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dc.contributor.authorMburu, Caroline
dc.contributor.authorBukachi, Salome A.
dc.contributor.authorShilabukha, Khamati
dc.contributor.authorTokpa, Kathrin H.
dc.contributor.authorEzekiel, Mangi
dc.contributor.authorFokou, Gilbert
dc.contributor.authorBonfoh, Bassirou
dc.contributor.authorKazwala, Rudovick
dc.identifier.citationMburu , C , Bukachi , S A , Shilabukha , K , Tokpa , K H , Ezekiel , M , Fokou , G , Bonfoh , B & Kazwala , R 2021 , ' Determinants of treatment-seeking behavior during self-reported febrile illness episodes using the socio-ecological model in Kilombero District, Tanzania ' , BMC Public Health , vol. 21 , 1075 .
dc.identifier.otherPURE: 280400957
dc.identifier.otherPURE UUID: ebecbe90-f254-478e-9672-b1986c1312ad
dc.identifier.otherScopus: 85107382716
dc.identifier.otherORCID: /0000-0002-8460-9213/work/115631008
dc.descriptionThe authors acknowledge support from the DELTAS Africa Initiative [Afrique One-ASPIRE /DEL-15-008]. Afrique One-ASPIRE is funded by a consortium of donor including the African Academy of Sciences (AAS) Alliance for Accelerating Excellence in Science in Africa (AESA), the New Partnership for Africa’s Development Planning and Coordinating (NEPAD) Agency, the Wellcome Trust [107753/A/15/Z] and the UK government.en
dc.description.abstractBackground: Febrile diseases in Sub-Saharan Africa cause acute and chronic illness. Co-infections are common and these diseases have a complex etiology that includes zoonoses. For the implementation of appropriate treatment and control strategies, determinants of lay treatment-seeking behavior by the affected communities need to be understood. The objective of this study was to explore, using the socio-ecological model, the determinants of treatment-seeking actions among self-identified febrile illness cases in the Kilombero District of Tanzania. Methods: Thirty-nine in-depth interviews were conducted with 28 men and 11 women in three villages in Kilombero district. These villages were purposively selected due to malaria endemicity in the area, animal husbandry practices, and proximity to livestock-wildlife interaction, all risk factors for contracting febrile zoonotic infections. Thematic analysis was conducted on the interviews to identify the key determinants of treatmentseeking actions. Results: Study participants attributed febrile illnesses to malaria, typhoid and urinary tract infections. Treatmentseeking behavior was an iterative process, influenced by individual, socio-cultural, ecological and policy factors. Age, expendable income, previous history with a febrile illness, perceptions on disease severity, seasonal livelihood activities and access to timely healthcare were some of the determinants. Self-treatment with pharmaceutical drugs and herbs was usually the initial course of action. Formal healthcare was sought only when self-treatment failed and traditional healers were consulted after the perceived failure of conventional treatment. Delays in seeking appropriate health care and the consultation of medically unqualified individuals was very common. Conclusion: The results imply that treatment-seeking behavior is shaped by multiple factors across all levels of the socio-ecological model. Public policy efforts need to focus on facilitating prompt health care seeking through community education on the complicated etiology of febrile illnesses. Improved access to timely treatment and better differential diagnostics by health professionals are essential to ensure correct and appropriate treatment and to reduce reliance of patients on unqualified persons.
dc.relation.ispartofBMC Public Healthen
dc.rightsCopyright © The Author(s) 2021. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.en
dc.subjectFebrile illnessen
dc.subjectTreatment-seeking behavioren
dc.subjectAgro pastoralistsen
dc.subjectSocio-ecological modelen
dc.subjectRA Public aspects of medicineen
dc.titleDeterminants of treatment-seeking behavior during self-reported febrile illness episodes using the socio-ecological model in Kilombero District, Tanzaniaen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. Social Anthropologyen
dc.description.statusPeer revieweden

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