scholarly journals Appropriateness of Antibiotic use for the Management of Acute Diarrhea Among Under-Five Children Treated at Primary Care Centers in Northwest Ethiopia: A Cross-Sectional Study

2020 ◽  
Author(s):  
Sumeya Tadesse Abegaz ◽  
Addisu Jember Zeleke ◽  
Zelalem Tilahun Tesfaye
Keyword(s):  
Primary Care ◽  
Health Center ◽  
Acute Diarrhea ◽  
Antibiotic Use ◽  
Northwest Ethiopia ◽  
Watery Diarrhea ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Acute Watery Diarrhea

Abstract Background Acute diarrhea management is solely aimed at fluid replacement and nutritional support while antibiotics have a very limited role. Antibiotic treatment is recommended only for bloody diarrhea (dysentery), cholera and invasive bacterial diarrhea. This study is launched to assess the appropriateness of antibiotic use for the management of acute diarrhea among under-five children in Gondar town primary care centers.Methods Institutional based cross-sectional study was conducted in three primary care centers located in Gondar town, Northwest Ethiopia. Children aged from 2–59 months who visited the three primary care centers from September 12, 2015 to September 10, 2016 and received treatment for acute diarrhea were included in the study. We selected 176 cases from Azezo Health Center, 166 from Poly Health Center and 80 from Woleka Health Center. Cases were drawn using systematic random sampling technique. The findings of the study were summarized using tables and figures; binary logistic analysis was used to identify association between the independent and outcome variables at 95% confidence level where p < 0.05 was considered as statistically significant.Results The mean age of the study participants was 19.1 ± 12.8 months. The majority (60.8%) were males. Appropriate antibiotic use was recorded in less than half (47.2%) of the study subjects. Almost all (98.1%) of children subjected to inappropriate antibiotic use were those with watery diarrhea treated with antibiotics. Out of 253 children who received antidiarrheal antibiotics 202 (79.8%) had acute watery diarrhea which should not be treated with antibiotics. Children diagnosed with acute watery diarrhea were less likely to receive treatment qualified as appropriate antibiotic use [AOR: 0.003 (0.001,0.017)]. Conversely, receiving no antibiotic [AOR: 391.00 (92.46, 1653.37)] and prescriber’s profession of Clinical Nurse [AOR: 3.57 (1.02, 12.51)] were positive predictors for appropriate antibiotic use.Conclusion The findings of the study confirm the prevalence of widespread inappropriate antibiotic use on under-five children presenting with acute diarrhea. The findings can be used by stakeholders as input for promoting appropriate antibiotic use in the healthcare system as well as to deter antimicrobial resistance.

scholarly journals Risk of nutritional status on diarrhea among under five children

2015 ◽  
Vol 55 (4) ◽  
pp. 235
Author(s):  
Wiliam Jayadi Iskandar ◽  
I wayan Sukardi ◽  
Yati Soenarto
Keyword(s):  
Logistic Regression ◽  
Nutritional Status ◽  
Hospital Stay ◽  
Acute Diarrhea ◽  
Length Of Hospital Stay ◽  
Watery Diarrhea ◽  
Under Five ◽  
Under Five Children ◽  
Malnourished Children ◽  
Acute Watery Diarrhea

