Pinnacle Medicine & Medical Sciences

(ISSN: 2360-9516)

May 2016, Vol. 3 (2).

© Author(s) 2016. This work is distributed under the Creative Commons Attribution 3.0 License.

Research Article

 

Factors Associated With Late Presentation To Kenyatta National Hospital For Acute Severe Illness In Children Aged 2-59 Months

J. Gitau1*, G. Irimu2, D. Wamalwa3, D. Njai4

MMed Postgraduate student1*
University of Nairobi,
Dept of Paediatrics, P.O Box 2257-00202, Nairobi.

School of Medicine2,3,4
Dept of Paediatrics,
University of Nairobi, P.O Box 19676-00202, Nairobi.

Accepted 11 May, 2016; Available Online 16 May, 2016.

Abstract:

Background: Delay in seeking appropriate healthcare for ill children is an important cause of morbidity and mortality especially for those aged below five years. Understanding factors that contribute to these delays in any particular setting is helpful to enable the concerned health worker(s) address the caretaker concerns insofar as this leads to late care seeking for illness with its subsequent implications. Objective: Determine the factors associated with late healthcare seeking behaviour among severely ill children aged 2-59 months presenting to Kenyatta National hospital. Design: A hospital-based case control study. Setting: The Paediatric Filter Clinic and the paediatric medical wards at the Kenyatta National Hospital (KNH). Subject: Children aged 2- 59 months brought to hospital with acute severe illness and their caretakers. 316 caretakers and their ill children were enrolled into the study between November 2007 and February 2008. Results: Symptoms of cough and diarrhoea were likely to be associated with presentation later than 3 days with OR of 2.09 (CI 1.23-3.56) and 1.57(CI 1.01-2.73) respectively. Herbal Medicine was used by 5% of the study population and was associated with marked likelihood of late presentation [OR 41.7(CI 4.70-369.1)]. On survival outcome, there was enhanced chance of death in the cases compared to the controls [OR 4.69 (CI 1.62-14.6)]. The median length of hospital stay was longer for the cases (7 days vs 5 days) p=0.05. Conclusion: Caretakers bringing their acute severely ill children later than 3 days from illness onset to KNH (cases) are more likely to have explored other healthcare options first compared to similarly ill children brought within 3 days (controls). Cases had more adverse outcomes in terms of mortality and morbidity (as reflected by longer periods of hospitalization) 

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