Le SIDA en Afrique subsaharienne (serveur d'exploration)

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Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program

Identifieur interne : 000305 ( Pmc/Corpus ); précédent : 000304; suivant : 000306

Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program

Auteurs : Ursula Panzner ; Gi Deok Pak ; Peter Aaby ; Yaw Adu-Sarkodie ; Mohammad Ali ; Abraham Aseffa ; Stephen Baker ; Morten Bjerregaard-Andersen ; John A. Crump ; Jessica Deerin ; Ligia Maria Cruz Espinoza ; Nagla Gasmelseed ; Jean Noël Heriniaina ; Julian T. Hertz ; Justin Im ; Vera Von Kalckreuth ; Karen H. Keddy ; Bruno Lankoande ; Sandra L Fberg ; Christian G. Meyer ; Michael Munishi Oresto ; Jin Kyung Park ; Se Eun Park ; Raphaël Rakotozandrindrainy ; Nimako Sarpong ; Abdramane Bassiahi Soura ; Amy Gassama Sow ; Adama Tall ; Mekonnen Teferi ; Alemayehu Worku ; Biruk Yeshitela ; Thomas F. Wierzba ; Florian Marks

Source :

RBID : PMC:4772834

Abstract

Background. Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population.

Methods. A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility–based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined.

Results. Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion—namely, 20%–45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania—sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites.

Conclusions. Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever.


