Barriers and facilitators to seeking care for persons with acute brain infections: a cross sectional study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20231294Keywords:
Acute brain infections, Encephalitis, Meningitis, Psychosocial research, Barriers and facilitators, Social determinants of healthAbstract
Background: Acute brain infections including encephalitis are less common but serious conditions characterized by the inflammation of the brain requiring immediate accurate diagnosis and management. For many infections appropriate therapies exist, but the outcome is often less desirable because of failure to receive appropriate treatment on time due to multiple factors. The aim of the study was to understand the barriers and facilitators towards receiving care for persons with acute brain infections in a low resource setting.
Methods: The study design was cross sectional exploratory study. Consecutive patients presenting to neurology department of a tertiary referral care center for Neuropsychiatry in South India from July 2020 to September 2020 with the diagnosis of acute brain infections were assessed using the modified Kuppuswamy scale, Glasgow coma scale, the pathway scale: encounter form, patient centered health services in India and client socio-demographic and service receipt inventory.
Results: A total of 110 participants, both male and female, were recruited for the study. The average age was 39.64±16.5 years, with more female (65.45%) representation. 29% of individuals reported continued use of traditional practices while seeking care for the brain infections. Costs associated with care increased with the increase in duration of infection. There are major barriers and facilitators which either prohibit or facilitate care for persons with acute brain infections.
Conclusions: Acute brain infections continuing to be a public health challenge in developing country context, and the recognition that the delay in treatment causes significant disability, it becomes imperative to focus on the social, cultural, economic, environmental factors to understand the barriers and facilitators to health seeking among this population.
Metrics
References
NHP. Acute encephalitis syndrome, 2014. Available at: https://www.nhp.gov.in/disease/commune/acute-encephalitis-syndrome. Accessed on 06 March 2023.
Tan K, Patel S, Gandhi N, Chow F, Rumbaugh J, Nath A. Burden of neuroinfectious diseases on the neurology service in a tertiary care center. Neurology. 2008;71(15):1160-6.
GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1260-344.
Jmor F, Emsley HC, Fischer M, Solomon T, Lewthwaite P. The incidence of acute encephalitis syndrome in Western industrialised and tropical countries. Virol J. 2008;5:134.
Kasthuri A. Challenges to Healthcare in India - The Five A's. Indian J Community Med. 2018;43(3):141-3.
Kumar P, Pisudde PM, Sarthi PP, Sharma MP, Keshri VR. Status and trend of acute encephalitis syndrome and Japanese encephalitis in Bihar, India. Natl Med J India. 2017;30(6):317-20.
Nath HK. Japanese Encephalitis, Acute Encephalitis Syndrome hit Assam, 120 deaths recorded this year, 2021. Available at: https://www.indiatoday.in/india/ story/japanese-120-deaths-recorded-this-year. Accessed on 06 March 2023.
WHO. Global health risks, 2018. Available at: https://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full. Accessed on 06 March 2023.
Ravi V, Mani R, Govekar SR, Desai A, Lakshman L. Aetiology and Laboratory Diagnosis of Acute Encephalitis Syndrome with Special Reference to India. J Communic Dis. 2014;(46):12-23.
Jayaraman Y, Veeraraghavan B, Chethrapilly Purushothaman GK, Sukumar B, Kangusamy B, Nair Kapoor A, et al. Burden of bacterial meningitis in India: Preliminary data from a hospital based sentinel surveillance network. PLoS One. 2018;13(5):e0197198.
Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81-4.
Bahrami MA, Atashbahar O, Asqari R, Fallahzadeh H. An examination of treatment seeking behavior affecting factors: A qualitative study in Iran. World Appl Sci J. 2013.
Marmot M, Bell R. Social determinants and non-communicable diseases: time for integrated action. BMJ. 2019;364:l251.
WHO. One Health, 2014. Available at: https://www.who.int/newsroom/questionsandanswers/item/one-health. Accessed on 06 March 2023.
Saleem SM. Modified Kuppuswamy socioeconomic scale updated for the year 2019. Indian J Forensic Community Med. 2019;6(1):1-3.
WHO. The Pathway Study: Encounter Form, 1987. Available at: http://apps.who.int/iris/bitstream/ handle/10665/61855/MNH_NAT_87.1.pdf;jsessionid=832429E94744A585B41082722D536705?sequence=1. Accessed on 06 March 2023.
Rao KD, Peters DH, Bandeen-Roche K. Towards patient-centered health services in India--a scale to measure patient perceptions of quality. Int J Qual Health Care. 2006;18(6):414-21.
Chisholm D, Knapp MR, Knudsen HC, Amaddeo F, Gaite L, Wijngaarden B. Client Socio-Demographic and Service Receipt Inventory--European Version: development of an instrument for international research. EPSILON Study 5. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs. Br J Psychiatry Suppl. 2000;(39):28-33.
Morano JP, Holt DA. The social determinants of health contextualized for the Zika virus. Int J Infect Dis. 2017;65:142-3.
WHO. Closing the gap in a generation: health equity through action on the social determinants of health - Final report of the commission on social determinants of health, 2008. Available at: https://www.who. int/publications-deredirect/WHO-IER-CSDH-08.1. Accessed on 06 March 2023.
Mwesige A, Mohammed AH, Kristensson K, Juliano SL, Lutwama JJ. Emerging Viral Infections in Sub-Saharan Africa and the Developing Nervous System: A Mini Review. Front Neurol. 2018;9:82.
Desmond NA, Nyirenda D, Dube Q, Mallewa M, Molyneux E, Lalloo DG, et al. Recognising and treatment seeking for acute bacterial meningitis in adults and children in resource-poor settings: a qualitative study. PLoS One. 2013;8(7):e68163.
Onyeonoro UU, Ogah OS, Ukegbu AU, Chukwuonye II, Madukwe OO, Moses AO. Urban-rural differences in health-care-seeking pattern of residents of Abia State, Nigeria, and the implication in the control of NCDs. Health Serv Insights. 2016;9:29-36.
Begashaw B, Tessema F, Gesesew HA. Health care seeking behavior in Southwest Ethiopia. PLoS One. 2016;11(9):e0161014.
Uddin MJ, Alam N, Koehlmoos TP, Sarma H, Chowdhury MA, Alam DS, et al. Consequences of hypertension and chronic obstructive pulmonary disease, healthcare-seeking behaviors of patients, and responses of the health system: a population-based cross-sectional study in Bangladesh. BMC Public Health. 2014;14:547.
Abdullahi AM, Sarmast ST, Jahan N. Viral Infections of the Central Nervous System in Children: A Systematic Review. Cureus. 2020;12(10):e11174.
Nath A. Neuroinfectious Diseases A Crisis in Neurology and a Call for Action. JAMA Network. 2023.
WHO. The End TB Strategy, 2018. Available at: https://www.who.int/tb/strategy/End_TB_Strategy.pdf. Accessed on 06 March 2023.
Downloads
Published
How to Cite
Issue
Section
