD
Author: Peter Atkinson
Author: Emelda Okiro
Author: Robert Snow
Author: Andrew Tatem ORCID iD

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