Household costs and time to treatment for children with severe febrile illness in rural Burkina Faso: the role of rectal artesunate

Castellani, Joëlle; Mihaylova, Borislava; Siribié, Mohamadou; Gansane, Zakaria; Ouedraogo, Amidou Z.; Fouque, Florence; Sirima, Sodiomon B.; Evers, Silvia M. A. A.; Paulus, Aggie T. G.; Gomes, Melba

doi:10.1186/s12936-018-2526-8

Table 3 Time taken in hours to seek treatment and deterioration of clinical status, by symptoms: children treated with RA versus children not treated with RA

From: Household costs and time to treatment for children with severe febrile illness in rural Burkina Faso: the role of rectal artesunate

Category	CNS + other symptoms^a				No CNS but prostrated with other symptoms^a				Total
	RA		No RA		RA		No RA		RA		No RA
	N	% or mean (SD)	N	% or mean (SD)	N	% or mean (SD)	N	% or mean (SD)	N	% or mean (SD)	N	% or mean (SD)
“Modern” provider^b
Yes	30	100%	13^c	54%	69	100%	20	42%	99	100%	33^c	46%
No	–	–	11	46%	–	–	28	58%	–	–	39	54%
From onset of illness to 1st “modern” provider: Was the child treated within 24 h?
Yes	26	87%	9	69%	59	86%	14	70%	85	86%	23	70%
No	4	13%	4	31%	10	14%	6	30%	14	14%	10	30%
Mean time (h)^{d, e}	30	9.0 (9.9)	9	16.1 (16.5)	69	12.2 (12.0)*	14	20.1 (18.3)	99	11.2 (11.5)*	23	18.5 (17.3)
Deterioration: CNS on arrival^f	4/30	13%	2/11	18%	–	–	–	–	4/99	4%	2/31	6%
From onset of illness to health centre: mean time (h) to reach a health centre^g	30	14.5 (10.7)	7	17.2 (17.7)	68	15.2 (12.0)	14	20.1 (18.3)^h	98	15.0 (11.5)	21	19.1 (17.7)
From danger signs to health centreⁱ : mean time (h) to reach a health centre^{j, k}	22	10.4 (10.3)	7	12.0 (18.7)	54	11.3 (11.5)	12	14.8 (18.6)	76	11.1 (11.1)^k	19	13.7 (18.2)

RA rectal artesunate, CNS central nervous system (convulsions; altered consciousness/coma), SD standard deviation, h hours
* RA vs. no RA: p < 0.05
^aRepeated vomiting ± too weak to take oral medication/“lethargy”
^b“Modern” defined to include community health workers, drug shops, dispensaries, health centres, and hospitals for RA children and drug shops, dispensaries, and health centres for non-RA children. Traditional or informal care providers were excluded
^cCNS: 11 children went to a health centre, 1 to a drug shop and 1 to a dispensary/CSPS; Total: 31 children went to a health centre, 1 to a drug shop and 1 to a dispensary/CSPS
^dCNS: missing for 4 children with no RA; No CNS: missing for 6 children with no RA; Total: missing for 10 children with no RA
^eMean time from onset of illness to 1st provider (home stock, traditional healer, drug hawkers) for children who did not go to a “modern” provider: CNS and no RA: N = 8, Mean = 2.0, SD = 3.1, missing for 3 children; No CNS and no RA: N = 17, Mean = 12.3, SD = 11.5, missing for 10 children, 1 child did not go to any provider; Total and no RA: N = 25, Mean = 9.0, SD = 10.7, missing for 13 children, 1 child did not go to any provider
^fSymptoms after baseline, documented at health centre
^gCNS: missing for 4 children with no RA; No CNS: missing for 1 child with RA and 6 children with no RA; Total: missing for 1 child with RA and 10 children with no RA
^hSame as the mean time from onset of illness to 1^st “modern” provider because the health centre was the only “modern” provider visited
ⁱAny danger signs (coma/altered consciousness, convulsions, repeated vomiting, lethargy) for the CNS and total groups
^jCNS: missing for 8 children with RA, 4 children with no RA; No CNS: missing for 15 children with RA, 8 children with no RA; Total: missing for 23 children with RA, 12 children with no RA
^kMean referral time (h) from RA to the health centre: Total—RA: 3.2 h

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ISSN: 1475-2875

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