Sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in Kilifi district, Kenya
OBJECTIVE: To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district, Kenya. METHODS: In 2002-2006, clinical information was obtained from all children admitted to Kilifi District Hospital a...
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| Autor*in: |
Jennifer C Moïsi [verfasserIn] D James Nokes [verfasserIn] Hellen Gatakaa [verfasserIn] Thomas N Williams [verfasserIn] Evasius Bauni [verfasserIn] Orin S Levine [verfasserIn] J Anthony G Scott [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
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In: Bulletin of the World Health Organization - The World Health Organization, 2024 |
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| Links: |
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| DOI / URN: |
10.1590/S0042-96862011000200009 |
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DOAJ098512277 |
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| 520 | |a OBJECTIVE: To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district, Kenya. METHODS: In 2002-2006, clinical information was obtained from all children admitted to Kilifi District Hospital and linked to demographic surveillance data. Travel times to the hospital were calculated using geographic information systems and regression models were constructed to examine the relationships between travel time, cause-specific hospitalization rates and probability of death in hospital. Access to care ratios relating hospitalization rates to community mortality rates were computed and used to estimate surveillance sensitivity. FINDINGS: The analysis included 7200 admissions (64 per 1000 child-years). Median pedestrian and vehicular travel times to hospital were 237 and 61 minutes, respectively. Hospitalization rates decreased by 21% per hour of travel by foot and 28% per half hour of travel by vehicle. Distance decay was steeper for meningitis than for pneumonia, for females than for males, and for areas where mothers had less education on average. Distance was positively associated with the probability of dying in hospital. Overall access to care ratios, which represent the probability that a child in need of hospitalization will have access to care at the hospital, were 51-58% for pneumonia and 66-70% for meningitis. CONCLUSION: In this setting, hospital utilization rates decreased and the severity of cases admitted to hospital increased as distance between homestead and hospital increased. Access to hospital care for children living in remote areas was low, particularly for those with less severe conditions. Distance decay was attenuated by increased levels of maternal education. Hospital-based surveillance underestimated pneumonia and meningitis incidence by more than 45% and 30%, respectively. | ||
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10.1590/S0042-96862011000200009 doi (DE-627)DOAJ098512277 (DE-599)DOAJb7987ac8ce1a407ba6da5d06f8e35121 DE-627 ger DE-627 rakwb eng RA1-1270 Jennifer C Moïsi verfasserin aut Sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in Kilifi district, Kenya Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier OBJECTIVE: To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district, Kenya. METHODS: In 2002-2006, clinical information was obtained from all children admitted to Kilifi District Hospital and linked to demographic surveillance data. Travel times to the hospital were calculated using geographic information systems and regression models were constructed to examine the relationships between travel time, cause-specific hospitalization rates and probability of death in hospital. Access to care ratios relating hospitalization rates to community mortality rates were computed and used to estimate surveillance sensitivity. FINDINGS: The analysis included 7200 admissions (64 per 1000 child-years). Median pedestrian and vehicular travel times to hospital were 237 and 61 minutes, respectively. Hospitalization rates decreased by 21% per hour of travel by foot and 28% per half hour of travel by vehicle. Distance decay was steeper for meningitis than for pneumonia, for females than for males, and for areas where mothers had less education on average. Distance was positively associated with the probability of dying in hospital. Overall access to care ratios, which represent the probability that a child in need of hospitalization will have access to care at the hospital, were 51-58% for pneumonia and 66-70% for meningitis. CONCLUSION: In this setting, hospital utilization rates decreased and the severity of cases admitted to hospital increased as distance between homestead and hospital increased. Access to hospital care for children living in remote areas was low, particularly for those with less severe conditions. Distance decay was attenuated by increased levels of maternal education. Hospital-based surveillance underestimated pneumonia and meningitis incidence by more than 45% and 30%, respectively. Public aspects of medicine D James Nokes verfasserin aut Hellen Gatakaa verfasserin aut Thomas N Williams verfasserin aut Evasius Bauni verfasserin aut Orin S Levine verfasserin aut J Anthony G Scott verfasserin aut In Bulletin of the World Health Organization The World Health Organization, 2024 (DE-627)324741111 (DE-600)2030027-X 15640604 nnns https://doi.org/10.1590/S0042-96862011000200009 kostenfrei https://doaj.org/article/b7987ac8ce1a407ba6da5d06f8e35121 kostenfrei http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862011000200009&lng=en&tlng=en kostenfrei https://doaj.org/toc/0042-9686 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR |
