Antibiotic prescription from qualified sources for children with fever/cough: cross-sectional study from 59 low- and middle-income countries

Md Sabbir Hossain; Md Fakrul Islam; Prosenjit Basak Arka; Mahfuzer Rohman; Talha Sheikh Ahmed; Tanvir Ahammed; Muhammad Abdul Baker Chowdhury; Md Jamal Uddin

doi:10.1016/j.eclinm.2023.102055

Antibiotic prescription from qualified sources for children with fever/cough: cross-sectional study from 59 low- and middle-income countries

EClinicalMedicine. 2023 Jun 29:61:102055. doi: 10.1016/j.eclinm.2023.102055. eCollection 2023 Jul.

Authors

Md Sabbir Hossain¹, Md Fakrul Islam¹, Prosenjit Basak Arka¹, Mahfuzer Rohman¹, Talha Sheikh Ahmed², Tanvir Ahammed¹, Muhammad Abdul Baker Chowdhury¹, Md Jamal Uddin^{1

3}

Affiliations

¹ Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh.
² Department of Geography and Environment, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh.
³ Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh.

Abstract

Background: Children in low and middle-income countries (LMICs) receive a staggering number of antibiotic prescriptions, many of which are inappropriate. We aimed to explore the proportion of antibiotic prescriptions from qualified sources of children under five who had a fever/cough in the two weeks prior to the survey in LMICs.

Methods: We used data from cross-sectional studies of the latest Demographic and Health Survey (DHS) datasets (n = 43,166) in 59 LMICs covering Sub-Saharan Africa, North Africa-West Asia-Europe, Central Asia, South & Southeast Asia, Oceania, and Latin America & the Caribbean regions. The study was conducted from March 2, 2020 to October 15, 2022. We only included the latest available surveys by country, and children under five who had taken antibiotics for fever/cough were included in the study. Finally, the outcome variable was classified into two distinct categories: those who had taken antibiotics from qualified sources and those who did not.

Findings: About three in four children (74.0%) received antibiotics from qualified sources. Tanzania (22.4%) and Malawi (99.9%) had the lowest and highest percentages of antibiotic prescriptions by qualified sources, respectively. Oceania had the highest percentage of qualified antibiotic prescriptions with 88.9% and Central Asia had the lowest percentage with 56.3%.

Interpretation: As unqualified sources of antibiotics for fever/cough in children under five were alarmingly high in some of the LMICs, the study emphasises the importance of nationwide efforts to regulate antibiotics prescriptions.

Funding: None.

Keywords: Antibiotics; LMICs; Qualified source; Standard DHS; Under-five children.