Non-prescription antibiotic use for cough among Chinese children under 5 years of age: a community-based cross-sectional study

ObjectiveThis study aimed to investigate the non-prescription use of antibiotics for cough among children under 5 years in China.DesignA community-based cross-sectional survey.SettingA face-to-face interview based on a standard questionnaire in the community from October to December 2019.ParticipantsA total of 3102 children under 5 years of age were enrolled with probability proportionate to size sampling method. The children’s caregivers provided the responses as their agents.Outcome measuresCough in the past month, non-prescription use of antibiotics after cough.Results1211 of 3102 children were reported to have a cough in the past month. Of these, 40.2% (487/1211) were medicated with antibiotics, and 18.7% (91/487) of these were not prescribed. Cephalosporins were the most frequently used antibiotic (52.8%), and community pharmacies were the main source (53.7%). Children who coughed for 1–2 weeks (OR 1.73, 95% CI 1.03 to 2.90) or 3–4 weeks (OR 2.39, 95% CI 1.08 to 4.97), with runny nose (OR 1.86, 95% CI 1.13 to 3.19) or those whose family annual income between ¥50 000 and ¥100 000 (OR 4.44, 95% CI 1.52 to 18.95) had a higher risk of non-prescription use of antibiotics than those coughing for <1 week, without runny nose or with family annual income <¥50 000.ConclusionsOur findings indicated that a high proportion of infants and young children had been treated with antibiotics for cough, and nearly one in five of them were used without prescription. More public health campaigns and further education on the appropriate use of antibiotics are needed to ensure the rational treatment of cough in children.

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Non-Prescription Antibiotic Use for Cough Among Chinese Children Aged Under 5 Years: A Community-Based Cross-Sectional Study

10.21203/rs.3.rs-107046/v1 ◽

2020 ◽

Author(s):

Yao Zhu ◽

Shuying Luo ◽

Hanqing He ◽

Rui Yan ◽

Yang Zhou ◽

...

Keyword(s):

Antibiotic Use ◽

Cross Sectional Study ◽

Sampling Procedure ◽

Common Symptom ◽

Annual Income ◽

Health Campaigns ◽

Community Based ◽

Cross Sectional ◽

Children's Caregivers ◽

Accompanying Symptoms

Abstract Background: Cough is a common symptom in childhood and is an important circumstance of inappropriate antibiotic use. This study aimed to investigate the non-prescription use of antibiotics for cough among children aged under 5 years.Methods: We conducted a community-based survey of under-5 children in Yiwu, China from October to November 2019. The subjects were enrolled from 14 townships using a two-stage stratified sampling procedure. Detailed information was collected through a face-to-face interview based on a standard questionnaire, and the children’s caregivers answered as agents. Univariable and multivariable logistic regression analyses were performed to explore the factors associated with nonprescription use of antibiotics for cough in children. Results: A total of 3102 children were included in the study, and 1211 children were reported to have a cough in the past month. Among them, 40.2% (487/1211) were medicated with antibiotics, and 18.7% (91/487) of these were unprescribed. Cephalosporins were the most frequently used antibiotic (52.8%), and community pharmacies were the main source (53.7%). Children who coughed for 1–2 weeks (OR=1.73, 95% CI=1.03-2.90) or 3–4 weeks (OR=2.39, 95%CI=1.08-4.97), with 2 or more accompanying symptoms (OR=2.44, 95% CI=1.14-5.72), or with a family annual income between 50000 and 100000 RMB (OR=4.14, 95% CI=1.41-17.69) had a higher risk of non-prescription use of antibiotics than those coughing for <1 week, without accompanying symptoms, or with family annual income <50000 RMB.Conclusions: Our findings indicated that a high proportion of infants and young children had been treated with antibiotics for cough, and nearly 1/5 of them were used without prescription. More public health campaigns and further health teaching on the appropriate use of antibiotics are needed to ensure the rational treatment of cough in children.

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Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-020-00811-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Jiayao Xu ◽

Xiaomin Wang ◽

Kai Sing Sun ◽

Leesa Lin ◽

Xudong Zhou

Keyword(s):

Antibiotic Use ◽

Antibiotic Prescribing ◽

Clinical Settings ◽

Cross Sectional Survey ◽

Self Medication ◽

Cross Sectional ◽

Prescribing Behavior ◽

The Past ◽

Outpatient Settings ◽

The Impact

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.