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10.1590/S0042-96862011000200009 doi (DE-627)DOAJ098512277 (DE-599)DOAJb7987ac8ce1a407ba6da5d06f8e35121 DE-627 ger DE-627 rakwb eng RA1-1270 Jennifer C Moïsi verfasserin aut Sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in Kilifi district, Kenya Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier OBJECTIVE: To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district, Kenya. METHODS: In 2002-2006, clinical information was obtained from all children admitted to Kilifi District Hospital and linked to demographic surveillance data. Travel times to the hospital were calculated using geographic information systems and regression models were constructed to examine the relationships between travel time, cause-specific hospitalization rates and probability of death in hospital. Access to care ratios relating hospitalization rates to community mortality rates were computed and used to estimate surveillance sensitivity. FINDINGS: The analysis included 7200 admissions (64 per 1000 child-years). Median pedestrian and vehicular travel times to hospital were 237 and 61 minutes, respectively. Hospitalization rates decreased by 21% per hour of travel by foot and 28% per half hour of travel by vehicle. Distance decay was steeper for meningitis than for pneumonia, for females than for males, and for areas where mothers had less education on average. Distance was positively associated with the probability of dying in hospital. Overall access to care ratios, which represent the probability that a child in need of hospitalization will have access to care at the hospital, were 51-58% for pneumonia and 66-70% for meningitis. CONCLUSION: In this setting, hospital utilization rates decreased and the severity of cases admitted to hospital increased as distance between homestead and hospital increased. Access to hospital care for children living in remote areas was low, particularly for those with less severe conditions. Distance decay was attenuated by increased levels of maternal education. Hospital-based surveillance underestimated pneumonia and meningitis incidence by more than 45% and 30%, respectively. Public aspects of medicine D James Nokes verfasserin aut Hellen Gatakaa verfasserin aut Thomas N Williams verfasserin aut Evasius Bauni verfasserin aut Orin S Levine verfasserin aut J Anthony G Scott verfasserin aut In Bulletin of the World Health Organization The World Health Organization, 2024 (DE-627)324741111 (DE-600)2030027-X 15640604 nnns https://doi.org/10.1590/S0042-96862011000200009 kostenfrei https://doaj.org/article/b7987ac8ce1a407ba6da5d06f8e35121 kostenfrei http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862011000200009&lng=en&tlng=en kostenfrei https://doaj.org/toc/0042-9686 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR |
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10.1590/S0042-96862011000200009 doi (DE-627)DOAJ098512277 (DE-599)DOAJb7987ac8ce1a407ba6da5d06f8e35121 DE-627 ger DE-627 rakwb eng RA1-1270 Jennifer C Moïsi verfasserin aut Sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in Kilifi district, Kenya Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier OBJECTIVE: To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district, Kenya. METHODS: In 2002-2006, clinical information was obtained from all children admitted to Kilifi District Hospital and linked to demographic surveillance data. Travel times to the hospital were calculated using geographic information systems and regression models were constructed to examine the relationships between travel time, cause-specific hospitalization rates and probability of death in hospital. Access to care ratios relating hospitalization rates to community mortality rates were computed and used to estimate surveillance sensitivity. FINDINGS: The analysis included 7200 admissions (64 per 1000 child-years). Median pedestrian and vehicular travel times to hospital were 237 and 61 minutes, respectively. Hospitalization rates decreased by 21% per hour of travel by foot and 28% per half hour of travel by vehicle. Distance decay was steeper for meningitis than for pneumonia, for females than for males, and for areas where mothers had less education on average. Distance was positively associated with the probability of dying in hospital. Overall access to care ratios, which represent the probability that a child in need of hospitalization will have access to care at the hospital, were 51-58% for pneumonia and 66-70% for meningitis. CONCLUSION: In this setting, hospital utilization rates decreased and the severity of cases admitted to hospital increased as distance between homestead and hospital increased. Access to hospital care for children living in remote areas was low, particularly for those with less severe conditions. Distance decay was attenuated by increased levels of maternal education. Hospital-based surveillance underestimated pneumonia and meningitis incidence by more than 45% and 30%, respectively. Public aspects of medicine D James Nokes verfasserin aut Hellen Gatakaa verfasserin aut Thomas N Williams verfasserin aut Evasius Bauni verfasserin aut Orin S Levine verfasserin aut J Anthony G Scott verfasserin aut In Bulletin of the World Health Organization The World Health Organization, 2024 (DE-627)324741111 (DE-600)2030027-X 15640604 nnns https://doi.org/10.1590/S0042-96862011000200009 kostenfrei https://doaj.org/article/b7987ac8ce1a407ba6da5d06f8e35121 kostenfrei http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862011000200009&lng=en&tlng=en kostenfrei https://doaj.org/toc/0042-9686 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR |
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Jennifer C Moïsi D James Nokes Hellen Gatakaa Thomas N Williams Evasius Bauni Orin S Levine J Anthony G Scott |
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Jennifer C Moïsi |
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sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in kilifi district, kenya |
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RA1-1270 |
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Sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in Kilifi district, Kenya |
| abstract |
