Antibiotic use for acute respiratory infections among under-5 children in Bangladesh : a population-based survey
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
INTRODUCTION: Despite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown.
METHODS: We analysed nationally representative, population-based, household survey data from the Bangladesh Demographic and Health Survey 2014 to determine the prevalence of antibiotic use in the community for ARI in under-5 children. Using a causal graph and multivariable logistical regression, we then identified and determined the sociodemographic and antibiotic source factors significantly associated with the use of antibiotics for an episode of ARI.
RESULTS: We analysed data for 2 144 children aged <5 years with symptoms of ARI from 17 300 households. In our sample, 829 children (39%) received antibiotics for their ARI episode (95% CI 35.4% to 42.0%). Under-5 children from rural households were 60% (adjusted OR (aOR): 1.6; 95% CI 1.2 to 2.1) more likely to receive antibiotics compared with those from urban households, largely driven by prescriptions from unqualified or traditional practitioners. Private health facilities were 50% (aOR: 0.5; 95% CI 0.3 to 0.7) less likely to be sources of antibiotics compared with public health facilities and non-governmental organisations. Age of children, sex of children or household wealth had no impact on use of antibiotics.
CONCLUSION: In this first nationally representative analysis of antibiotic use in under-5 children in Bangladesh, we found almost 40% of children received antibiotics for an ARI episode. The significant prevalence of antibiotic exposure in under-5 children supports the need for coordinated policy interventions and implementation of clinical practice guidelines at point of care to minimise the adverse effects attributed to antibiotic overuse.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
BMJ global health - 6(2021), 4 vom: 15. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hassan, Md Zakiul [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Bacterial Agents |
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| Anmerkungen: |
Date Completed 24.06.2021 Date Revised 24.06.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1136/bmjgh-2020-004010 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM324566522 |
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| 100 | 1 | |a Hassan, Md Zakiul |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Antibiotic use for acute respiratory infections among under-5 children in Bangladesh |b a population-based survey |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a INTRODUCTION: Despite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown | ||
| 520 | |a METHODS: We analysed nationally representative, population-based, household survey data from the Bangladesh Demographic and Health Survey 2014 to determine the prevalence of antibiotic use in the community for ARI in under-5 children. Using a causal graph and multivariable logistical regression, we then identified and determined the sociodemographic and antibiotic source factors significantly associated with the use of antibiotics for an episode of ARI | ||
| 520 | |a RESULTS: We analysed data for 2 144 children aged <5 years with symptoms of ARI from 17 300 households. In our sample, 829 children (39%) received antibiotics for their ARI episode (95% CI 35.4% to 42.0%). Under-5 children from rural households were 60% (adjusted OR (aOR): 1.6; 95% CI 1.2 to 2.1) more likely to receive antibiotics compared with those from urban households, largely driven by prescriptions from unqualified or traditional practitioners. Private health facilities were 50% (aOR: 0.5; 95% CI 0.3 to 0.7) less likely to be sources of antibiotics compared with public health facilities and non-governmental organisations. Age of children, sex of children or household wealth had no impact on use of antibiotics | ||
| 520 | |a CONCLUSION: In this first nationally representative analysis of antibiotic use in under-5 children in Bangladesh, we found almost 40% of children received antibiotics for an ARI episode. The significant prevalence of antibiotic exposure in under-5 children supports the need for coordinated policy interventions and implementation of clinical practice guidelines at point of care to minimise the adverse effects attributed to antibiotic overuse | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a child health | |
| 650 | 4 | |a diseases | |
| 650 | 4 | |a disorders | |
| 650 | 4 | |a infections | |
| 650 | 4 | |a injuries | |
| 650 | 4 | |a public health | |
| 650 | 4 | |a respiratory infections | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Monjur, Mohammad Riashad |e verfasserin |4 aut | |
| 700 | 1 | |a Biswas, Md Abdullah Al Jubayer |e verfasserin |4 aut | |
| 700 | 1 | |a Chowdhury, Fahmida |e verfasserin |4 aut | |
| 700 | 1 | |a Kafi, Mohammad Abdullah Heel |e verfasserin |4 aut | |
| 700 | 1 | |a Braithwaite, Jeffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Jaffe, Adam |e verfasserin |4 aut | |
| 700 | 1 | |a Homaira, Nusrat |e verfasserin |4 aut | |
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