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A Cross-Sectional Survey on Knowledge, Attitudes and Practices Towards Malaria Control and Prevention Among Caregivers of Children Under-5 in the Western Area of Sierra Leone

10.21203/rs.3.rs-270948/v1 ◽

2021 ◽

Author(s):

Joan Mabinty Koroma ◽

Yuji Wang ◽

Xiang Guo ◽

Xiaoqing Zhang ◽

Jone Jama Kpanda Ngobeh ◽

...

Keyword(s):

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Inappropriate Behaviors ◽

Attitudes And Practices ◽

Positive Attitudes ◽

Western Area ◽

Control And Prevention ◽

Knowledge Attitudes And Practices ◽

Children Under 5

Abstract BackgroundChildren under-5 are the most vulnerable to malaria infection and they suffer serious complications. Sierra Leone is one of the countries with the highest malaria burden in the world. This study aimed to assess the knowledge, attitudes and practices (KAPs) towards malaria control and prevention among caregivers of children under-5 in the Western Area of Sierra Leone.MethodsA cross-sectional survey was conducted among caregivers of children under-5 visiting the out-patient department of six selected hospitals/community health centers. Data were collected via questionnaire interview with 350 caregivers. Further statistical analyses were performed primarily Spearman’s rank test for inferring the correlations among KAPs, univariate and multivariate logistic regression for demonstration the association between KAPs and socio-demographic characteristics.ResultsWomen made up 97.1% of respondents with the majority being young mothers-including 33 single student moms. 46.3% among respondents were unemployed and 27.1% had no educational background. Only 1.4% received malaria related information from the internet/social media. This KAPs survey indicated that misconception of cause, transmission and clinical symptoms of malaria; unawareness of lethality and severity; inappropriate behaviors in prevention and treatment such as self-medicating were still in existence in caregivers. But a positive correlation in knowledge-attitudes (rs = 0.13, P < 0.05) and attitudes-practices (rs = 0.45, P < 0.001) were revealed. The caregivers being a mother and having at least secondary education were demonstrated associated with positive attitudes and practices. Meanwhile, more urban-based caregivers (79.8%) followed a complete malaria treatment course of ACTs than the rural (63.3%), but in view of ITNs use, more rural-based caregivers presented positive attitudes (85.3%) and practices (70.1%) than the urban (69.9%, 52.0%). The student moms might know more but do less. ConclusionsIn order to better protect children under-5 against lethal malaria, their caregivers, especially young mothers, need strong support to reduce misconceptions, inappropriate behaviors, and provide increased vigilance. It is important to develop an efficient communication channel to disseminate information regarding malaria, especially strengthening community-based media infrastructure, including internet/social media. A increase in education and employment opportunities for women, as well as setting up community-based malaria counselling services, is urgently needed.

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Mothers’ and Caregivers’ Knowledge and Experience of Neonatal Danger Signs: A Cross-Sectional Survey in Saudi Arabia

BioMed Research International ◽

10.1155/2019/1750240 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Amani Abu-Shaheen ◽

Isamme AlFayyad ◽

Muhammad Riaz ◽

Abdullah Nofal ◽

Abdulrahman AlMatary ◽

...

Keyword(s):

Health Seeking ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Neonatal Deaths ◽

Danger Signs ◽

The Past ◽

Seeking Behavior ◽

Knowledge Of Danger Signs ◽

Late Recognition

Introduction. The majority of neonatal deaths in developing countries occur at home. Many of these deaths are related to late recognition of the signs of a serious illness by parents and a delay in the decision to seek medical care. Since the health-seeking behavior of mothers for neonatal care depends on the mothers' knowledge about WHO recognized danger signs, it is essential to investigate their knowledge of these signs. Objective. To investigate the knowledge and the experience of mothers and caregivers towards the WHO suggested neonatal danger signs. Methods. A community-based study was conducted on mothers who had delivered or had nursed a baby in the past two years. Results. A total of 1428 women were included in the analysis. Only 37% of the participant's knowledge covered three or more danger signs. The frequently reported participants’ knowledge of danger signs in this study was for yellow soles (48.0%), not feeding since birth or stopping to feed (46.0%), and signs of local infection (37.0%). The majority (69.0%) of the participants had experienced at least one of the danger signs with their baby. The noteworthy frequent reports of the participants’ experiences were for yellow soles (27.0%), not feeding since birth or stopping to feed (25.0%), and umbilical complications (19.0%). Conclusion. The proportion of mothers with knowledge of at least three neonatal danger signs is low. There is a need for developing interventions to increase a mother’s knowledge of newborns danger signs.

