scholarly journals Management of Children Admitted to Hospitals across Bangladesh with Suspected or Confirmed COVID-19 and the Implications for the Future: A Nationwide Cross-Sectional Study

Antibiotics ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 105
Author(s):  
Kona Chowdhury ◽  
Mainul Haque ◽  
Nadia Nusrat ◽  
Nihad Adnan ◽  
Salequl Islam ◽  
...  

There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO ‘Watch’ list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021501 ◽  
Author(s):  
Wan-Hua Hsieh ◽  
Chien-Hsing Wang ◽  
Tsung-Hsueh Lu

ObjectiveTo compare the drowning mortality rates and proportion of deaths of each intent among all drowning deaths in Organisation for Economic Co-operation and Development (OECD) countries in 2012–2014.DesignA population-based cross-sectional study.Setting32 OECD countries.ParticipantsIndividuals in OECD countries who died from drowning.Main outcome measuresDrowning mortality rates (deaths per 100 000 population) and proportion (%) of deaths of each intent (ie, unintentional intent, intentional self-harm, assault, undetermined intent and all intents combined) among all drowning deaths.ResultsCountries with the highest drowning mortality rates (deaths per 100 000 population) were Estonia (3.53), Japan (3.49) and Greece (2.40) for unintentional intent; Ireland (0.96), Belgium (0.96) and Korea (0.89) for intentional self-harm; Austria (0.57), Korea (0.56) and Hungary (0.44) for undetermined intent and Japan (4.35), Estonia (3.70) and Korea (2.73) for all intents combined. Korea ranked 12th and 3rd for unintentional intent and all intents combined, respectively. By contrast, Belgium ranked 2nd and 15th for intentional self-harm and all intents combined, respectively. The proportion of deaths of each intent among all drowning deaths in each country varied greatly: from 26.2% in Belgium to 96.8% in Chile for unintentional intent; 0.7% in Mexico to 57.4% in Belgium for intentional self-harm; 0.0% in nine countries to 4.9% in Mexico for assault and 0.0% in Israel and Turkey to 38.3% in Austria for undetermined intent.ConclusionsA large variation in the practice of classifying undetermined intent in drowning deaths across countries was noted and this variation hinders valid international comparisons of intent-specific (unintentional and intentional self-harm) drowning mortality rates.


2020 ◽  
Author(s):  
Tamara Jimah ◽  
Ama P. Fenny ◽  
Oladele Ogunseitan

Abstract Background Antibiotic resistance is a major contributing factor to global morbidity and mortality and is associated with inappropriate medication use. However, the level of antibiotic consumption and knowledge about antibiotic resistance in Ghana is inadequately quantified. Our study identifies strategies for improved stewardship of antibiotics to prevent the proliferation of resistant pathogens by assessing the level of antibiotic knowledge, attitudes, and consumption behaviors by region, gender, age, and education in rural and urban Ghana. Methods A cross-sectional study was conducted in 12 communities in the urban Greater Accra and rural Upper West regions of Ghana. A questionnaire survey was administered to 400 individuals aged 18 years and older in selected locations during September-October 2018 to gather data on individual knowledge, attitudes, and practices concerning antibiotics and antibiotic resistance. Multivariate analysis was used to investigate the association between demographic characteristics and knowledge, attitudes, and related behaviors. Results Over 30% (125/400) had not received a doctor’s prescription during their last illness. Seventy percent (278/400) had taken at least one antibiotic in the year prior to the survey. The top five frequently used antibiotics were Amoxicillin , Amoxicillin-clavulanic acid , Ampicillin , Ciprofloxacin , and Metronidazole . Women and older adults had higher knowledge compared to their respective counterparts (p<0.01). Furthermore, prudent antibiotic use was significantly more prevalent in women than men (p<0.05). Although no regional differences were found in overall knowledge, compared to urban residents, individuals residing in rural settings exhibited higher knowledge about the ineffectiveness of antibiotics for viruses like the cold and HIV/AIDS (p<0.001). Two hundred and fifty-two (63%) respondents were unaware of antibiotic resistance. There was generally a low level of self-efficacy among participants regarding their role in preserving the effectiveness of antibiotics. Conclusion Antibiotic knowledge, attitudes, and use varied significantly across demographics, suggesting a context-specific approach to developing effective community interventions.


Pharmacy ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 103 ◽  
Author(s):  
Oumar Bassoum ◽  
Ndèye Sougou ◽  
Mayassine Diongue ◽  
Mamadou Lèye ◽  
Mouhamad Mbodji ◽  
...  