Background Diarrhea is still the leading cause of children’s mortality worldwide and the main cause of malnutrition. Meanwhile, malnourished children are proven to have more severe, prolonged, and frequent episodes of diarrhea, making them a vicious circle.Objective To investigate the risk of nutritional status on diarrheal severity and duration as well as length of hospital stay.Methods We conducted a cross sectional study involving 176 under five children who admitted to Mataram Province Hospital with acute diarrhea since January until December 2013. We analyzed data using logistic regression model.Results Most subjects were infants (median 12 months, range 1-53), male (56.8%), well-nourished (85.8%), admitted with acute watery diarrhea (97.2%), mild-to-moderate dehydration (71.6%), diarrhea severity score ≥11 (74.4%), duration of diarrhea ≤7 days (96.6%), and length of stay <5 days (73.3%). Logistic regression model indicated significant risk of nutritional status on length of hospital stay (adjusted OR 2.09, 95% CI 1.06 to 6.38), but neither diarrheal severity (adjusted OR 1.03, 95% CI 0.38 to 2.80) nor duration of diarrhea (adjusted OR = 1.17, 95% CI = 0.13 to 10.89) indicated significant risks. However, malnourished children had more severe (76% versus 74.2%) and longer duration (4% versus 3.3%) of diarrhea than well-nourished children.Conclusion Nutritional status is the risk for length of hospital stay in under-five children admitted with acute diarrhea. [

scholarly journals Socioeconomic Predictors of Intestinal Parasitic Infections Among Under-Five Children in Rural Dembiya, Northwest Ethiopia: A Community-Based Cross-sectional Study

2019 ◽  
Vol 13 ◽  
pp. 117863021989680
Author(s):  
Zemichael Gizaw ◽  
Ayenew Addisu ◽  
Mulat Gebrehiwot
Keyword(s):  
Parasitic Infection ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Parasitic Infections ◽  
Intestinal Parasitic Infection ◽  
Cross Sectional ◽  
Intestinal Parasitic Infections ◽  
Under Five ◽  
Under Five Children ◽  
Health Supervision

Background: Soil-transmitted helminths and protozoan parasitic infections are endemic throughout the world. The problem of intestinal parasitic infection is higher among developing countries where children are the most vulnerable groups. Although health information related to parasitic infections is available globally, it is often limited in rural setups in least developed countries. This study was, therefore, conducted to assess socioeconomic predictors of intestinal parasitic infections among under-five children in rural Dembiya, Northwest Ethiopia. Methods: This cross-sectional study was conducted among 224 randomly selected households with under-five children. We used questionnaire to collect data and direct stool examination to identify intestinal parasitic infections. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and P < .05 was used to identify socioeconomic predictors of parasitic infections. Results: We found that 25.4% (95% CI = [20.2, 31.1]) under-five children had intestinal parasitic infection. Ascaris lumbricoides was the leading infection, which accounted 44 of 224 (19.6%). The prevalence of childhood intestinal parasitic infections was higher among households with no members whose education level is secondary and above (AOR = 3.36, 95% CI = [1.23, 9.17]). Similarly, intestinal parasitic infections were statistically associated with presence of 2 under-five children in a household (AOR = 3.56, 95% CI = [1.29, 9.82]), absence of frequent health supervision (AOR = 3.49, 95% CI = [1.72, 7.09]), larger family size (AOR = 2.30, 95% CI = [1.09, 4.85]), and poor household economic status (AOR = 2.58, 95% CI = [1.23, 5.41]). Conclusions: Significant proportion of children was infected with intestinal parasitic infection in rural Dembiya. Educational status of family members, number of under-five children in a household, health supervision, family size, and wealth index were statistically associated with parasitic infections. Provision of anthelmintic drugs, health supervision, and health education targeted with transmission and prevention of infections are recommended.

scholarly journals Diarrhea Prevention Practice and Associated Factors among Caregivers of Under-Five Children in Enemay District, Northwest Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Melese Dubie Agegnehu ◽  
Liknaw Bewket Zeleke ◽  
Yitayal Ayalew Goshu ◽  
Yonas Lamore Ortibo ◽  
Yohannes Mehretie Adinew
Keyword(s):  
Family Size ◽  
Associated Factors ◽  
Diarrheal Disease ◽  
Good Practice ◽  
Multivariable Analysis ◽  
Sampling Technique ◽  
Northwest Ethiopia ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children

