TABLE 4—

Associations for Factors Related to Formal Care Seeking for Children Younger Than 5 Years With Severe Pneumonia and Severe Diarrhea: San Marcos, Guatemala, 2008–2009

Variable	No. of Episodes (%)	Unadjusted OR (95% CI)	P	Adjusted ORa (95% CI)	P
Severe pneumonia: formal care seeking any time during episode
Age of child
< 12 mo	66 (55.5)	1.00 (Ref)		1.00 (Ref)
1–5 y	114 (46.9)	0.71 (0.46, 1.10)	.13	0.73 (0.44, 1.21)	.22
Gender of child
Male	97 (55.4)	1.00 (Ref)		1.00 (Ref)
Female	83 (45.6)	0.67 (0.44, 1.02)	.06	0.76 (0.48, 1.21)	.25
Underweight (weight 2 SD below norm)
No	123 (53.0)	1.00 (Ref)		1.00 (Ref)
Yes	49 (44.5)	0.71 (0.45, 1.12)	.14	0.83 (0.50, 1.38)	.47
Mother’s education level
None	43 (44.8)	1.00 (Ref)		1.00 (Ref)
Elementary	98 (48.5)	1.16 (0.71, 1.89)	.55	0.97 (0.56, 1.68)	.91
> elementary	40 (60.6)	1.90 (1.01, 3.59)	.04	1.53 (0.74, 3.17)	.25
Mother’s perceived severity of illness episode
Not serious	24 (42.1)	1.00 (Ref)		1.00 (Ref)
Serious	77 (45.6)	1.15 (0.63, 2.11)	.65	1.11 (0.58, 2.14)	.75
Very serious	80 (58.4)	1.93 (1.03, 3.61)	.04	2.05 (1.05, 4.03)	.04
Mother knows emergency plan
No	40 (39.2)	1.00 (Ref)		1.00 (Ref)
Yes	141 (53.8)	1.81 (1.13, 2.88)	.01	1.59 (0.97, 2.62)	.07
Municipality
Comitancillo	117 (45.9)	1.00 (Ref)		1.00 (Ref)
San Lorenzo	64 (58.7)	1.67 (1.06, 2.64)	.03	1.65 (0.96, 2.84)	.07
Asset index scoreb
0–1	105 (46.9)	1.00 (Ref)		1.00 (Ref)
2–3	76 (54.3)	1.35 (0.88, 2.06)	.17	1.29 (0.79, 2.09)	.31
Mother recognized WHO sign
No	52 (37.7)	1.00 (Ref)		1.00 (Ref)
Yes	129 (57.1)	2.20 (1.43, 3.39)	.001	2.14 (1.32, 3.47)	.002
Severe pneumonia: formal care seeking within 2 days of onset
Gender of child
Male	54 (30.9)	1.00 (Ref)		1.00 (Ref)
Female	43 (23.6)	0.69 (0.43, 1.11)	.13	0.83 (0.50, 1.35)	.44
Mother experienced previous death of a child
No	93 (28.1)	1.00 (Ref)		1.00 (Ref)
Yes	5 (15.2)	0.46 (0.17, 1.22)	.11	0.49 (0.18, 1.34)	.17
Mother’s literacy
Illiterate	21 (18.9)	1.00 (Ref)		1.00 (Ref)
Literate	77 (30.4)	1.88 (1.09, 3.24)	.02	2.13 (0.60, 7.58)	.24
Mother’s education level
None	18 (18.8)	1.00 (Ref)		1.00 (Ref)
Elementary	58 (28.7)	1.75 (0.98, 3.17)	.07	0.73 (0.18, 2.94)	.66
> elementary	22 (33.3)	2.17 (1.05, 4.47)	.04	0.97 (0.27, 3.51)	.96
Mother knows emergency plan
No	21 (20.6)	1.00 (Ref)		1.00 (Ref)
Yes	77 (29.4)	1.61 (0.93, 2.78)	.09	1.46 (0.83, 2.56)	.19
Municipality
Comitancillo	62 (24.3)	1.00 (Ref)		1.00 (Ref)
San Lorenzo	36 (33.0)	1.53 (0.94, 2.51)	.09	1.11 (0.65, 1.89)	.70
Someone to look after household in emergency
No	24 (21.2)	1.00 (Ref)		1.00 (Ref)
Yes	74 (29.5)	1.55 (0.92, 2.62)	.10	1.43 (0.83, 2.49)	.20
Location of household: 1 km closer to town		1.06 (0.99, 1.15)	.05	1.08 (0.99, 1.16)	.06
Severe diarrhea: formal care seeking any time during episode
Age of child
< 12 mo	47 (36.7)	1.00 (Ref)		1.00 (Ref)
1–5 y	100 (28.6)	0.69 (0.45, 1.06)	.09	0.79 (0.49, 1.26)	.32
Ethnic group of child
Non-Indigenous	12 (52.2)	1.00 (Ref)		1.00 (Ref)