Background: Bacterial resistance is a major public health problem worldwide. One solution to this scourge is to sensitize the general public on rational use of antibiotics. Our goal was to assess people’s knowledge and opinions about antibiotic use and bacterial resistance in an urban setting. Method: We performed a cross-sectional study. A convenience sampling was done. A questionnaire was administered to 400 persons during face-to-face interviews. Results: Most respondents thought that antibiotics are effective against colds/flu (69.8%), cough (72.3%) and sore throat (64.4%). At the same time, 42.8% stated that antibiotic therapy can be stopped as soon as the symptoms disappear. Only 8.8% and 41.8% of people knew that handwashing and vaccination prevented bacterial resistance. Globally, 7% of people had a good knowledge. Socio-demographic variables were not associated with the level of knowledge. The main sources of information were entourage and pharmacy staff. Regarding the opinions, 78.3% of surveyed participants the people thought that that people overuse antibiotics. Additionally, 28% said that they have no role to play against bacterial resistance. Conclusion: People living in an urban setting had a low knowledge about antibiotic use and bacterial resistance. There is a need to implement awareness campaigns. Further studies on population practices toward antibiotic use are necessary.


2018 ◽  
Vol 6 (3) ◽  
pp. 96-101
Author(s):  
Satish Kumar Deo ◽  
Sita Rijal ◽  
Tulza K.C

Background: Antibiotics are considered to be among the most commonly sold drug classes globally. Antibiotic resistance is a recognized public health issue at the local, national and global levels.Objectives: The aim of this study was to identify awareness of general public regarding the use and resistance of antibiotics.Methodology: A descriptive cross-sectional study was conducted in Kathmandu in November 2016 using a quantitative questionnaire among 120 adult people aged 20–60 years. Convenience sampling method was used and information on use of antibiotics and resistance was obtained using semi-structured questionnaire through interview method. Descriptive statistics was done to describe the respondent’s level of awareness regarding use of antibiotics and resistance.Results: Among the total respondents, majority had incorrect awareness as regards to action, reasons for using antibiotics, possible side effects of the antibiotic. Seventy one percent of the respondents had not heard about antibiotic resistance. The study finding showed that about 66.7% of the participants had inadequate awareness towards use and resistance of antibiotics.Conclusion: The findings demonstrate that the overall awareness on antibiotic use and resistance is poorly understood among our respondents. This information can be utilized in future educational and antibiotic resistance awareness raising campaigns.


2020 ◽  
Vol 35 (7) ◽  
pp. 819-828
Author(s):  
Abdu A Adamu ◽  
Muktar A Gadanya ◽  
Rabiu I Jalo ◽  
Olalekan A Uthman ◽  
Charles S Wiysonge

Abstract Patent and proprietary medicine vendors (PPMVs) increase access to antibiotics through non-prescription sales in their drug retail outlets. This fosters irrational antibiotic use among people, thus contributing to the growing burden of resistance. Although training programmes on antibiotic use and resistance exist, they have disproportionately targeted health workers in hospital settings. It’s unclear if there is a relationship between such trainings and non-prescription sales of antibiotics among PPMVs which are more embedded in communities. Therefore, a cross-sectional study was conducted to elicit the determinants of non-prescription antibiotic sales among PPMVs in Kano metropolis, Nigeria. Through brainstorming, causal loop diagrams (CLDs) were used to illustrate the dynamics of factors that are responsible for non-prescription antibiotic sales. Multilevel logistic regression model was used to determine the relationship between training on antibiotic use and resistance and non-prescription antibiotic sales, after controlling for potential confounders. We found that two-third (66.70%) of the PPMVs reported that they have sold non-prescribed antibiotics. A total of three CLDs were constructed to illustrate the complex dynamics of the factors that are related to non-prescription antibiotic sales. After controlling for all factors, PPMVs who reported that they had never received any training on antibiotic use and resistance were twice as more likely to sell antibiotic without prescription compared with those who reported that they have ever received such training (OR = 2.07, 95% CI: 1.27–3.37). This finding suggests that there is an association between training on antibiotic use and resistance and non-prescription sales of antibiotics. However, the complex dynamics of the factors should not be ignored as it can have implications for the development of intervention programmes. Multifaceted and multicomponent intervention packages (incorporating trainings on antibiotic use and resistance) that account for the inherent complexity within the system are likely to be more effective for this setting.


Author(s):  
Christie M Bertram ◽  
Michael Postelnick ◽  
Christian M Mancini ◽  
Xiaoqing Fu ◽  
Yuqing Zhang ◽  
...  

Abstract Alternative antibiotics for surgical prophylaxis are associated with increased adverse events and surgical site infection compared to cefazolin. In a sample of perioperative inpatients from 100 hospitals in the United States, cefazolin was 9-fold less likely to be used in patients with a documented β-lactam allergy whereas clindamycin was 45-fold more likely.


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