Fourth meeting of the Eastern Mediterranean Acute Respiratory Infection Surveillance (EMARIS) network and first scientific conference on acute respiratory infections in the Eastern Mediterranean Region, 11-14 December, 2017, Amman, Jordan

Abstract Background Recently, inappropriate use of antibiotics has been correlated with life-threatening side-effects such as adverse effects, increased cost of treatment, and the higher rate of microbial resistance. Besides, it leads to a waste of resources. Therefore, this review sought to determine the pooled prevalence of self-medication with antibiotics, self-medicated illness, reasons for self-medication, antibiotics used for self-medication, source of obtaining antibiotics, the inappropriate practice of antibiotics and suggested recommendations for talking self-medication with antibiotics in the Eastern Mediterranean Region of the World Health Organization (EMRWHO). Methods Review conforms to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Database search was conducted in PubMed, Scopus, Embase, and Web of Science using a combination of keywords which included; antimicrobial, antibacterial, antibiotic, self-medication, self-treatment, self-prescription, non-prescribed, irrational use, inappropriate use, misuse, abuse and Eastern Mediterranean Region of WHO countries. The lists of references of the selected articles were also hand-searched to obtained additional relevant articles. Studies published in English from 2000 to 2018 were included in the review. Results We report on data from 60 articles and 49629 participants in this review. The overall prevalence of self-medication with antibiotics in EMRWHO was 47.2% (95% CI 41.6% – 52.9%). Yemen has the highest pooled rate with a rate of 75.0% (95% CI 63.4% − 83.9%), whilst Lebanon has the lowest pooled rate with a prevalence of 28.7% (95% CI 18.4% − 41.8%). The most common illnesses implicated in antibiotic self-medication were upper-respiratory infections and the most common antibiotic was Amoxicillin-Clavulanic acid. The commonest reasons for antibiotic self-medication include: saving time and money. Pharmacies pointed out as the most common source of obtaining antibiotics for self-medication. Conclusion Self-medication with antibiotics is significantly high in the member states of EMRWHO. Intervention such as an educational program for communities’ members to change their behaviors, policy on the mechanism of distribution of antibiotics is called for in this area.

Download Full-text

ANALISIS FAKTOR RISIKO KEJADIAN ISPA DITINJAU DARI STATUS RUMAH DI WILAYAH KERJA PUSKESMAS KOTA WILAYAH UTARA KOTA KEDIRI

IKESMA ◽

10.19184/ikesma.v13i1.7020 ◽

2017 ◽

Vol 13 (1) ◽

Author(s):

Ema Mayasari

Keyword(s):

Public Health ◽

Respiratory Infection ◽

Physical Condition ◽

Acute Respiratory Infection ◽

Respiratory Infections ◽

Health Centers ◽

Dominant Factor ◽

Acute Respiratory Infections ◽

Floor Area ◽

Home Ventilation

Acute Respiratory Infections (ARI) is one of the most common causes of death in children of developing countries. The cause of ARI include home building materials made of asbestos, has a floor with a thickness of less than 20cm and has a floor area of less than 10% of the floor area. The objective of this study was to determine the effect of physical condition to Acute Respiratory Infections (ARI) at public health centers in the region of the northern town of Kediri.This study was an analyticstudy with cross-sectional approach. There were 102 samples on society at public health centers in the region of the northern town of Kediri, and use simple random sampling. The independent variable is the building constructures, the type of floor, and size of ventilation, while the dependent variable was the incident of Acute Respiratory Infection. Data were analyzed by logistic regression.The results showed that, p value = 0,000 <a =0,05, so there is physical condition home has affected the occurrence ARI. While the most dominant factor of the three factors is size of ventilation where the value of Exp (B) 0,014 more than the other two factors, are building contructure where the value Exp (B) 0,012 and the type of floor where the value Exp (B) 0,010.The majority of respondents suffering from ARI and most the of respondent have a home ventilation that does not qualify, therefore people should pay more attention to the ventilation of their homes so spacious home ventilation of at least 10 % of their floor area. Keywords: Acute Respiratory Infection, Building Material, Floor, Ventilation

Download Full-text

Differences in antibiotic prescriptions between direct-to-consumer telehealth and telehealth in the emergency department

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211034994 ◽

2021 ◽

pp. 1357633X2110349

Author(s):

Peter Yao ◽

Kriti Gogia ◽

Sunday Clark ◽

Hanson Hsu ◽

Rahul Sharma ◽

...