Url:
DOI: 10.1093/cid/civ891
PubMed: 26933023
PubMed Central: 4772834

Links to Exploration step

PMC:4772834

Le document en format XML

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<name sortKey="L Fberg, Sandra" sort="L Fberg, Sandra" uniqKey="L Fberg S" first="Sandra" last="L Fberg">Sandra L Fberg</name>
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<name sortKey="Meyer, Christian G" sort="Meyer, Christian G" uniqKey="Meyer C" first="Christian G." last="Meyer">Christian G. Meyer</name>
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<name sortKey="Oresto, Michael Munishi" sort="Oresto, Michael Munishi" uniqKey="Oresto M" first="Michael Munishi" last="Oresto">Michael Munishi Oresto</name>
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<name sortKey="Park, Jin Kyung" sort="Park, Jin Kyung" uniqKey="Park J" first="Jin Kyung" last="Park">Jin Kyung Park</name>
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<name sortKey="Rakotozandrindrainy, Raphael" sort="Rakotozandrindrainy, Raphael" uniqKey="Rakotozandrindrainy R" first="Raphaël" last="Rakotozandrindrainy">Raphaël Rakotozandrindrainy</name>
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<name sortKey="Sarpong, Nimako" sort="Sarpong, Nimako" uniqKey="Sarpong N" first="Nimako" last="Sarpong">Nimako Sarpong</name>
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<name sortKey="Soura, Abdramane Bassiahi" sort="Soura, Abdramane Bassiahi" uniqKey="Soura A" first="Abdramane Bassiahi" last="Soura">Abdramane Bassiahi Soura</name>
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<name sortKey="Gassama Sow, Amy" sort="Gassama Sow, Amy" uniqKey="Gassama Sow A" first="Amy" last="Gassama Sow">Amy Gassama Sow</name>
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<name sortKey="Tall, Adama" sort="Tall, Adama" uniqKey="Tall A" first="Adama" last="Tall">Adama Tall</name>
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<institution>Institute Pasteur de Dakar</institution>
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<name sortKey="Teferi, Mekonnen" sort="Teferi, Mekonnen" uniqKey="Teferi M" first="Mekonnen" last="Teferi">Mekonnen Teferi</name>
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<nlm:aff id="af6">
<institution>Armauer Hansen Research Institute</institution>
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<addr-line>Addis Ababa</addr-line>
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<country>Ethiopia</country>
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</affiliation>
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<name sortKey="Worku, Alemayehu" sort="Worku, Alemayehu" uniqKey="Worku A" first="Alemayehu" last="Worku">Alemayehu Worku</name>
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<institution>School of Public Health</institution>
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<institution>Addis Ababa University</institution>
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<country>Ethiopia</country>
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<name sortKey="Yeshitela, Biruk" sort="Yeshitela, Biruk" uniqKey="Yeshitela B" first="Biruk" last="Yeshitela">Biruk Yeshitela</name>
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<nlm:aff id="af6">
<institution>Armauer Hansen Research Institute</institution>
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<addr-line>Addis Ababa</addr-line>
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<country>Ethiopia</country>
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</affiliation>
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<author>
<name sortKey="Wierzba, Thomas F" sort="Wierzba, Thomas F" uniqKey="Wierzba T" first="Thomas F." last="Wierzba">Thomas F. Wierzba</name>
<affiliation>
<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
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<addr-line>Seoul</addr-line>
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<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Marks, Florian" sort="Marks, Florian" uniqKey="Marks F" first="Florian" last="Marks">Florian Marks</name>
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<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
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<addr-line>Seoul</addr-line>
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<country>Republic of Korea</country>
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<name sortKey="Adu Sarkodie, Yaw" sort="Adu Sarkodie, Yaw" uniqKey="Adu Sarkodie Y" first="Yaw" last="Adu-Sarkodie">Yaw Adu-Sarkodie</name>
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<name sortKey="Ali, Mohammad" sort="Ali, Mohammad" uniqKey="Ali M" first="Mohammad" last="Ali">Mohammad Ali</name>
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<addr-line>Seoul</addr-line>
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<country>Republic of Korea</country>
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<nlm:aff id="af5">
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<name sortKey="Aseffa, Abraham" sort="Aseffa, Abraham" uniqKey="Aseffa A" first="Abraham" last="Aseffa">Abraham Aseffa</name>
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<addr-line>Addis Ababa</addr-line>
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</affiliation>