Background. Diarrhea is the leading cause of mortality among infants and children younger than 5 years of age in both underdeveloped and developing countries. Factors determining the occurrence of diarrhea in children are complex, and the relative contribution of each factor varies as a function of interaction between socioeconomic, environmental, and behavioral variables. Objectives. To assess diarrhea prevention practice and associated factors of diarrheal disease among caregivers who have under-five children in Enemay district, Ethiopia, 2018. Methods. Community-based cross-sectional study was done from June 1–30, 2018, among 398 caregivers who have under-five children, in the Enemay district that were selected by using the simple random sampling technique. A structured and pretested data collection tool was used to collect the data. Data were entered using EPI DATA version 4.2, and analysis was done using SPSS version 20 statistical package to be cleaned and analyzed. Descriptive analysis was done to describe study participants, and logistic regression (bivariable and multivariable) analysis was done to identify factors that have association with the dependent variable. The P value was less than 0.05. Results. A total of 398 with a response rate of 97% under-five caregivers were participated in this study. Nearly, half (48.7%) of the participants were in the age group 25–34. The study revealed that good practice of diarrhea prevention was 52.8%. This study was also identified that occupation (AOR: 3.922, 95% CI: 1.593, 9.657), family size (AOR: 0.088, 95% CI: 0.009, 0.916), and understanding on diarrhea (AOR: 0.237, 95% CI: 0.091, 0.613) were associated factors of diarrhea prevention practice of under-five children caregivers. Conclusion. This finding showed that diarrhea prevention practice among under-five children caregivers was low and prevention practice was significantly associated with caregivers’ awareness on frequency of diarrhea in a day, occupation, and family size in a house.

scholarly journals Contact Screening and Isoniazid Preventive Therapy Initiation for Under-Five Children among Pulmonary Tuberculosis-Positive Patients in Bahir Dar Special Zone, Northwest Ethiopia: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Netsanet Fentahun ◽  
Yosef Wasihun ◽  
Abebe Mamo ◽  
Lakew Abebe Gebretsadik
Keyword(s):  
Pulmonary Tuberculosis ◽  
Preventive Therapy ◽  
Northwest Ethiopia ◽  
Isoniazid Preventive Therapy ◽  
Bahir Dar ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Therapy Initiation ◽  
Contact Screening

Background. Children are highly susceptible to Mycobacterium tuberculosis infection, and about 70% of children living in the same households with pulmonary tuberculosis-positive patients will become infected. However, pulmonary positive tuberculosis is a common phenomenon and the implementation of the recommended contact screening and initiation of isoniazid preventive therapy is very low. Therefore, this study is aimed at assessing contact screening practice and initiation of isoniazid preventive therapy of under-five children among pulmonary tuberculosis-positive patients in Bahir Dar, northwest Ethiopia. Methods. A facility-based cross-sectional study was conducted from March 1 to 30, 2016. A total of 267 pulmonary tuberculosis-positive patients were included in this study. To identify independent predictors of contact screening and isoniazid preventive therapy initiation, we performed multivariable logistic regression analyses using SPSS version 20 with CI of 95% at p value < 0.05. Results. A total of 230 (90.2%) pulmonary tuberculosis-positive patients had single contacts with their under-five children. One hundred nine (64.8%) children were screened. From those screened, 11 (7.4%) developed tuberculosis disease and started antituberculosis treatment. Forty-four (31.9%) children started isoniazid preventive therapy. Sex of the participants, place of service delivery, relationship with contacts, HIV status, and attitude of PTB+ cases were significant predictors of contact screening (p<.05). Participant’s knowledge, attitude of participants, and relationship of the child with participant were significant predictors of isoniazid preventive therapy initiation (p<0.05). Conclusion. Contact screening practice and isoniazid preventive therapy initiation of children under the age of 5 in Bahir Dar zone were very low. Intimate family contact with pulmonary tuberculosis-positive patients, place of service delivery, and attitude towards screening are the key factors of contact screening. Participant’s knowledge, attitude of participants, and relationship of the child with participant are the key factors of isoniazid preventive therapy initiation. Therefore, household contact screening and isoniazid preventive therapy initiation should be paid attention to reduce transmission.

