Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey

Omale, Ugwu I.; Oka, Onyinyechukwu U.; Okeke, Ifeyinwa M.; Azuogu, Benedict N.; Alo, Chihurumnanya; Madubueze, Ugochukwu C.; Eze, Irene I.; Okeke, Kingsley C.; Utulu, Rowland; Akpan, Uduak E.; Iloke, Chijioke V.; Nnubia, Anthonia O.; Ibemesi, Desi O.; Nnabu, Chukwuka R.; Anene, Ogechukwu C.

doi:10.1186/s12913-021-06865-8

Table 4 Factors associated with health care-seeking behaviour among participants¹

From: Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey

Factors	Care-seeking with orthodox providers5 the same or next day				Care-seeking with public providers6 the same or next day
Factors	cOR (95% CI)	p-value	aOR (95% CI)	p-value	cOR (95% CI)	p-value	aOR (95% CI)	p-value
Children under 5 years of age
Age group (months)		0.7708^A		0.7453^A		0.7130^A		0.6445^A
< 12	1.0	–	1.0	–	1.0	–	1.0	–
12–23	0.9 (0.5–1.4)	0.603	0.9 (0.6–1.5)	0.716	0.9 (0.6–1.5)	0.782	0.9 (0.6–1.6)	0.847
24–35	0.8 (0.5–1.2)	0.256	0.8 (0.5–1.3)	0.357	1.1 (0.7–1.8)	0.582	1.2 (0.8–1.9)	0.453
36–47	0.9 (0.6–1.4)	0.660	0.9 (0.6–1.5)	0.919	1.1 (0.7–1.6)	0.845	1.03 (0.7–1.6)	0.882
48–59	0.9 (0.6–1.4)	0.735	1.01 (0.6–1.6)	0.986	0.9 (0.6–1.4)	0.623	0.9 (0.6–1.4)	0.680
Sex		–		–		–		–
Male	0.8 (0.7–1.1)	0.156	0.8 (0.6–1.02)	0.072	1.1 (0.9–1.4)	0.319	1.1 (0.9–1.4)	0.460
Female	1.0	–	1.0	–	1.0	–	1.0	–
Educ. level of resp³		0.1559^A		0.7074^A		0.0175^A		0.0740^A
No education	1.0	–	1.0	–	1.0	–	1.0	–
Primary	1.3 (0.9–1.8)	0.207	1.1 (0.7–1.5)	0.726	1.3 (0.9–1.9)	0.233	1.2 (0.8–1.8)	0.344
Secondary	1.5 (1.0–2.1)	0.027	1.1 (0.8–1.7)	0.568	1.3 (0.9–1.9)	0.196	1.3 (0.8–1.9)	0.283
Tertiary	1.5 (0.8–2.6)	0.208	0.8 (0.4–1.6)	0.503	2.5 (1.4–4.4)	0.002	2.6 (1.3–5.2)	0.009
Occupation of resp³		0.0017^A		0.0060^A		0.0946^A		0.3074^A
Farmer	1.0	–	1.0	–	1.0	–	1.0	–
Trader	1.6 (1.2–2.1)	< 0.001	1.6 (1.2–2.1)	0.003	1.2 (0.9–1.6)	0.111	1.1 (0.9–1.5)	0.381
Teacher	2.8 (1.2–6.3)	0.015	3.2 (1.3–8.2)	0.015	1.6 (0.8–3.0)	0.171	0.9 (0.4–2.0)	0.867
Civil servant	1.6 (0.7–3.8)	0.282	1.9 (0.7–5.1)	0.200	1.7 (0.8–3.8)	0.164	0.9 (0.4–2.4)	0.931
Others*	1.1 (0.8–1.6)	0.590	1.1 (0.7–1.6)	0.747	0.8 (0.6–1.2)	0.341	0.7 (0.5–1.1)	0.143
Knowledge/opinion⁴ of respondent³		0.0019^A		0.0064^A		0.4236^A		0.8029^A
Poor	1.0	–	1.0	–	1.0	–	1.0	–
Fair	2.1 (1.4–3.1)	< 0.001	1.9 (1.3–2.9)	0.002	1.3 (0.8–2.0)	0.292	1.2 (0.7–1.9)	0.531
Good	1.8 (1.2–2.7)	0.005	1.6 (1.1–2.5)	0.025	1.4 (0.9–2.2)	0.191	1.2 (0.7–1.9)	0.518
Children ages 5 yrs. & above & adults²
Age group (years)		0.0001^A		0.0001^A		0.0003^A		0.0045^A
5–14	1.7 (1.3–2.2)	< 0.001	1.5 (1.1–2.0)	0.013	1.9 (1.3–2.7)	0.001	1.4 (0.9–2.1)	0.084
15–24	1.2 (0.9–1.7)	0.195	1.2 (0.8–1.6)	0.359	1.5 (1.0–2.3)	0.048	1.3 (0.8–2.0)	0.237