</author>
<author>
<name sortKey="Baker, Stephen" sort="Baker, Stephen" uniqKey="Baker S" first="Stephen" last="Baker">Stephen Baker</name>
<affiliation>
<nlm:aff id="af7">
<institution>Oxford University Clinical Research Unit</institution>
,
<addr-line>Ho Chi Minh City</addr-line>
,
<country>Vietnam</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Bjerregaard Andersen, Morten" sort="Bjerregaard Andersen, Morten" uniqKey="Bjerregaard Andersen M" first="Morten" last="Bjerregaard-Andersen">Morten Bjerregaard-Andersen</name>
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<nlm:aff id="af2">
<addr-line>Bandim Health Project, Bissau</addr-line>
,
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<affiliation>
<nlm:aff id="af8">
<institution>Research Center for Vitamins and Vaccines, Statens Serum Institut</institution>
,
<addr-line>Copenhagen</addr-line>
,
<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Crump, John A" sort="Crump, John A" uniqKey="Crump J" first="John A." last="Crump">John A. Crump</name>
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,
<addr-line>Moshi</addr-line>
,
<country>Tanzania</country>
</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="af10">
<institution>Centre for International Health, University of Otago</institution>
,
<addr-line>Dunedin</addr-line>
,
<country>New Zealand</country>
</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="af11">
<addr-line>Division of Infectious Diseases and International Health</addr-line>
,
<institution>Duke University Medical Center</institution>
,
<addr-line>Durham, North Carolina</addr-line>
</nlm:aff>
</affiliation>
</author>
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<name sortKey="Deerin, Jessica" sort="Deerin, Jessica" uniqKey="Deerin J" first="Jessica" last="Deerin">Jessica Deerin</name>
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<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Cruz Espinoza, Ligia Maria" sort="Cruz Espinoza, Ligia Maria" uniqKey="Cruz Espinoza L" first="Ligia Maria" last="Cruz Espinoza">Ligia Maria Cruz Espinoza</name>
<affiliation>
<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Gasmelseed, Nagla" sort="Gasmelseed, Nagla" uniqKey="Gasmelseed N" first="Nagla" last="Gasmelseed">Nagla Gasmelseed</name>
<affiliation>
<nlm:aff id="af12">
<addr-line>Faculty of Medicine</addr-line>
,
<institution>University of Gezira</institution>
,
<addr-line>Wad Medani</addr-line>
,
<country>Sudan</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Heriniaina, Jean Noel" sort="Heriniaina, Jean Noel" uniqKey="Heriniaina J" first="Jean Noël" last="Heriniaina">Jean Noël Heriniaina</name>
<affiliation>
<nlm:aff id="af13">
<institution>University of Antananarivo</institution>
,
<country>Madagascar</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hertz, Julian T" sort="Hertz, Julian T" uniqKey="Hertz J" first="Julian T." last="Hertz">Julian T. Hertz</name>
<affiliation>
<nlm:aff id="af9">
<institution>Kilimanjaro Christian Medical Centre</institution>
,
<addr-line>Moshi</addr-line>
,
<country>Tanzania</country>
</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="af11">
<addr-line>Division of Infectious Diseases and International Health</addr-line>
,
<institution>Duke University Medical Center</institution>
,
<addr-line>Durham, North Carolina</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Im, Justin" sort="Im, Justin" uniqKey="Im J" first="Justin" last="Im">Justin Im</name>
<affiliation>
<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Von Kalckreuth, Vera" sort="Von Kalckreuth, Vera" uniqKey="Von Kalckreuth V" first="Vera" last="Von Kalckreuth">Vera Von Kalckreuth</name>
<affiliation>
<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Keddy, Karen H" sort="Keddy, Karen H" uniqKey="Keddy K" first="Karen H." last="Keddy">Karen H. Keddy</name>
<affiliation>
<nlm:aff id="af14">
<institution>National Institute for Communicable Diseases</institution>
</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="af15">
<addr-line>Faculty of Health Sciences</addr-line>
,
<institution>University of the Witwatersrand</institution>
,
<addr-line>Johannesburg</addr-line>
,
<country>South Africa</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Lankoande, Bruno" sort="Lankoande, Bruno" uniqKey="Lankoande B" first="Bruno" last="Lankoande">Bruno Lankoande</name>
<affiliation>
<nlm:aff id="af16">
<institution>University of Ouagadougou</institution>
,
<country>Burkina Faso</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="L Fberg, Sandra" sort="L Fberg, Sandra" uniqKey="L Fberg S" first="Sandra" last="L Fberg">Sandra L Fberg</name>
<affiliation>
<nlm:aff id="af2">
<addr-line>Bandim Health Project, Bissau</addr-line>
,
<country>Guinea-Bissau</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Meyer, Christian G" sort="Meyer, Christian G" uniqKey="Meyer C" first="Christian G." last="Meyer">Christian G. Meyer</name>
<affiliation>
<nlm:aff id="af17">
<institution>Institute of Tropical Medicine, Eberhard-Karls University</institution>
,
<addr-line>Tübingen</addr-line>
,
<country>Germany</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Oresto, Michael Munishi" sort="Oresto, Michael Munishi" uniqKey="Oresto M" first="Michael Munishi" last="Oresto">Michael Munishi Oresto</name>
<affiliation>