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Use of antibiotics to treat humans and animals in Uganda: a cross-sectional survey of households and farmers in rural, urban and peri-urban settings

JAC-Antimicrobial Resistance ◽

10.1093/jacamr/dlaa082 ◽

2020 ◽

Vol 2 (4) ◽

Author(s):

Susan Nayiga ◽

Miriam Kayendeke ◽

Christine Nabirye ◽

Laurie Denyer Willis ◽

Clare I R Chandler ◽

...

Keyword(s):

Antibiotic Use ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Middle Income ◽

Middle Income Countries ◽

The Past ◽

Chi Squared ◽

Veterinary Antibiotic ◽

Prevalence Ratios

Abstract Background Use of antibiotics to treat humans and animals is increasing worldwide, but evidence from low- and middle-income countries (LMICs) is limited. We conducted cross-sectional surveys in households and farms in Uganda to assess patterns of antibiotic use among humans and animals. Methods Between May and December 2018, a convenience sample of 100 households in Nagongera (rural), 174 households in Namuwongo (urban) and 115 poultry and piggery farms in Wakiso (peri-urban) were selected and enrolled. Using the ‘drug bag’ method, participants identified antibiotics they used frequently and the sources of these medicines. Prevalence outcomes were compared between different sites using prevalence ratios (PRs) and chi-squared tests. Results Nearly all respondents in Nagongera and Namuwongo reported using antibiotics to treat household members, most within the past month (74.7% Nagongera versus 68.8% Namuwongo, P = 0.33). Use of metronidazole was significantly more common in Namuwongo than in Nagongera (73.6% versus 40.0%, PR 0.54, 95% CI: 0.42–0.70, P < 0.001), while the opposite was true for amoxicillin (33.3% versus 58.0%, PR 1.74, 95% CI: 1.33–2.28, P < 0.001).Veterinary use of antibiotics within the past month was much higher in Wakiso than in Nagongera (71.3% versus 15.0%, P < 0.001). At both sites, oxytetracycline hydrochloride was the most frequently used veterinary antibiotic, but it was used more commonly in Wakiso than in Nagongera (76.5% versus 31.0%, PR 0.41, 95% CI: 0.30–0.55, P < 0.001). Conclusions Antibiotics are used differently across Uganda. Further research is needed to understand why antibiotics are relied upon in different ways in different contexts. Efforts to optimize antibiotic use should be tailored to specific settings.

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Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052434 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2434

Author(s):

Yoshito Nishimura ◽

Tomoko Miyoshi ◽

Hideharu Hagiya ◽

Yoshinori Kosaki ◽

Fumio Otsuka

Keyword(s):

Healthcare Workers ◽

Healthcare Professionals ◽

Healthcare Delivery ◽

General Medicine ◽

Maslach Burnout Inventory ◽

University Hospital ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Past

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.

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Evaluation of Antibiotic Supply Decisions by Community Pharmacists in Thailand: A Vignette Study

Antibiotics ◽

10.3390/antibiotics10020154 ◽

2021 ◽

Vol 10 (2) ◽

pp. 154

Author(s):

Sisira Donsamak ◽

Marjorie C. Weiss ◽

Dai N. John

Keyword(s):

Respiratory Infections ◽

Acute Diarrhoea ◽

Community Pharmacists ◽

Antibiotic Use ◽

Educational Interventions ◽

Community Pharmacies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Case Vignettes ◽

A Chain

In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported. The study aimed to evaluate the appropriateness of antibiotics selected by community pharmacists in Thailand in response to vignettes. A cross-sectional survey of community pharmacists across Thailand was conducted using a self-administered questionnaire including nine case vignettes with three conditions, namely upper respiratory infections (URIs), acute diarrhoea and simple wounds. A total of 208 questionnaires were completed and analysed (20.8% response rate). In response to vignettes relating to URIs, 50.8% of pharmacist recommendations were not in accordance with antibiotic guidelines. Inappropriate recommendations for diarrhoea and wound cases were 20.8% and 16.7%, respectively. A higher proportion of younger pharmacists, those with less experience, Pharm. D. graduate pharmacists, employee pharmacists and those pharmacists who worked in a chain pharmacy were more likely to recommend appropriate antibiotic treatment in response to the vignettes (p < 0.05). These findings will be useful to promote educational interventions for community pharmacists regarding common infectious disease management in order to improve appropriate antibiotic use.

