Diarrheal Illness and Healthcare Seeking Behavior among a Population at High Risk for Diarrhea in Dhaka, Bangladesh

PLoS One. 2015 Jun 29;10(6):e0130105. doi: 10.1371/journal.pone.0130105. eCollection 2015.

Abstract

Diarrhea remains one of the major causes of death in Bangladesh. We studied diarrheal disease risk and healthcare seeking behavior among populations at high risk for diarrhea in Dhaka, Bangladesh. Data were obtained from a cross-sectional survey conducted during April and September 2010. The prevalence of diarrhea was calculated by age-group and sex. A generalized estimating equation with logit link function was used to predict diarrheal disease risk and seeking care from a professional healthcare provider. Of 316,766 individuals, 10% were young children (<5 years). The prevalence of diarrhea was 16 per 1000 persons among all ages; young children accounted for 44 per 1000 persons. Prevalence of diarrhea was significantly higher (p=.003) among younger males (<15 years) compared to that among younger females. In contrast, prevalence of diarrhea was significantly higher (p<.0001) among older females (≥15 years) compared to that among older males. An increased risk for diarrhea was observed in young children, males, and those staying in rented houses, lower family members in the house, using non-sanitary toilets, living in the area for short times, living in a community with less educated persons, living in a community with less use of safe water source for drinking, or living close to the hospital. About 80% of those with diarrhea sought care initially from a non-professional healthcare provider. Choice of the professional healthcare provider was driven by age of the patient, educational status of the household head, and hygienic practices by the household. The study reaffirms that young children are at greater risk for diarrhea. Like other developing countries most people in this impoverished setting of Dhaka are less likely to seek care from a professional healthcare provider than from a non-professional healthcare provider, which could be attributed to a higher number of diarrheal deaths among young children in Bangladesh. Dissemination of information on health education, increasing the supply of skilled healthcare providers, and low-cost and quality healthcare services may encourage more people to seek care from professional healthcare providers, thus may help reduce child mortality in the country. Further studies are warranted to validate the results.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Bangladesh
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diarrhea / diagnosis*
  • Diarrhea / epidemiology*
  • Female
  • Geography
  • Health Services Accessibility*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Prevalence
  • Sex Factors
  • Socioeconomic Factors
  • Water Supply
  • Young Adult

Grants and funding

The study was funded by Grant OPP50419 from the Bill & Melinda Gates Foundation. Additionally the study was also supported by core grants to the icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh). The icddr,b is thankful to the Governments of Australia, Bangladesh, Canada, Sweden and the UK for providing core/unrestricted support (http://www.gatesfoundation.org/). The funding agency of the study, the Bill and Melinda Gates Foundation provided input in the design and planning of the study. They had no role in data collection, data analysis, data interpretation, analysis, decision to publish, or preparation of the manuscript.