OBJECTIVE: To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district, Kenya. METHODS: In 2002-2006, clinical information was obtained from all children admitted to Kilifi District Hospital and linked to demographic surveillance data. Travel times to the hospital were calculated using geographic information systems and regression models were constructed to examine the relationships between travel time, cause-specific hospitalization rates and probability of death in hospital. Access to care ratios relating hospitalization rates to community mortality rates were computed and used to estimate surveillance sensitivity. FINDINGS: The analysis included 7200 admissions (64 per 1000 child-years). Median pedestrian and vehicular travel times to hospital were 237 and 61 minutes, respectively. Hospitalization rates decreased by 21% per hour of travel by foot and 28% per half hour of travel by vehicle. Distance decay was steeper for meningitis than for pneumonia, for females than for males, and for areas where mothers had less education on average. Distance was positively associated with the probability of dying in hospital. Overall access to care ratios, which represent the probability that a child in need of hospitalization will have access to care at the hospital, were 51-58% for pneumonia and 66-70% for meningitis. CONCLUSION: In this setting, hospital utilization rates decreased and the severity of cases admitted to hospital increased as distance between homestead and hospital increased. Access to hospital care for children living in remote areas was low, particularly for those with less severe conditions. Distance decay was attenuated by increased levels of maternal education. Hospital-based surveillance underestimated pneumonia and meningitis incidence by more than 45% and 30%, respectively. |
| abstractGer |
OBJECTIVE: To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district, Kenya. METHODS: In 2002-2006, clinical information was obtained from all children admitted to Kilifi District Hospital and linked to demographic surveillance data. Travel times to the hospital were calculated using geographic information systems and regression models were constructed to examine the relationships between travel time, cause-specific hospitalization rates and probability of death in hospital. Access to care ratios relating hospitalization rates to community mortality rates were computed and used to estimate surveillance sensitivity. FINDINGS: The analysis included 7200 admissions (64 per 1000 child-years). Median pedestrian and vehicular travel times to hospital were 237 and 61 minutes, respectively. Hospitalization rates decreased by 21% per hour of travel by foot and 28% per half hour of travel by vehicle. Distance decay was steeper for meningitis than for pneumonia, for females than for males, and for areas where mothers had less education on average. Distance was positively associated with the probability of dying in hospital. Overall access to care ratios, which represent the probability that a child in need of hospitalization will have access to care at the hospital, were 51-58% for pneumonia and 66-70% for meningitis. CONCLUSION: In this setting, hospital utilization rates decreased and the severity of cases admitted to hospital increased as distance between homestead and hospital increased. Access to hospital care for children living in remote areas was low, particularly for those with less severe conditions. Distance decay was attenuated by increased levels of maternal education. Hospital-based surveillance underestimated pneumonia and meningitis incidence by more than 45% and 30%, respectively. |
| abstract_unstemmed |
OBJECTIVE: To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district, Kenya. METHODS: In 2002-2006, clinical information was obtained from all children admitted to Kilifi District Hospital and linked to demographic surveillance data. Travel times to the hospital were calculated using geographic information systems and regression models were constructed to examine the relationships between travel time, cause-specific hospitalization rates and probability of death in hospital. Access to care ratios relating hospitalization rates to community mortality rates were computed and used to estimate surveillance sensitivity. FINDINGS: The analysis included 7200 admissions (64 per 1000 child-years). Median pedestrian and vehicular travel times to hospital were 237 and 61 minutes, respectively. Hospitalization rates decreased by 21% per hour of travel by foot and 28% per half hour of travel by vehicle. Distance decay was steeper for meningitis than for pneumonia, for females than for males, and for areas where mothers had less education on average. Distance was positively associated with the probability of dying in hospital. Overall access to care ratios, which represent the probability that a child in need of hospitalization will have access to care at the hospital, were 51-58% for pneumonia and 66-70% for meningitis. CONCLUSION: In this setting, hospital utilization rates decreased and the severity of cases admitted to hospital increased as distance between homestead and hospital increased. Access to hospital care for children living in remote areas was low, particularly for those with less severe conditions. Distance decay was attenuated by increased levels of maternal education. Hospital-based surveillance underestimated pneumonia and meningitis incidence by more than 45% and 30%, respectively. |
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Sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in Kilifi district, Kenya |
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https://doi.org/10.1590/S0042-96862011000200009 https://doaj.org/article/b7987ac8ce1a407ba6da5d06f8e35121 http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862011000200009&lng=en&tlng=en https://doaj.org/toc/0042-9686 |
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10.1590/S0042-96862011000200009 |
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