<nlm:aff id="af9">
<institution>Kilimanjaro Christian Medical Centre</institution>
,
<addr-line>Moshi</addr-line>
,
<country>Tanzania</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Park, Jin Kyung" sort="Park, Jin Kyung" uniqKey="Park J" first="Jin Kyung" last="Park">Jin Kyung Park</name>
<affiliation>
<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Park, Se Eun" sort="Park, Se Eun" uniqKey="Park S" first="Se Eun" last="Park">Se Eun Park</name>
<affiliation>
<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Rakotozandrindrainy, Raphael" sort="Rakotozandrindrainy, Raphael" uniqKey="Rakotozandrindrainy R" first="Raphaël" last="Rakotozandrindrainy">Raphaël Rakotozandrindrainy</name>
<affiliation>
<nlm:aff id="af13">
<institution>University of Antananarivo</institution>
,
<country>Madagascar</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sarpong, Nimako" sort="Sarpong, Nimako" uniqKey="Sarpong N" first="Nimako" last="Sarpong">Nimako Sarpong</name>
<affiliation>
<nlm:aff id="af3">
<institution>Kumasi Centre for Collaborative Research in Tropical Medicine</institution>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Soura, Abdramane Bassiahi" sort="Soura, Abdramane Bassiahi" uniqKey="Soura A" first="Abdramane Bassiahi" last="Soura">Abdramane Bassiahi Soura</name>
<affiliation>
<nlm:aff id="af16">
<institution>University of Ouagadougou</institution>
,
<country>Burkina Faso</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Gassama Sow, Amy" sort="Gassama Sow, Amy" uniqKey="Gassama Sow A" first="Amy" last="Gassama Sow">Amy Gassama Sow</name>
<affiliation>
<nlm:aff id="af18">
<institution>Institute Pasteur de Dakar</institution>
</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="af19">
<institution>Université Cheikh Anta Diop de Dakar</institution>
,
<country>Senegal</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Tall, Adama" sort="Tall, Adama" uniqKey="Tall A" first="Adama" last="Tall">Adama Tall</name>
<affiliation>
<nlm:aff id="af18">
<institution>Institute Pasteur de Dakar</institution>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Teferi, Mekonnen" sort="Teferi, Mekonnen" uniqKey="Teferi M" first="Mekonnen" last="Teferi">Mekonnen Teferi</name>
<affiliation>
<nlm:aff id="af6">
<institution>Armauer Hansen Research Institute</institution>
,
<addr-line>Addis Ababa</addr-line>
,
<country>Ethiopia</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Worku, Alemayehu" sort="Worku, Alemayehu" uniqKey="Worku A" first="Alemayehu" last="Worku">Alemayehu Worku</name>
<affiliation>
<nlm:aff id="af20">
<institution>School of Public Health</institution>
,
<institution>Addis Ababa University</institution>
,
<country>Ethiopia</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Yeshitela, Biruk" sort="Yeshitela, Biruk" uniqKey="Yeshitela B" first="Biruk" last="Yeshitela">Biruk Yeshitela</name>
<affiliation>
<nlm:aff id="af6">
<institution>Armauer Hansen Research Institute</institution>
,
<addr-line>Addis Ababa</addr-line>
,
<country>Ethiopia</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Wierzba, Thomas F" sort="Wierzba, Thomas F" uniqKey="Wierzba T" first="Thomas F." last="Wierzba">Thomas F. Wierzba</name>
<affiliation>
<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Marks, Florian" sort="Marks, Florian" uniqKey="Marks F" first="Florian" last="Marks">Florian Marks</name>
<affiliation>
<nlm:aff id="af1">
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</title>
<idno type="ISSN">1058-4838</idno>
<idno type="eISSN">1537-6591</idno>
<imprint>
<date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>
<bold>
<italic>Background.</italic>
</bold>
 Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population.</p>
<p>
<bold>
<italic>Methods.</italic>
</bold>
 A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility–based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined.</p>
<p>
<bold>
<italic>Results.</italic>
</bold>
 Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion—namely, 20%–45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania—sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites.</p>
<p>
<bold>
<italic>Conclusions.</italic>
</bold>
 Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Clin Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin. Infect. Dis</journal-id>
<journal-id journal-id-type="publisher-id">cid</journal-id>
<journal-id journal-id-type="hwp">cid</journal-id>
<journal-title-group>
<journal-title>Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</journal-title>
</journal-title-group>
<issn pub-type="ppub">1058-4838</issn>
<issn pub-type="epub">1537-6591</issn>
<publisher>
<publisher-name>Oxford University Press</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26933023</article-id>
<article-id pub-id-type="pmc">4772834</article-id>
<article-id pub-id-type="doi">10.1093/cid/civ891</article-id>
<article-id pub-id-type="publisher-id">civ891</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Typhoid Fever Surveillance in Africa Program (Tsap)</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Panzner</surname>
<given-names>Ursula</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pak</surname>
<given-names>Gi Deok</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Aaby</surname>
<given-names>Peter</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Adu-Sarkodie</surname>