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Antibiotic use in goats: role of experience and education of Missouri veterinarians

Veterinary Record ◽

10.1136/vr.105455 ◽

2020 ◽

Vol 186 (11) ◽

pp. 349-349

Author(s):

Lauren Landfried ◽

Patrick Pithua ◽

Roger D Lewis ◽

Steven Rigdon ◽

Jonathan Jacoby ◽

...

Keyword(s):

Continuing Education ◽

Health Management ◽

Intestinal Parasites ◽

Antibiotic Use ◽

Herd Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Attitudes And Practices ◽

Prescription Practices

BackgroundIn a previous study, we found that rates of antibiotic residues in goat carcasses in Missouri were three times the published national average, warranting further research in this area.MethodsWe conducted a cross-sectional survey of goat veterinarians to determine attitudes and practices regarding antibiotics, recruiting 725 veterinarians listed on the American Association of Small Ruminant Practitioners (AASRP) website and 64 Missouri Veterinary Medical Association (MVMA) veterinarians.ResultsWe collected 189 responses (26.1%) from AASRP members (170 valid) and 8 (12.5%) from MVMA veterinarians totalling 178 responses. While the vast majority of all veterinarians indicated that they prescribed antibiotics less than half of the time, Missouri veterinarians indicated that they spent more time treating goats for overt disease like intestinal parasites and less time on proactive practices such as reproductive herd health management comparatively. While veterinarians agreed that antibiotic resistance was a growing concern, veterinarians outside of Missouri seemed more confident that their own prescription practices was not a contributor. Although nationally most veterinarians felt that attending continuing education classes was beneficial, 73.4% in other states attended classes on antibiotic use compared to only four of the nine Missouri veterinarians.ConclusionMissouri veterinarians had less veterinary experience than veterinarians in other states, and this, in conjunction with low continuing education requirements in Missouri relative to most other states, may hinder development of more proactive and effective client–veterinary relationships.

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Health and Safety in Nail Salons: A Cross-Sectional Survey

Annals of Work Exposures and Health ◽

10.1093/annweh/wxaa078 ◽

2020 ◽

Author(s):

Sadaf Sanaat ◽

D Linn Holness ◽

Victoria H Arrandale

Keyword(s):

Occupational Health ◽

Small Businesses ◽

Health And Safety ◽

Musculoskeletal Symptoms ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Safety Practices ◽

Runny Nose ◽

Few Data ◽

Nail Salons

Abstract Objectives In recent years, nail salons have become more abundant than ever. The majority are small businesses, often employing immigrant women. Nail technicians have many exposures at work including chemical, biological, physical, and ergonomic hazards but few data exist on their symptoms or occupational health and safety practices, particularly in the Canadian context. The aim of this study was to learn about nail technicians, their work, and their health and safety practices. Methods Nail technicians were recruited from nail salons in Toronto, Ontario. Participants completed an anonymous survey with questions about demographics, work tasks, workplace health and safety practices, and symptoms (skin, respiratory, and musculoskeletal). Results A total of 155 nail technicians (95% female) participated in the survey. The majority of nail technicians performed manicures (99%) and pedicures (96%) and applied shellac polishes (86%). Only a third (34%) applied acrylic artificial nails. The reported use of personal protective equipment (PPE) was very high; 88% reported using a mask at work and 96% reporting using gloves. The most common symptoms reported by technicians were neck (44%) and back pain (38%). Skin and respiratory symptoms were less common with 6% of technicians reporting cough, 8% wheeze, and 5% a current rash. Technicians working over 30 h per week reported more neck pain (52 vs. 32%, P = 0.02). Technicians who reported using shellac polishes were more likely to report a runny nose (25 vs. 0%, P = 0.01). Conclusions Nail technicians in Toronto, Canada are experiencing work-related symptoms. Musculoskeletal symptoms were the most common symptoms reported. Much of the focus on nail salons and health has been on chemical exposures, but ergonomic hazards should not be overlooked. Efforts to increase knowledge and improve occupational health in nail salons should include information on multiple possible workplace hazards and how to reduce impacts of exposure.

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