Healthcare utilization for common infectious disease syndromes in Soweto and Klerksdorp, South Africa

  • Karen Kai-Lun Wong
  • Claire von Mollendorf
  • Neil Martinson
  • Shane Norris
  • Stefano Tempia
  • Sibongile Walaza
  • Ebrahim Variava
  • Meredith Lynn McMorrow
  • Shabir Madhi
  • Cheryl Cohen
  • Adam Lauren Cohen
Keywords: Diarrhea, health services, meningitis, respiratory tract infections, South Africa

Abstract

Introduction: Understanding healthcare utilization helps characterize access to healthcare, identify barriers and improve surveillance data interpretation. We describe healthcare-seeking behaviors for common infectious syndromes and identify reasons for seeking care.

Methods: We conducted a cross-sectional survey among residents in Soweto and Klerksdorp, South Africa. Households were interviewed about demographic characteristics; recent self-reported episodes of pneumonia, influenza-like illness (ILI), chronic febrile respiratory illness and meningitis in individuals of all ages; recent diarrhea in children aged < 5 years; and consultation with healthcare facilities and providers.

Results: From July-October 2012, we interviewed 1,442 households in Klerksdorp and 973 households in Soweto. Public clinics were consulted most frequently for pneumonia, ILI and diarrhea in a child <5 years old at both sites; public hospitals were most frequently consulted for chronic respiratory and meningitis syndromes. Of all illness episodes reported, there were 110 (35%) in Klerksdorp and 127 (32%) in Soweto for which the person did not seek care with a licensed medical provider. Pharmacies were often consulted by individuals with pneumonia (Klerksdorp: 17, 16%; Soweto: 38, 22%) or ILI (Klerksdorp: 35, 24%; 44, 28%). Patients who did not seek care with a licensed provider reported insufficient time (Klerksdorp: 7%; Soweto, 20%) and lack of medications at the facility (Klerksdorp: 4%; Soweto: 8%) as barriers.

Conclusion: Public government healthcare facilities are commonly consulted for infectious syndromes and pharmacies are frequently consulted particularly for respiratory diseases. Improving
medication availability at healthcare facilities and streamlining healthcare delivery may improve access of licensed providers for serious illnesses.

Keywords: Diarrhea, health services, meningitis, respiratory tract infections, South Africa

Author Biographies

Karen Kai-Lun Wong
Centers for Disease Control and Prevention, Atlanta, Georgia USA; United States Public Health Service
Claire von Mollendorf
National Institute for Communicable Diseases, Johannesburg, South Africa; University of Witwatersrand, Johannesburg, South Africa
Neil Martinson
MRC Developmental Pathways for Health Research Unit, University of Witwatersrand, Johannesburg, South Africa; Johns Hopkins University, Baltimore, Maryland USA
Shane Norris
University of Witwatersrand, Johannesburg, South Africa
Stefano Tempia
Centers for Disease Control and Prevention, Atlanta, Georgia USA; National Institute for Communicable Diseases, Johannesburg, South Africa,
Sibongile Walaza
National Institute for Communicable Diseases, Johannesburg, South Africa
Ebrahim Variava
University of Witwatersrand, Johannesburg, South Africa; Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa
Meredith Lynn McMorrow
Centers for Disease Control and Prevention, Atlanta, Georgia USA; National Institute for Communicable Diseases, Johannesburg, South Africa
Shabir Madhi
National Institute for Communicable Diseases, Johannesburg, South Africa; University of Witwatersrand, Johannesburg, South Africa
Cheryl Cohen
National Institute for Communicable Diseases, Johannesburg, South Africa; University of Witwatersrand, Johannesburg, South Africa
Adam Lauren Cohen
Centers for Disease Control and Prevention, Atlanta, Georgia USA; United States Public Health Service
Published
2019-02-11
Section
Articles

Journal Identifiers


eISSN: 1937-8688