Patient and health system-related determinants of delayed health seeking among pediatric encephalitis cases.

Abstract

Acute Encephalitis Syndrome (AES) has been a serious public health concern in India. Choosing uncertified medical practitioners (UMPs) for AES treatment significantly delays presentation at proper healthcare facilities, leading to poor outcomes in pediatric AES cases. This study elucidates the socio-economic, demographic, and behavioral determinants influencing treatment-seeking behaviors among parents or caregivers of pediatric AES patients. This Cross-sectional study was conducted from July to December 2023. Data related to socioeconomic and demographic characteristics, point of contact for seeking the treatment, and factors associated with it, were collected from the parents and caregivers of confirmed AES pediatric patients. Continuous variables were reported as Mean (SD) and/or Median (IQR). Categorical variables were reported as numbers and percentages. Bivariate and multivariable logistic regressions were used to study the relationship between binary dependent variables and categorical independent variables. The first choice for treatment was UMPs in 55/91 (60.4%) cases. Distance of government healthcare facilities 36/49 (73.5%), availability of UMPs near home 39/45 (86.7%), and no awareness about the disease and its treatment 32/49 (65.3%) were key contributors to choosing UMPs. Patient ≥12 years of age [AOR. (95% C.I.), P] = [4.1 (1.9, 17.8), 0.06]; rural resident [1.4 (0.3, 6.2), 0.68]; from upper lower class [5.6 (0.2, 127.2), 0.27] had higher odds of choosing UMPs. We found significant involvement of UMPs in the treatment of pediatric AES patients causing adverse health outcomes. There is an urgent need to strengthen peripheral public health facilities and increase awareness of AES prevention and treatment among the community and healthcare providers.