Keyword(s):

Emergency Department ◽

Confidence Interval ◽

Respiratory Infection ◽

Antibiotic Stewardship ◽

Odds Ratio ◽

Acute Respiratory Infection ◽

Respiratory Infections ◽

Antibiotic Prescribing ◽

Acute Respiratory Infections ◽

Direct To Consumer

Background Telemedicine, which allows physicians to assess and treat patients via real-time audiovisual conferencing, is a rapidly growing modality for providing medical care. Antibiotic stewardship is one important measure of care quality, and research on antibiotic prescribing for acute respiratory infections in direct-to-consumer telemedicine has yielded mixed results. We compared antibiotic prescription rates for acute respiratory infections in two groups treated by telemedicine: (1) patients treated via a direct-to-consumer telemedicine application and (2) patients treated via telemedicine while physically inside the emergency department. Methods We included direct-to-consumer telemedicine and emergency department telemedicine visits for patients 18 years and older with physician-coded International Classification of Diseases, Tenth Revision acute respiratory infection diagnoses between November 2016 and December 2018. Patients in both groups were seen by the same emergency department faculty working dedicated telemedicine shifts. We compared antibiotic prescribing rates for direct-to-consumer telemedicine and emergency department telemedicine visits before and after adjustment for age, sex, and diagnosis. Results We identified a total of 468 acute respiratory infection visits: 191 direct-to-consumer telemedicine visits and 277 emergency department telemedicine visits. Overall, antibiotics were prescribed for 47% of visits (59% of direct-to-consumer telemedicine visits vs 39% of emergency department telemedicine visits; odds ratio 2.23; 95% confidence interval 1.53–3.25; P < 0.001). The difference in antibiotic prescribing rates remained significant after adjustment for age, sex, and diagnosis (odds ratio 2.49; 95% confidence interval 1.65–3.77; P < 0.001). Conclusion Patients seen by the same group of physicians for acute respiratory infection were significantly more likely to be prescribed antibiotics by direct-to-consumer telemedicine care compared with telemedicine care in the emergency department. This work suggests that contextual factors rather than evaluation over video may contribute to differences in antibiotic stewardship for direct-to-consumer telemedicine encounters.

Download Full-text

A model for improving and assessing outpatient stewardship initiatives for acute respiratory infection

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.206 ◽

2019 ◽

Vol 40 (10) ◽

pp. 1198-1200 ◽

Cited By ~ 1

Author(s):

Joan Guzik ◽

Pooja Kothari ◽

Misha Sharp ◽

Belinda Ostrowsky ◽

Gopi Patel ◽

...

Keyword(s):

Healthcare System ◽

Respiratory Infection ◽

Antibiotic Stewardship ◽

Acute Respiratory Infection ◽

Respiratory Infections ◽

Acute Respiratory Infections ◽

New Yorker ◽

Stage 1

Many hospitals have established inpatient antibiotic stewardship programs (ASPs), but outpatient activities remain limited. In 2016, the United Hospital Fund (UHF), an independent nonprofit working to build a more effective healthcare system for every New Yorker, launched a 2-stage grant-funded initiative to evaluate outpatient antibiotic stewardship, focusing on adults with acute respiratory infections (ARIs). Conclusions from stage 1 included few outpatient antibiotic stewardship activities, variation in prescribing, macrolides as the most commonly prescribed antibiotic, and provider interest in improving prescribing.1

Download Full-text

Risk factors of acute respiratory infections among under five children attending public hospitals in southern Tigray, Ethiopia, 2016/2017

BMC Pediatrics ◽

10.1186/s12887-019-1767-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Sielu Alemayehu ◽

Kalayou Kidanu ◽

Tensay Kahsay ◽

Mekuria Kassa

Keyword(s):

Risk Factors ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Respiratory Infections ◽

Public Hospitals ◽

Cow Dung ◽

Acute Respiratory Infections ◽

Under Five ◽

Under Five Children ◽

Maternal Literacy

Abstract Background Acute Respiratory infection accounts for 94,037000 disability adjusted life years and 1.9 million deaths worldwide. Acute respiratory infections is the most common causes of under-five illness and mortality. The under five children gets three to six episodes of acute respiratory infections annually regardless of where they live. Disease burden due to acute respiratory infection is 10–50 times higher in developing countries when compared to developed countries. The aim of this study was to assess risk factors of acute respiratory infection among under-five children attending Public hospitals in Southern Tigray, Ethiopia 2016/2017. Methods Institution based case control study was conducted from Nov 2016 to June 2017. Interviewer administered structured questionnaire was used to collect data from a sample of 288 (96 cases and 192 controls) children under 5 years of age. Systematic random sampling was used to recruit study subjects and SPSS version 20 was used to analyze the data. Bivariate and multivariate analysis were employed to examine statistical association between the outcome variable and selected independent variables at 95% confidence level. Level of statistical Significance was declared at p < 0.05. Tables, figures and texts were used to present data. Result One hundred sixty (55.6%) and 128 (44.4%) of the participants were males and females respectively. Malnutrition (AOR = 2.89; 95%CI: 1.584–8.951; p = 0.039), cow dung use (AOR =2.21; 95%CI: 1.121–9.373; p = 0.014), presence of smoker in the family (AOR = 0.638; 95% CI: 0.046–0.980; p = 0.042) and maternal literacy (AOR = 3.098; 95%CI: 1.387–18.729; p = 0.021) were found to be significant predictors of acute respiratory infection among under five children. Conclusion According to this study maternal literacy, smoking, cow dung use and nutritional status were strongly associated with increased risk of childhood acute respiratory infection. Health care providers should work jointly with the general public, so that scientific knowledge and guidelines for adopting particular preventive measures for acute respiratory infection are disseminated.

Download Full-text