Abstract
BACKGROUND: Diarrhea is a common cause of morbidity and mortality, and its incidence worldwide has changed little over the past four decades. Therefore, to estimate the disease burden of diarrhea, this study aimed to assess the prevalence, risk factor, and determinants of health-seeking behavior in people with diarrhea in Chongqing. METHODS: This cross-sectional study was conducted in Chongqing, China, between May and June 2024. An online questionnaire was used to survey respondents' demographic information, experience of diarrhea symptoms, and treatment-seeking behaviors in the past 6 months (from October 2023 to April 2024). Descriptive statistics, univariate and multivariate logistic regression analyses were used to summarize the data and identify the possible determinants of medical treatment-seeking behaviors. RESULTS: Among 27,150 respondents, 7.98% were young children (≤ 5 years). Diarrhea prevalence was 25.38% overall, and higher among children ≤ 5 years (29.5%) and adults ≥ 60 years (26.7%). Only 23.23% (1601/6891) of diarrhea cases sought medical care, primarily due to perceived mild severity or treatment unnecessary. Higher odds of healthcare-seeking behaviors were observed in children aged ≤ 5 years, rural residents, and those with higher household incomes (particularly ≥ 12,000 yuan). Proximity to primary healthcare facilities (< 1 km), poorer self-rated health, fewer diarrhea episodes, more severe symptoms, longer duration of illness (especially ≥ 7 days), and greater perceived impact of diarrhea were also positively associated with healthcare-seeking behaviors. The main reasons individuals with diarrhea did not seek medical care were that they felt their condition was not serious and that a visit to a medical facility was unnecessary (71.40%). CONCLUSION: Diarrhea is highly prevalent in Chongqing, especially among young children and the elderly, coupled with a low rate of medical seeking. The findings underscore the influence of socioeconomic, geographic, clinical severity, and perceptual factors on healthcare-seeking behavior. Targeted interventions should focus on high-risk groups and improving accessibility and awareness to encourage appropriate care for diarrhea.