Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North India
Introduction Acute encephalitis syndrome (AES) poses a significant health challenge to children across India. Late arrival at tertiary care hospitals is a primary contributor to disease severity and poor outcomes. This study identifies the determinants of delayed health seeking and disease severity...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/2/2/e001071.full |
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| author | Manoj Murhekar Neha Srivastava Mahima Mittal Rajni Kant Umaer Alam Aman Agrawal Rohit Beniwal Ashok Kumar Pandey Mahim Mittal Bhoopendra Sharma Urmila Gupta |
| author_facet | Manoj Murhekar Neha Srivastava Mahima Mittal Rajni Kant Umaer Alam Aman Agrawal Rohit Beniwal Ashok Kumar Pandey Mahim Mittal Bhoopendra Sharma Urmila Gupta |
| author_sort | Manoj Murhekar |
| collection | DOAJ |
| description | Introduction Acute encephalitis syndrome (AES) poses a significant health challenge to children across India. Late arrival at tertiary care hospitals is a primary contributor to disease severity and poor outcomes. This study identifies the determinants of delayed health seeking and disease severity in AES cases.Methods We interviewed the parents/guardians/caregivers of 242 patients with AES admitted at a tertiary care centre. Multivariable analyses identified factors for delayed health seeking, defined as >3 days spent at home after symptom onset; and disease severity on admission, defined as need for oxygen support. 131 patients were evaluated for long-term outcomes after 3 years using the Liverpool Outcome Score.Results 90 (37.2%) patients had delayed health seeking and 202 (83.5%) had severe disease on admission. Lack of awareness about AES was a significant risk factor (OR 2.4, 95% CI 1.2 to 5.0, p=0.01) for delayed health seeking. Disease severity was associated with seeking treatment from uncertified medical practitioners (UMPs) (OR 7.3, 95% CI 2.7 to 19.8, p<0.01) and ≥2 days of time spent between the first healthcare provider and tertiary care admission (OR 3.0, 95% CI 1.3 to 7.3, p=0.01). At follow-up, disability was observed in 18.3% (n=24) of the patients.Conclusion Delayed health seeking, treatment from UMPs and multiple healthcare consultations contributed to disease severity in patients with AES on admission at tertiary care health facilities. |
| format | Article |
| id | doaj-art-c22aaf8fb07f4a79acda1d64ee2da061 |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-c22aaf8fb07f4a79acda1d64ee2da0612024-12-06T06:15:10ZengBMJ Publishing GroupBMJ Public Health2753-42942024-12-012210.1136/bmjph-2024-001071Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North IndiaManoj Murhekar0Neha Srivastava1Mahima Mittal2Rajni Kant3Umaer Alam4Aman Agrawal5Rohit Beniwal6Ashok Kumar Pandey7Mahim Mittal8Bhoopendra Sharma9Urmila Gupta10Division of Epidemiology, ICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, IndiaICMR-Regional Medical Research Centre, Gorakhpur, Gorakhpur, Uttar Pradesh, IndiaDepartment of Pediatrics, All India Institute of Medical Sciences Gorakhpur, Gorakhpur, IndiaICMR-Regional Medical Research Centre, Gorakhpur, Gorakhpur, Uttar Pradesh, IndiaDepartment of Social and Behavioral Health, ICMR - Regional Medical Research Centre Gorakhpur, Gorakhpur, Uttar Pradesh, IndiaDepartment of Biostatistics, ICMR - Regional Medical Research Centre Gorakhpur, Gorakhpur, Uttar Pradesh, IndiaDepartment of Molecular Biology, ICMR - Regional Medical Research Centre Gorakhpur, Gorakhpur, Uttar Pradesh, IndiaDepartment of Immunology, ICMR - Regional Medical Research Centre Gorakhpur, Gorakhpur, Uttar Pradesh, IndiaDepartment of General Medicine, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, IndiaDepartment of Pediatrics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, IndiaDepartment of Pediatrics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, IndiaIntroduction Acute encephalitis syndrome (AES) poses a significant health challenge to children across India. Late arrival at tertiary care hospitals is a primary contributor to disease severity and poor outcomes. This study identifies the determinants of delayed health seeking and disease severity in AES cases.Methods We interviewed the parents/guardians/caregivers of 242 patients with AES admitted at a tertiary care centre. Multivariable analyses identified factors for delayed health seeking, defined as >3 days spent at home after symptom onset; and disease severity on admission, defined as need for oxygen support. 131 patients were evaluated for long-term outcomes after 3 years using the Liverpool Outcome Score.Results 90 (37.2%) patients had delayed health seeking and 202 (83.5%) had severe disease on admission. Lack of awareness about AES was a significant risk factor (OR 2.4, 95% CI 1.2 to 5.0, p=0.01) for delayed health seeking. Disease severity was associated with seeking treatment from uncertified medical practitioners (UMPs) (OR 7.3, 95% CI 2.7 to 19.8, p<0.01) and ≥2 days of time spent between the first healthcare provider and tertiary care admission (OR 3.0, 95% CI 1.3 to 7.3, p=0.01). At follow-up, disability was observed in 18.3% (n=24) of the patients.Conclusion Delayed health seeking, treatment from UMPs and multiple healthcare consultations contributed to disease severity in patients with AES on admission at tertiary care health facilities.https://bmjpublichealth.bmj.com/content/2/2/e001071.full |
| spellingShingle | Manoj Murhekar Neha Srivastava Mahima Mittal Rajni Kant Umaer Alam Aman Agrawal Rohit Beniwal Ashok Kumar Pandey Mahim Mittal Bhoopendra Sharma Urmila Gupta Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North India BMJ Public Health |
| title | Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North India |
| title_full | Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North India |
| title_fullStr | Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North India |
| title_full_unstemmed | Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North India |
| title_short | Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North India |
| title_sort | factors associated with delayed health seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome an observational study from north india |
| url | https://bmjpublichealth.bmj.com/content/2/2/e001071.full |
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