Gbemisola Allwell-Brown1, Laith Hussain-Alkhateeb2, Maquins Odhiambo Sewe3, Freddy Eric Kitutu4, Susanne Strömdahl5, Andreas Mårtensson6, Emily White Johansson6. 1. Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, SE-751 85 Uppsala, Sweden. Electronic address: gbemisola.allwell-brown@kbh.uu.se. 2. Global Health, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden. 3. Department of Public Health and Clinical Medicine, Sustainable Health Section, Umeå University, SE-901 87, Umeå, Sweden. 4. Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, SE-751 85 Uppsala, Sweden; Sustainable Pharmaceutical Systems (SPS) Unit, Department of Pharmacy, School of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda. 5. Section of Infectious Diseases, Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden. 6. Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, SE-751 85 Uppsala, Sweden.
Abstract
OBJECTIVES: This study aimed to analyze any reported antibiotic use for children aged <5 years with fever, diarrhea or cough with fast or difficult breathing (outcome) from low-income and middle-income countries (LMICs) during 2005-2017 by user characteristics: rural/urban residence, maternal education, household wealth, and healthcare source visited. METHODS: Based on 132 demographic and health surveys and multiple indicator cluster surveys from 73 LMICs, the outcome by user characteristics for all country-years was estimated using a hierarchical Bayesian linear regression model. RESULTS: Across LMICs during 2005-2017, the greatest relative increases in the outcome occurred in rural areas, poorest quintiles and least educated populations, particularly in low-income countries and South-East Asia. In low-income countries, rural areas had a 72% relative increase from 17.8% (Uncertainty Interval (UI): 5.2%-44.9%) in 2005 to 30.6% (11.7%-62.1%) in 2017, compared to a 29% relative increase in urban areas from 27.1% (8.7%-58.2%) in 2005 to 34.9% (13.3%-67.3%) in 2017. Despite these increases, the outcome was consistently highest in urban areas, wealthiest quintiles, and populations with the highest maternal education. CONCLUSION: These estimates suggest that the increasing reported antibiotic use for sick children aged <5 years in LMICs during 2005-2017 was driven by gains among groups often underserved by formal health services.
OBJECTIVES: This study aimed to analyze any reported antibiotic use for children aged <5 years with fever, diarrhea or cough with fast or difficult breathing (outcome) from low-income and middle-income countries (LMICs) during 2005-2017 by user characteristics: rural/urban residence, maternal education, household wealth, and healthcare source visited. METHODS: Based on 132 demographic and health surveys and multiple indicator cluster surveys from 73 LMICs, the outcome by user characteristics for all country-years was estimated using a hierarchical Bayesian linear regression model. RESULTS: Across LMICs during 2005-2017, the greatest relative increases in the outcome occurred in rural areas, poorest quintiles and least educated populations, particularly in low-income countries and South-East Asia. In low-income countries, rural areas had a 72% relative increase from 17.8% (Uncertainty Interval (UI): 5.2%-44.9%) in 2005 to 30.6% (11.7%-62.1%) in 2017, compared to a 29% relative increase in urban areas from 27.1% (8.7%-58.2%) in 2005 to 34.9% (13.3%-67.3%) in 2017. Despite these increases, the outcome was consistently highest in urban areas, wealthiest quintiles, and populations with the highest maternal education. CONCLUSION: These estimates suggest that the increasing reported antibiotic use for sick children aged <5 years in LMICs during 2005-2017 was driven by gains among groups often underserved by formal health services.
Authors: Salahuddin Ahmed; Dipak Kumar Mitra; Harish Nair; Steven Cunningham; Ahad Mahmud Khan; Asmd Ashraful Islam; Ian Mitra McLane; Nabidul Haque Chowdhury; Nazma Begum; Mohammod Shahidullah; Muhammad Shariful Islam; John Norrie; Harry Campbell; Aziz Sheikh; Abdullah H Baqui; Eric D McCollum Journal: BMJ Open Date: 2022-02-09 Impact factor: 2.692
Authors: Justin Dixon; Eleanor Elizabeth MacPherson; Susan Nayiga; Salome Manyau; Christine Nabirye; Miriam Kayendeke; Esnart Sanudi; Alex Nkaombe; Portia Mareke; Kenny Sitole; Coll de Lima Hutchison; John Bradley; Shunmay Yeung; Rashida Abbas Ferrand; Sham Lal; Chrissy Roberts; Edward Green; Laurie Denyer Willis; Sarah G Staedke; Clare I R Chandler Journal: BMJ Glob Health Date: 2021-11