scholarly journals Antibiotic use for acute respiratory infections among under-5 children in Bangladesh: a population-based survey

2021 ◽  
Vol 6 (4) ◽  
pp. e004010
Author(s):  
Md Zakiul Hassan ◽  
Mohammad Riashad Monjur ◽  
Md Abdullah Al Jubayer Biswas ◽  
Fahmida Chowdhury ◽  
Mohammad Abdullah Heel Kafi ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Point Of Care ◽  
Household Survey ◽  
Antibiotic Use ◽  
Household Wealth ◽  
Population Based ◽  
Health Facilities ◽  
Acute Respiratory Infections ◽  
Antibiotic Overuse ◽  
Nationally Representative

IntroductionDespite 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.MethodsWe 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.ResultsWe 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.ConclusionIn 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.

Enhanced surveillance for covid-19 response in Lagos State, Nigeria: lessons learnt, 2020 (Preprint)

2021 ◽  
Author(s):  
Gregory Chukwuemeka Umeh ◽  
Khalid Abubakar ◽  
Peter Akinmusire ◽  
Adamu M. Isa ◽  
Aminu Zauro ◽  
...  
Keyword(s):  
Service Industry ◽  
Respiratory Infections ◽  
Health Facilities ◽  
Acute Respiratory Infections ◽  
Surveillance Strategy ◽  
Active Case ◽  
Governmental Organizations ◽  
Significant Difference ◽  
Lagos State ◽  
The Impact

BACKGROUND The SARS-CoV-2, the novel virus which causes the coronavirus disease (COVID-19), has changed the world. No aspect of humanity is untouched from health, aviation, service industry, politics, economy, education, and entertainment to social and personal lives, since the outbreak of influenza-like illness in Wuhan, China, in December 2019. The Lagos State COVID-19 response team deployed enhanced surveillance through Active Case Search (ACS) for Acute Respiratory Infections (ARI) at health facilities and communities in the 20 Local Government Areas (LGAs) of Lagos State. Lagos State was the first state in Nigeria to deploy this specific surveillance strategy for Nigeria’s COVID-19 response. OBJECTIVE We documented the methods, findings, and review of the active case search for acute respiratory infections, part of COVID-19 response in 20 LGAs of Lagos State, between 1st April and 15th May 2020. METHODS We utilized descriptive and quantitative approaches to describe and assess the impact of the Active Case Search (ACS) for Acute Respiratory Infections (ARI) in health facilities and communities in 20 LGAs of Lagos State between 1st April and 15th May 2020. RESULTS We found a significant difference in mean scores of suspected COVID-19 cases (M=60, SD=109, before ACS for ARI compared to M=568, SD=732, after ACS for ARI, P=0.0039), confirmed cases (M=10, SD=19, before ACS for ARI compared to M=144, SD=187, after ACS for ARI, P=0.0028) and contacts (M=56, SD=116, before ACS for ARI compared to M=152, SD=177, after ACS for ARI, P=0.044) before and after ACS for ARI in 20 LGAs of Lagos State, between 1st April and 15th May 2020. CONCLUSIONS The deployment of the Lagos State government’s polio-eradication structure for the COVID-19 response is both innovative and effective. The response to COVID-19 requires robust surveillance, credible and timely communication, collaboration, coordination among government, inter-governmental organizations (e.g., WHO), non-governmental organizations, and citizens to succeed and limit the medical, economic, social, and personal losses to the COVID-19 pandemic.

scholarly journals 725. Clinical Outcomes of Elderly Individuals Presenting with Acute Respiratory Infections

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S260-S260
Author(s):  
Allison Bloom ◽  
Sunil Suchindran ◽  
Micah T Mcclain
Keyword(s):  
Clinical Outcomes ◽  
Bacterial Infections ◽  
Respiratory Infections ◽  
Point Of Care ◽  
Predictive Ability ◽  
Elderly Subjects ◽  
Acute Respiratory Infections ◽  
Elderly Individuals ◽  
Increased Risk ◽  
Scoring Tool

Abstract Background Elderly individuals experience increased morbidity and mortality from acute respiratory infections (ARI), which are complicated by difficulties defining etiologies of ARI and risk-stratifying patients in order to guide care. A number of scoring tools have been developed to predict illness severity and patient outcome for proven pneumonia, however less is known about the use of such metrics for all causes of ARIs. Methods We analyzed risk factors, clinical course and major outcomes of individuals ≥60 years of age presenting to the emergency department with a clinical diagnosis of ARI over a 5-year period. Results Of the enrolled individuals 40 had proven viral infection and 52 proven bacterial infections, but 184 patients with clinically adjudicated ARI (67%) remained without a proven microbial etiology despite extensive workup. Age (71.5 vs. 65.9 years, P &lt; 0.001) and presence of cancer and heart failure were strongly predictive of illness severe enough to require hospital admission as compared with treatment in the outpatient setting. Of those with proven etiology, individuals with bacterial infection were more likely to require hospital and ICU admission (P &lt; 0.001). When applied to this study, a modified PORT score was found to correlate more closely with clinical outcome measures than a modified CURB-65 (r, 0.54 vs. 0.39). Jackson symptom scores, historically used for viral illness, were found to inversely correlate with outcomes (r, −0.34) and show potential for differentiating viral and bacterial etiologies (P = 0.02). Interestingly, a multivariate analysis showed that a novel scoring tool utilizing sex, heart rate, respiratory rate, blood pressure, BUN, glucose and presence of chronic lung disease and cancer was highly predictive of poor outcome in elderly subjects with all-cause ARI. Conclusion Elderly subjects are at increased risk for poor clinical outcomes from ARI and their clinical management remains challenging. However, modified PORT, CURB-65, Jackson symptom score, and a novel scoring tool presented herein all offer some predictive ability for all-cause ARI in elderly subjects. Such broadly applicable scoring metrics have the potential to assist in treatment and triage decisions at the point of care. Disclosures All authors: No reported disclosures.

Biomarkers as point-of-care tests to guide prescription of antibiotics in patients with acute respiratory infections in primary care

2012 ◽  
Author(s):  
Rune Aabenhus ◽  
Jens-Ulrik S Jensen ◽  
Karsten Juhl Jørgensen ◽  
Asbjørn Hróbjartsson ◽  
Lars Bjerrum
Keyword(s):  
Primary Care ◽  
Respiratory Infections ◽  
Point Of Care ◽  
Acute Respiratory Infections ◽  
Point Of Care Tests
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