25–34	1.1 (0.8–1.6)	0.567	0.9 (0.6–1.4)	0.723	1.4 (0.9–2.3)	0.155	1.01 (0.6–1.7)	0.960
35–44	0.9 (0.7–1.4)	0.740	0.8 (0.5–1.1)	0.147	1.1 (0.7–1.9)	0.606	0.8 (0.5–1.4)	0.410
45–54	1.1 (0.7–1.6)	0.765	0.9 (0.6–1.4)	0.772	0.8 (0.5–1.5)	0.542	0.7 (0.4–1.2)	0.190
> =55	1.0	–	1.0	–	1.0	–	1.0	–
Sex
Male	1.04 (0.9–1.2)	0.696	0.9 (0.7–1.1)	0.214	1.1 (0.9–1.3)	0.580	0.9 (0.7–1.2)	0.493
Female	1.0	–	1.0	–	1.0	–	1.0	–
Educational level of resp³		0.0007^A		0.0041^A		< 0.0001^A		< 0.0001^A
No education	1.0	–	1.0	–	1.0	–	1.0	–
Primary	1.1 (0.9–1.3)	0.495	1.1 (0.8–1.3)	0.671	1.1 (0.9–1.5)	0.350	1.1 (0.8–1.4)	0.648
Secondary	1.4 (1.1–1.8)	0.002	1.5 (1.1–1.9)	0.006	1.7 (1.3–2.2)	< 0.001	1.5 (1.1–2.1)	0.009
Tertiary	1.9 (1.3–2.8)	0.002	2.0 (1.2–3.3)	0.007	3.8 (2.6–5.6)	< 0.001	3.3 (2.0–5.4)	< 0.001
Occupation of resp³		< 0.0001^A		< 0.0001^A		< 0.0001^A		0.0032^A
Farmer	1.0	–	1.0	–	1.0	–	1.0	–
Trader	1.3 (1.1–1.6)	0.005	1.1 (0.9–1.4)	0.362	1.3 (1.1–1.7)	0.010	1.03 (0.8–1.3)	0.802
Teacher	1.4 (0.8–2.4)	0.249	0.8 (0.4–1.5)	0.459	2.3 (1.4–4.1)	0.002	0.9 (0.5–1.7)	0.717
Civil servant	1.6 (0.9–2.7)	0.080	0.9 (0.5–1.8)	0.913	2.9 (1.8–4.8)	< 0.001	1.1 (0.6–2.0)	0.734
Others*	0.6 (0.4–0.8)	< 0.001	0.4 (0.3–0.6)	< 0.001	0.7 (0.5–1.04)	0.080	0.5 (0.3–0.7)	< 0.001
Knowledge/opinion⁴ of resp³		< 0.0001^A		< 0.0001^A		< 0.0001^A		< 0.0001^A
Poor	1.0	–	1.0	–	1.0	–	1.0	–
Fair	2.3 (1.8–2.9)	< 0.001	2.2 (1.7–2.8)	< 0.001	3.4 (2.2–5.2)	< 0.001	3.1 (2.0–4.8)	< 0.001
Good	2.0 (1.6–2.6)	< 0.001	1.8 (1.3–2.3)	< 0.001	4.4 (2.8–6.8)	< 0.001	3.4 (2.1–5.3)	< 0.001

cOR = crude odds ratio from bivariate logistic regression. aOR = adjusted odds ratio from multivariate logistic regression controlling for the other factors (age group, sex, educational level, occupation, and knowledge/opinion level). ^Ap-value from overall test for the effect of the independent variables (using the postestimation test command in Stata). *Mainly include hair dressers, tailors, house wives, and students. ¹Children and adults (excluding pregnant women) with fever/malaria-like illness in the two weeks preceding a survey. ²Adults excluding pregnant women. ³Respondent female heads of households (the mother of the house or female primary care giver). ⁴Knowledge and opinion level of survey respondents about malaria and malaria diagnosis (knowledge and opinion score of < 50 was poor knowledge, 50–< 70 was fair, > = 70 was good). ⁵Include public and private sector providers (excluding traditional practitioners and drug hawkers). ⁶Include mostly the public primary health centres/providers (others include government hospitals, health posts, community health workers, and free mobile clinics)

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