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. 2021 Aug 30:66:634000.
doi: 10.3389/ijph.2021.634000. eCollection 2021.

Definitions of Severity in Treatment Seeking Studies of Febrile Illness in Children in Low and Middle Income Countries: A Scoping Review

Nina C Brunner  1   2 , Phyllis Awor  3 , Manuel W Hetzel  1   2
Affiliations

Definitions of Severity in Treatment Seeking Studies of Febrile Illness in Children in Low and Middle Income Countries: A Scoping Review

Nina C Brunner et al. Int J Public Health. .

Erratum in

Abstract

Objectives: Understanding treatment seeking for severe febrile illness (SFI) is methodologically challenging. In this scoping review, we investigate definitions of severe febrile illness in treatment seeking studies on children under 5 years of age in low and middle income countries. We analyze the association of SFI definitions with different concepts of treatment seeking and identify related research gaps. Methods: We searched Pubmed, Scopus and WHOLIS, and screened references of included publications for eligibility. Results: Definitions of SFI had either a biomedical perspective (predominantly in quantitative studies) or a caregiver perspective (predominantly in qualitative studies). In quantitative analyses of treatment seeking, severity was more often conceptualized as a determinant rather than an outcome of a treatment seeking process. The majority of quantitative analyses only included surviving children or did not explicitly mention dead children. Conclusion: Different research questions lead to diverse definitions and concepts of severity and treatment seeking outcomes, which limits the comparability of the available evidence. Systematic exclusion of dead children is likely to bias inferences on the association of treatment seeking and health outcomes of children with SFI in low and middle income countries.

Keywords: child; developing countries; fever; health behavior; severity; treatment seeking.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Summary of the literature search and selection process (Definitions of severity in treatment seeking studies of febrile illness in children in low and middle income countries: a scoping review, Switzerland, 2021).
FIGURE 2
FIGURE 2
Map showing low and middle income countries with number and location of included studies (Definitions of severity in treatment seeking studies of febrile illness in children in low and middle income countries: a scoping review, Switzerland, 2021).
FIGURE 3
FIGURE 3
Severe febrile illness definitions in quantitative treatment seeking analyses, by concept of severity and analysis approach (Definitions of severity in treatment seeking studies of febrile illness in children in low and middle income countries: a scoping review, Switzerland, 2021).
See this image and copyright information in PMC

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