Determinants of trends in reported antibiotic use among sick children under five years of age across low-income and middle-income countries in 2005–17: A systematic analysis of user characteristics based on 132 national surveys from 73 countries

International Journal of Infectious Diseases

Laith Hussain-Alkhateeb¹  Andreas Mårtensson²  Freddy Eric Kitutu³  Susanne Strömdahl⁴  Gbemisola Allwell-Brown⁴  Maquins Odhiambo Sewe⁵  Emily White Johansson⁶ 

[1]Corresponding author at: Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University, SE-751 85 Uppsala, Sweden.

[2]Sustainable Pharmaceutical Systems (SPS) Unit, Department of Pharmacy, School of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda

[3]Department of Public Health and Clinical Medicine, Sustainable Health Section, Umeå University, SE-901 87, Umeå, Sweden

[4]Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University, SE-751 85 Uppsala, Sweden

[5]Global Health, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden

[6]Section of Infectious Diseases, Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden

关键词: Antibiotic use;    Antibiotic consumption;    Determinants;    Children;    Low- and middle-income countries;    Global trends;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objectives: This study aimed to analyze any reported antibiotic use for children aged <5 years with fever, diarrhea or cough with fast or difficult breathing (outcome) from low-income and middle-income countries (LMICs) during 2005–2017 by user characteristics: rural/urban residence, maternal education, household wealth, and healthcare source visited. Methods: Based on 132 demographic and health surveys and multiple indicator cluster surveys from 73 LMICs, the outcome by user characteristics for all country-years was estimated using a hierarchical Bayesian linear regression model. Results: Across LMICs during 2005–2017, the greatest relative increases in the outcome occurred in rural areas, poorest quintiles and least educated populations, particularly in low-income countries and South-East Asia. In low-income countries, rural areas had a 72% relative increase from 17.8% (Uncertainty Interval (UI): 5.2%–44.9%) in 2005 to 30.6% (11.7%–62.1%) in 2017, compared to a 29% relative increase in urban areas from 27.1% (8.7%–58.2%) in 2005 to 34.9% (13.3%–67.3%) in 2017. Despite these increases, the outcome was consistently highest in urban areas, wealthiest quintiles, and populations with the highest maternal education. Conclusion: These estimates suggest that the increasing reported antibiotic use for sick children aged <5 years in LMICs during 2005–2017 was driven by gains among groups often underserved by formal health services.

【 授权许可】

Unknown