scholarly journals The relationship between environmental sanitation of family and stunting among underfive children: A cross-sectional study in the public health center of Jember, Indonesia

2021 ◽  
Author(s):  
Fitri Nur Ainy ◽  
Tantut Susanto ◽  
Latifa Aini Susumaningrum
Keyword(s):  
Public Health ◽  
Health Center ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Environmental Sanitation ◽  
Public Health Center ◽  
The Public ◽  
Under Five ◽  
Under Five Children ◽  
The Relationship

Background & Aim: Unhealthy environmental sanitation contributes to stunting among under-five children that correlated several factors, such as the house components, sanitation facilities, and behavior of poor food sanitation hygiene. This study aims to identify the relationship between family and stunting's environmental sanitation among under-five children in the Public Health Center in Indonesia. Methods & Materials: A cross-sectional study was conducted among 393 families with under-five children in the public health center of Panti of Jember district, East Java of Indonesia, using consecutive sampling from December 2019 to January 2020. A selfadministered questionnaire was used to measure participants’ characteristics and environmental sanitation. A Chi-square test was used to analyze the data. Results: Among 67.2% of families were unhealthy environmental sanitation. Meanwhile, children who suffer from stunting were 56.2%. There was a significant correlation between environmental sanitation of family and stunting among under-five children (χ2=38,440; p <0,001), The environmental sanitation of family had 0.254 times for a chance of stunting among under-five children (OR= 0.254; 95% CI= 0.163-0.397). Conclusions: The family’s unhealthy environmental sanitation of family is a relationship with stunting among under-five children. Improving healthy environmental sanitation should be maintained by involving the family to fulfill under-five children’s nutrition requirement based on height for age.

scholarly journals Diarrhea Prevalence and Associated Factors Among Under-Five Children in the Periphery Area of Azezo Sub-City, Gondar, Northwest Ethiopia: A community Based Cross-Sectional Study

2021 ◽  
Author(s):  
Bikes Destaw Bitew ◽  
Atalay Getachew ◽  
Jember Azanaw
Keyword(s):  
Associated Factors ◽  
Diarrheal Disease ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Age Group ◽  
Monthly Income ◽  
Community Based ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children

Abstract Background Although there has been a global decrease in childhood diarrheal disease in parallel with improvements in the standard of living, it still remains a significant public health problem that occurs due to poor WASH status and other related factors that cause massive childhood morbidity and mortality particularly in sub-Saharan Africa countries including Ethiopia. Objective To assess diarrheal disease prevalence and associated factors among under-five children in periphery area of Azezo sub-city, Gondar, northwest Ethiopia. Methods A community-based cross-sectional study was conducted in April 2019. A simple random sampling technique was applied to recruit the eligible clusters/villages. Structured interview questionnaires were used to collect data. The completed data were entered into Epi Info version 7 and exported to SPSS version 20 for further analysis. A binary logistic regression model was used to process bivariate and multivariable analysis of the data to establish the association between dependent and independent variables. The adjusted odds ratio (AOR) with 95% CI was used for the interpretation of data after controlling the confounders. Results The two-week prevalence of U5C diarrheal disease was 24.9% with 95% CI: (20.4 – 29.7). Age group of 1-12months [AOR: 9.22, 95%CI: (2.93-29.04)], age group of 13-24months [AOR: 4.44, 95%CI: (1.87-10.56)], low monthly income (AOR: 3.68, 95% CI: (1.81-7.51)], small family size [AOR: 0.32, 95% CI: (0.16-0.65)], poor hand washing practice [AOR: 8.37, 95% CI: (3.12-22.52), and immediate feed for cooked foods [AOR: 0.39, 95%CI: (0.19-0.81)] were significantly associated factors with childhood diarrhea. Conclusion Diarrhea was a common health problem among under-five children in the periphery area of Azezo sub-city. Age of children, family size, monthly income, hand-washing practice, and feeding time for cooked food were identified statistically significant risk factors. Therefore, an appropriate intervention program through health education would be recommended with a focus on identified risk factors to reduce the burden of diarrheal diseases.