<given-names>Yaw</given-names>
</name>
<xref ref-type="aff" rid="af3">3</xref>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ali</surname>
<given-names>Mohammad</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
<xref ref-type="aff" rid="af5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Aseffa</surname>
<given-names>Abraham</given-names>
</name>
<xref ref-type="aff" rid="af6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Baker</surname>
<given-names>Stephen</given-names>
</name>
<xref ref-type="aff" rid="af7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bjerregaard-Andersen</surname>
<given-names>Morten</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
<xref ref-type="aff" rid="af8">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Crump</surname>
<given-names>John A.</given-names>
</name>
<xref ref-type="aff" rid="af9">9</xref>
<xref ref-type="aff" rid="af10">10</xref>
<xref ref-type="aff" rid="af11">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Deerin</surname>
<given-names>Jessica</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cruz Espinoza</surname>
<given-names>Ligia Maria</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Gasmelseed</surname>
<given-names>Nagla</given-names>
</name>
<xref ref-type="aff" rid="af12">12</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Heriniaina</surname>
<given-names>Jean Noël</given-names>
</name>
<xref ref-type="aff" rid="af13">13</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hertz</surname>
<given-names>Julian T.</given-names>
</name>
<xref ref-type="aff" rid="af9">9</xref>
<xref ref-type="aff" rid="af11">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Im</surname>
<given-names>Justin</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>von Kalckreuth</surname>
<given-names>Vera</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Keddy</surname>
<given-names>Karen H.</given-names>
</name>
<xref ref-type="aff" rid="af14">14</xref>
<xref ref-type="aff" rid="af15">15</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lankoande</surname>
<given-names>Bruno</given-names>
</name>
<xref ref-type="aff" rid="af16">16</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Løfberg</surname>
<given-names>Sandra</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Meyer</surname>
<given-names>Christian G.</given-names>
</name>
<xref ref-type="aff" rid="af17">17</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Oresto</surname>
<given-names>Michael Munishi</given-names>
</name>
<xref ref-type="aff" rid="af9">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Park</surname>
<given-names>Jin Kyung</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Park</surname>
<given-names>Se Eun</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rakotozandrindrainy</surname>
<given-names>Raphaël</given-names>
</name>
<xref ref-type="aff" rid="af13">13</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sarpong</surname>
<given-names>Nimako</given-names>
</name>
<xref ref-type="aff" rid="af3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Soura</surname>
<given-names>Abdramane Bassiahi</given-names>
</name>
<xref ref-type="aff" rid="af16">16</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Gassama Sow</surname>
<given-names>Amy</given-names>
</name>
<xref ref-type="aff" rid="af18">18</xref>
<xref ref-type="aff" rid="af19">19</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tall</surname>
<given-names>Adama</given-names>
</name>
<xref ref-type="aff" rid="af18">18</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Teferi</surname>
<given-names>Mekonnen</given-names>
</name>
<xref ref-type="aff" rid="af6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Worku</surname>
<given-names>Alemayehu</given-names>
</name>
<xref ref-type="aff" rid="af20">20</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Yeshitela</surname>
<given-names>Biruk</given-names>
</name>
<xref ref-type="aff" rid="af6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wierzba</surname>
<given-names>Thomas F.</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Marks</surname>
<given-names>Florian</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<aff id="af1">
<label>1</label>
<institution>International Vaccine Institute</institution>
,
<addr-line>Seoul</addr-line>
,
<country>Republic of Korea</country>
</aff>
<aff id="af2">
<label>2</label>
<addr-line>Bandim Health Project, Bissau</addr-line>
,
<country>Guinea-Bissau</country>
</aff>
<aff id="af3">
<label>3</label>
<institution>Kumasi Centre for Collaborative Research in Tropical Medicine</institution>
</aff>
<aff id="af4">
<label>4</label>
<institution>School of Medical Sciences, Kwame Nkrumah University of Science and Technology</institution>
,
<addr-line>Kumasi</addr-line>
,
<country>Ghana</country>
</aff>
<aff id="af5">
<label>5</label>
<institution>Johns Hopkins University</institution>
,
<addr-line>Baltimore, Maryland</addr-line>
</aff>
<aff id="af6">
<label>6</label>
<institution>Armauer Hansen Research Institute</institution>
,
<addr-line>Addis Ababa</addr-line>
,
<country>Ethiopia</country>
</aff>
<aff id="af7">
<label>7</label>
<institution>Oxford University Clinical Research Unit</institution>
,
<addr-line>Ho Chi Minh City</addr-line>
,
