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Health Seeking Behaviour and Utilization of Health Facilities for Schistosomiasis-Related Symptoms in Ghana

Author

Listed:
  • Anthony Danso-Appiah
  • Wilma A Stolk
  • Kwabena M Bosompem
  • Joseph Otchere
  • Caspar W N Looman
  • J Dik F Habbema
  • Sake J de Vlas

Abstract

Background: Schistosomiasis causes long-term illness and significant economic burden. Morbidity control through integration within existing health care delivery systems is considered a potentially sustainable and cost-effective approach, but there is paucity of information about health-seeking behaviour. Methods: A questionnaire-based study involving 2,002 subjects was conducted in three regions of Ghana to investigate health-seeking behaviour and utilization of health facilities for symptoms related to urinary (blood in urine and painful urination) and intestinal schistosomiasis (diarrhea, blood in stool, swollen abdomen and abdominal pain). Fever (for malaria) was included for comparison. Results: Only 40% of patients with urinary symptoms sought care compared to >70% with intestinal symptoms and >90% with fever. Overall, about 20% of schistosomiasis-related symptoms were reported to a health facility (hospital or clinic), compared to about 30% for fever. Allopathic self-medication was commonly practiced as alternative action. Health-care seeking was relatively lower for patients with chronic symptoms, but if they took action, they were more likely to visit a health facility. In a multivariate logistic regression analysis, perceived severity was the main predictor for seeking health care or visiting a health facility. Age, socio-economic status, somebody else paying for health care, and time for hospital visit occasionally showed a significant impact, but no clear trend. The effect of geographic location was less marked, although people in the central region, and to a lesser extent the north, were usually less inclined to seek health care than people in the south. Perceived quality of health facility did not demonstrate impact. Conclusion: Perceived severity of the disease is the most important determinant of seeking health care or visiting a health facility in Ghana. Schistosomiasis control by passive case-finding within the regular health care delivery looks promising, but the number not visiting a health facility is large and calls for supplementary control options. Author Summary: The World Health Organization recommends that long-term benefit of schistosomiasis control should include treatment in local health facilities. This means that patients should visit a hospital or clinic with their complaints. However, little is known about whether they do so. We conducted a study in three regions of Ghana and interviewed two thousand people about whether they recently had schistosomiasis-related symptoms such as blood in urine or blood in faeces, and what they had done about it. We included fever (mostly caused by malaria) for comparison. We found that 40% of patients with urinary symptoms sought care compared to 70% of those with intestinal symptoms and 90% with fever. Overall, only 20% of all schistosomiasis-related symptoms were reported to a hospital or clinic, compared to 30% for fever. Self-medication with allopathic (i.e., orthodox) medicines was the main alternative. Our study showed that the most important determinant for seeking health care or visiting a health facility is perceived severity of the symptom. Factors such as age, sex, socio-economic status and geographic region showed no impact or a clear pattern. We conclude that many schistosomiasis patients do not visit a health facility, the only place with effective drugs, necessitating additional control measures.

Suggested Citation

  • Anthony Danso-Appiah & Wilma A Stolk & Kwabena M Bosompem & Joseph Otchere & Caspar W N Looman & J Dik F Habbema & Sake J de Vlas, 2010. "Health Seeking Behaviour and Utilization of Health Facilities for Schistosomiasis-Related Symptoms in Ghana," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 4(11), pages 1-10, November.
  • Handle: RePEc:plo:pntd00:0000867
    DOI: 10.1371/journal.pntd.0000867
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    References listed on IDEAS

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    1. Stock, Robert, 1983. "Distance and the utilization of health facilities in rural Nigeria," Social Science & Medicine, Elsevier, vol. 17(9), pages 563-570, January.
    2. Kloos, Helmut, 1995. "Human behavior, health education and schistosomiasis control: A review," Social Science & Medicine, Elsevier, vol. 40(11), pages 1497-1511, June.
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    1. Ralf Krumkamp & Nimako Sarpong & Benno Kreuels & Lutz Ehlkes & Wibke Loag & Norbert Georg Schwarz & Hajo Zeeb & Yaw Adu-Sarkodie & Jürgen May, 2013. "Health Care Utilization and Symptom Severity in Ghanaian Children – a Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    2. P. M. Amegbor, 2017. "An Assessment of Care-Seeking Behavior in Asikuma-Odoben-Brakwa District: A Triple Pluralistic Health Sector Approach," SAGE Open, , vol. 7(2), pages 21582440177, June.

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