scholarly journals Prevalence of Antibiotic Use and Household Water-Sanitation Risk Factors of Acute Watery Diarrhea Among Children <5 Years: A Retrospective Analysis of Multicounty Health Survey Data, 2006-2018

2021 ◽  
Author(s):  
Md. Shakil Ahmed
Keyword(s):  
Central Asia ◽  
Antibiotic Treatment ◽  
Central Africa ◽  
Antibiotic Use ◽  
The Other ◽  
Watery Diarrhea ◽  
South East Asia ◽  
Under Five ◽  
Other Hand ◽  
Acute Watery Diarrhea

Abstract A total of 12,69,944 under five years Childs were included in this study among them 1,80,067 Children were acute watery diarrhea (AWD) and 19,502 Children were bloody diarrhea respectively. Among them, 47,755 Childs was taken antibiotic treatment for AWD. The overall prevalence of acute watery diarrhea ~ 14% (prevalence = 0.142; 95% CI = 0.141, 0.142). On the other hand the prevalence of bloody diarrhea ~ 2% (prevalence = 0.015; 95% CI = 0.015, 0.016). The prevalence of antibiotic treatment for AWD was ~ 27% (prevalence = 0.27, 95% CI = 0.26, 0.27) among the under five years old children in DH survey regions in the world. The prevalence of acute watery diarrhea was higher ~ 17% (prevalence = 0.17, 95% CI = 0.16, 0.17) in the Latin America DHS survey region. The minimum prevalence of AWD was almost equal between South East Asia and Central Asia DHS survey regions ~ 12% (prevalence = 0.12, 95% CI = 0.11, 0.12) and ~ 12% (prevalence = 0.12, 95% CI = 0.10, 0.13) respectively. On the other hand the prevalence of AWD between Europe and West North and Central Africa DHS survey regions ~ 16% (prevalence = 0.16, 95% CI = 0.15, 0.16) and ~ 15% (prevalence = 0.15, 95% CI = 0.14, 0.15) correspondingly. In the central Asia of 15,089 under five Childs were included in the survey. Among them 1,748 Children were AWD and 967 Childs had taken antibiotic treatment for AWD. The highest prevalence of antibiotic use for AWD in Central Asia ~ 55% (prevalence=(967/1748) = 0.55, 95% CI = 0.52, 0.59) and Europe DH survey region ~ 44% (prevalence=(5483/12502) = 0.44, 95% CI = 0.43, 0.45). The lowest prevalence of antibiotic use for under five Child AWD was ~ 23% (prevalence=(11918/51328) = 0.23, 95% CI = 0.22, 0.24) in the DH survey region South East Asia. On the other hand the DH survey region Latin America and West North and Central Africa region the prevalence of antibiotic use for AWD were ~ 30% (prevalence=(7887/26396) = 0.30, 95% CI = 0.29, 0.31) and ~ 24% (prevalence=(21500/88093) = 0.24, 95% CI = 0.23, 0.24). The southeast Asia DH survey region countries DHS 2007 (Bangladesh), DHS 2014 and 2010 (Cambodia), DHS 2017 and 2012 (Indonesia), DHS 2009 (Maldives), DHS 2015–2016 (Myanmar), DHS 2012–2013 (Pakistan), DHS 2017 and 2013 (Philippines), and DHS 2009–2010 (Timor-Leste) were higher risks of AWD for drinking unimproved water sources. The prevalence of antibiotic use for u5c AWD was shown the highest prevalence in DHS 2007 (~ 44%), DHS 2012 (~ 49%), DHS 2016 (~ 40%), and DHS 2017 (~ 65%) from DH survey 2006 to 2018 in South East & Central Asia. The linear trend analysis showed an upward trend for using antibiotic of AWD in the South East & Central Asia DH survey region.

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