<country>Vietnam</country>
</aff>
<aff id="af8">
<label>8</label>
<institution>Research Center for Vitamins and Vaccines, Statens Serum Institut</institution>
,
<addr-line>Copenhagen</addr-line>
,
<country>Denmark</country>
</aff>
<aff id="af9">
<label>9</label>
<institution>Kilimanjaro Christian Medical Centre</institution>
,
<addr-line>Moshi</addr-line>
,
<country>Tanzania</country>
</aff>
<aff id="af10">
<label>10</label>
<institution>Centre for International Health, University of Otago</institution>
,
<addr-line>Dunedin</addr-line>
,
<country>New Zealand</country>
</aff>
<aff id="af11">
<label>11</label>
<addr-line>Division of Infectious Diseases and International Health</addr-line>
,
<institution>Duke University Medical Center</institution>
,
<addr-line>Durham, North Carolina</addr-line>
</aff>
<aff id="af12">
<label>12</label>
<addr-line>Faculty of Medicine</addr-line>
,
<institution>University of Gezira</institution>
,
<addr-line>Wad Medani</addr-line>
,
<country>Sudan</country>
</aff>
<aff id="af13">
<label>13</label>
<institution>University of Antananarivo</institution>
,
<country>Madagascar</country>
</aff>
<aff id="af14">
<label>14</label>
<institution>National Institute for Communicable Diseases</institution>
</aff>
<aff id="af15">
<label>15</label>
<addr-line>Faculty of Health Sciences</addr-line>
,
<institution>University of the Witwatersrand</institution>
,
<addr-line>Johannesburg</addr-line>
,
<country>South Africa</country>
</aff>
<aff id="af16">
<label>16</label>
<institution>University of Ouagadougou</institution>
,
<country>Burkina Faso</country>
</aff>
<aff id="af17">
<label>17</label>
<institution>Institute of Tropical Medicine, Eberhard-Karls University</institution>
,
<addr-line>Tübingen</addr-line>
,
<country>Germany</country>
</aff>
<aff id="af18">
<label>18</label>
<institution>Institute Pasteur de Dakar</institution>
</aff>
<aff id="af19">
<label>19</label>
<institution>Université Cheikh Anta Diop de Dakar</institution>
,
<country>Senegal</country>
</aff>
<aff id="af20">
<label>20</label>
<institution>School of Public Health</institution>
,
<institution>Addis Ababa University</institution>
,
<country>Ethiopia</country>
</aff>
</contrib-group>
<author-notes>
<corresp>Correspondence: U. Panzner, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea (
<email>upanzner@ivi.int</email>
).</corresp>
</author-notes>
<pub-date pub-type="ppub">
<day>15</day>
<month>3</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>01</day>
<month>3</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>15</day>
<month>3</month>
<year>2017</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and 0 days and was based on the . </pmc-comment>
<volume>62</volume>
<issue>Suppl 1</issue>
<issue-title>Typhoid Fever Surveillance in Africa Program (TSAP)</issue-title>
<fpage>S56</fpage>
<lpage>S68</lpage>
<permissions>
<copyright-statement>© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail
<email>journals.permissions@oup.com</email>
.</copyright-statement>
<copyright-year>2016</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:href="civ891.pdf"></self-uri>
<abstract>
<p>
<bold>
<italic>Background.</italic>
</bold>
 Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population.</p>
<p>
<bold>
<italic>Methods.</italic>
</bold>
 A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility–based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined.</p>
<p>
<bold>
<italic>Results.</italic>
</bold>
 Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion—namely, 20%–45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania—sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites.</p>
<p>
<bold>
<italic>Conclusions.</italic>
</bold>
 Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever.</p>
</abstract>
<kwd-group>
<kwd>healthcare utilization</kwd>
<kwd>typhoid fever</kwd>
<kwd>sub-Saharan Africa</kwd>
</kwd-group>
<funding-group>
<award-group id="funding-1">
<award-id>OPPGH5231</award-id>
</award-group>
<award-group id="funding-2">
<funding-source>Republic of Korea</funding-source>
</award-group>
<award-group id="funding-3">
<funding-source>Swedish International Development Cooperation Agency</funding-source>
</award-group>
<award-group id="funding-4">
<funding-source>National Institutes of Health
<named-content content-type="funder-id">http://dx.doi.org/10.13039/100000002</named-content>
</funding-source>
<award-id>R01TW009237</award-id>
<award-id>U01 AI062563</award-id>
<award-id>R24 TW007988</award-id>
<award-id>D43 PA-03-018</award-id>
<award-id>U01 AI069484</award-id>
<award-id>U01 AI067854</award-id>
<award-id>P30 AI064518</award-id>
</award-group>
<award-group id="funding-5">
<funding-source>UK Biotechnology and Biological Sciences Research Council</funding-source>
<award-id>BB/J010367</award-id>
</award-group>
<award-group id="funding-6">
<funding-source>Wellcome Trust
<named-content content-type="funder-id">http://dx.doi.org/10.13039/100004440</named-content>
</funding-source>
</award-group>
<award-group id="funding-7">
<funding-source>Royal Society
<named-content content-type="funder-id">http://dx.doi.org/10.13039/501100000288</named-content>
</funding-source>
<award-id>100087/Z/12/Z</award-id>
<award-id>OPP1129380</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>

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