Indigenous	135 (29.7)	0.39 (0.17, 0.90)	.02	0.55 (0.20, 1.49)	.24
Mother’s literacy
Illiterate	45 (26.2)	1.00 (Ref)		1.00 (Ref)
Literate	102 (33.1)	1.39 (0.92, 2.12)	.11	1.23 (0.48, 3.19)	.67
Mother’s education level
None	36 (24.8)	1.00 (Ref)		1.00 (Ref)
Elementary	76 (31.3)	1.38 (0.87, 2.19)	.18	0.97 (0.33, 2.81)	.95
> elementary	35 (38.0)	1.86 (1.06, 3.27)	.03	1.31 (0.52, 3.34)	.57
Mother’s perceived severity of illness episode
Not serious	16 (21.6)	1.00 (Ref)		1.00 (Ref)
Serious	69 (27.5)	1.37 (0.74, 2.55)	.31	1.23 (0.66, 2.40)	.53
Very serious	62 (40.0)	2.42 (1.27, 4.58)	.007	2.22 (1.14, 4.35)	.02
Mother knows emergency plan
No	38 (24.1)	1.00 (Ref)		1.00 (Ref)
Yes	109 (33.9)	1.62 (1.05, 2.49)	.03	1.73 (1.09, 2.76)	.02
Municipality
Comitancillo	105 (28.4)	1.00 (Ref)		1.00 (Ref)
San Lorenzo	42 (38.2)	1.56 (0.99, 2.44)	.052	1.21 (0.66, 2.22)	.55
Mother believed in mal de ojo
No	138 (31.9)	1.00 (Ref)		1.00 (Ref)
Yes	9 (19.1)	0.51 (0.24, 1.08)	.07	0.58 (0.27, 1.27)	.18
Location of household: 1 km closer to town		1.11 (1.05, 1.18)	.001	1.11 (1.04, 1.18)	.002
Severe diarrhea: formal care seeking within 2 days of onset
Ethnic group of child
Non-Indigenous	8 (34.8)	1.00 (Ref)		1.00 (Ref)
Indigenous	78 (17.1)	0.39 (0.16, 0.95)	.03	0.63 (0.22, 1.81)	.39
Mother experienced previous death of a child
No	81 (18.7)	1.00 (Ref)		1.00 (Ref)
Yes	5 (10.6)	0.52 (0.20, 1.35)	.17	0.69 (0.25, 1.88)	.47
Mother’s literacy
Illiterate	24 (14.0)	1.00 (Ref)		1.00 (Ref)
Literate	62 (20.1)	1.55 (0.93, 2.60)	.09	1.31 (0.74, 2.34)	.36
Mother’s perceived severity of illness episode
Not serious	9 (12.2)	1.00 (Ref)		1.00 (Ref)
Serious	43 (17.1)	1.49 (0.69, 3.23)	.31	1.32 (0.59, 2.95)	.51
Very serious	34 (21.9)	2.03 (0.92, 4.49)	.08	1.66 (0.72, 3.87)	.24
Mother knows emergency plan
No	23 (14.6)	1.00 (Ref)		1.00 (Ref)
Yes	63 (19.6)	1.43 (0.85, 2.40)	.18	1.58 (0.88, 2.80)	.12
Municipality
Comitancillo	57 (15.4)	1.00 (Ref)		1.00 (Ref)
San Lorenzo	29 (26.4)	1.97 (1.18, 3.27)	.009	1.32 (0.62, 2.81)	.47
Main language spoken in household
Mam only	28 (15.6)	1.00 (Ref)		1.00 (Ref)
Spanish first or second language	54 (20.5)	1.40 (0.85, 2.32)	.19	0.85 (0.46, 1.56)	.59
Someone to look after household in emergency
No	22 (14.4)	1.00 (Ref)		1.00 (Ref)
Yes	64 (19.6)	1.45 (0.86, 2.46)	.17	2.01 (1.10, 3.68)	.02
Mother believed in mal de ojo
No	82 (18.9)	1.00 (Ref)		1.00 (Ref)
Yes	4 (8.5)	0.40 (0.14, 1.14)	.08	0.44 (0.15, 1.32)	.14
Location of household: 1 km closer to town		1.14 (1.05, 1.22)	.001	1.12 (1.03, 1.22)	.007

Note. CI = confidence interval; mal de ojo = "evil eye"; OR = odds ratio; WHO = World Health Organization. Formal care includes all government and private medical services including extension of cover (Programme to Extend Coverage of Basic Health Services [Extension de Cobertura]). Mam is the local Mayan language.

^aAdjusted for all variables listed in unadjusted column (P < .02 in univariable analysis).

^bBased on radio, TV, or refrigerator ownership.