Table 3.
Predictors of seeking treatment in a formal vs. informal source in the previous 2 weeks among people reporting fever that sought any treatment
| Characteristic | Sought any treatment n | Used a formal* treatment source n (%) | Crude OR (95% CI) | Multilevel† adjusted OR (95% CI) |
|---|---|---|---|---|
| Season | ||||
| Dry | 1,533 | 876 (57.1%) | 1.0 (ref) | 1.0 (ref) |
| Rainy | 1,182 | 747 (63.2%) | 1.29 (1.10–1.51) | 1.28 (1.07–1.54) |
| Survey | ||||
| Dry season 2012 | 595 | 329 (55.3%) | 1.0 (ref) | – |
| Rainy season 2013 | 519 | 323 (62.2%) | 1.33 (1.05–1.69) | – |
| Dry season 2013 | 490 | 286 (58.4%) | 1.13 (0.89–1.44) | – |
| Rainy season 2014 | 663 | 424 (64.0%) | 1.43 (1.14–1.80) | – |
| Dry season 2014 | 448 | 261 (58.3%) | 1.13 (0.88–1.45) | – |
| Household-level factors | ||||
| District | ||||
| Blantyre | 804 | 538 (66.9%) | 1.0 (ref) | 1.0 (ref)*** |
| Thyolo | 793 | 455 (57.4%) | 0.67 (0.54–0.82) | 0.77 (0.32–1.81) |
| Chikhwawa | 1,118 | 630 (56.4%) | 0.64 (0.53–0.77) | 0.95 (0.38–2.37) |
| Distance to the nearest health facility of any kind (km) | Median: 2.36 | 0.92 (0.89–0.95) | – | |
| Range: 0.24–7.65 | ||||
| Blantyre | – | – | – | 0.89 (0.51–1.56) |
| Thyolo | – | – | – | 1.12 (0.80–1.55) |
| Chikhwawa | – | – | – | 0.92 (0.79–1.07) |
| Household wealth index | ||||
| Lowest quartile | 684 | 384 (56.1%) | 0.65 (0.52–0.81) | 0.88 (0.65–1.20) |
| Second quartile | 654 | 368 (56.3%) | 0.65 (0.52–0.81) | 0.84 (0.62–1.12) |
| Third quartile | 676 | 402 (59.5%) | 0.74 (0.59–0.93) | 0.91 (0.68–1.21) |
| Highest quartile | 676 | 449 (66.4%) | 1.0 (ref) | 1.0 (ref) |
| House construction quality | ||||
| Mostly unfinished | 1,319 | 739 (56.0%) | 1.0 (ref) | – |
| Mostly finished | 1,395 | 884 (63.4%) | 1.36 (1.16–1.58) | – |
| Eaves | ||||
| Closed | 1,910 | 1,186 (62.1%) | 1.0 (ref) | – |
| Open | 805 | 437 (54.3%) | 0.73 (0.61–0.86) | – |
| Highest education achieved by head of household or spouse | ||||
| No schooling | 438 | 251 (57.3%) | 0.76 (0.60–0.96) | – |
| Some standard level school | 1,417 | 821 (57.9%) | 0.78 (0.65–0.93) | – |
| Some education past standard 8 | 855 | 546 (63.9%) | 1.0 (Ref) | – |
| Individual-level factors | ||||
| Gender | ||||
| Female | 1,676 | 1,020 (60.9%) | 1.0 (ref) | 1.0 (ref) |
| Male | 1,039 | 603 (58.0%) | 0.89 (0.76–1.04) | 0.81 (0.67–0.97) |
| Net use/access on previous night | ||||
| No nets in household | 420 | 244 (58.1%) | 0.92 (0.74–1.14) | – |
| Nets in household, but not used by person | 561 | 336 (59.9%) | 0.99 (0.82–1.20) | – |
| Person slept under a net | 1,734 | 1,043 (60.1%) | 1.0 (ref) | – |
| Age | ||||
| Child (age < 5 years) | 732 | 507 (69.3%) | 1.0 (ref) | 1.0 (ref) |
| School-aged child (age 5–15 years) | 723 | 413 (57.1%) | 0.59 (0.48–0.73) | 0.59 (0.46–0.74) |
| Adult (age ≥ 16 years) | 1,253 | 700 (55.9%) | 0.56 (0.46–0.68) | 0.52 (0.42–0.65) |
* Formal treatment sources were any government or private health-care sources, including hospitals/centers/posts, mobile clinics, private doctors, and community health workers. Informal treatment sources were shops, traditional practitioners, or “other,” which was typically described as the use of treatments provided by neighbors or family members. People were classified as seeking formal treatment if they reported using at least one formal treatment source.
† Random intercepts included at the enumeration area (EA) and household levels. There was significant unexplained variation at the household level in the final model (P < 0.0001) but not the EA level. Final model included all variables that were significant in the multivariable model with fixed effects.
‡ The final model included an interaction between district and distance to the nearest health facility. The estimated OR for each district was presented for a distance of 2.5 km from the nearest health facility.