The impact of primary health care on malaria morbidity - defining access by disease burden

被引:46
作者
O'Meara, W. P. [1 ]
Noor, A. [2 ]
Gatakaa, H. [3 ]
Tsofa, B. [4 ]
McKenzie, F. E. [1 ]
Marsh, K. [4 ]
机构
[1] NIH, Fogarty Int Ctr, Bethesda, MD 20892 USA
[2] Wellcome Trust Collaborat Program, KEMRI, Nairobi, Kenya
[3] Kenya Govt Med Res Ctr, CGMRC, Wellcome Trust Collaborat Program, Kilifi, Kenya
[4] Minist Hlth, Kilifi, Kenya
基金
美国国家卫生研究院; 英国惠康基金;
关键词
primary health care; malaria morbidity; access; travel time; Kenya; KENYA; CHILDREN; SERVICES; COAST; TRANSMISSION; VACCINE; EQUITY; FEVERS;
D O I
10.1111/j.1365-3156.2008.02194.x
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Primary care facilities are increasingly becoming the focal point for distribution of malaria intervention strategies, but physical access to these facilities may limit the extent to which communities can be reached. To investigate the impact of travel time to primary care on the incidence of hospitalized malaria episodes in a rural district in Kenya. The incidence of hospitalized malaria in a population under continuous demographic surveillance was recorded over 3 years. The time to travel to the nearest primary health care facility was calculated for every child between birth and 5 years of age and trends in incidence of hospitalized malaria as a function of travel time were evaluated. The incidence of hospitalized malaria more than doubled as travel time to the nearest primary care facility increased from 10 min to 2 h. Good access to primary health facilities may reduce the burden of disease by as much as 66%. Our results highlight both the potential of the primary health care system in reaching those most at risk and reducing the disease burden. Insufficient access is an important risk factor, one that may be inequitably distributed to the poorest households.
引用
收藏
页码:29 / 35
页数:7
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