Sökning: WFRF:(White Emily) >
Antibiotic use amon...
Antibiotic use among children in low- and middle-income countries : Studies on global trends, and contextual determinants of antibiotic prescribing in Eastern Uganda
-
- Allwell-Brown, Gbemisola (författare)
- Uppsala universitet,Internationell barnhälsa och nutrition
-
- White Johansson, Emily, 1976- (preses)
- Uppsala universitet,Internationell barnhälsa och nutrition
-
- Mårtensson, Andreas, 1963- (preses)
- Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Internationell barnhälsa och nutrition
-
visa fler...
-
- Kitutu, Freddy (preses)
- Uppsala universitet,Internationell barnhälsa och nutrition
-
- Hussain-Alkhateeb, Laith, Dr. (preses)
- Gothenburg University
-
- Strömdahl, Susanne (preses)
- Uppsala universitet,Infektionsmedicin,Infektionssjukdomar
-
- English, Mike, Professor (opponent)
- University of Oxford
-
visa färre...
-
(creator_code:org_t)
- ISBN 9789151314662
- Uppsala : Acta Universitatis Upsaliensis, 2022
- Engelska 79 s.
-
Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 1830
- Relaterad länk:
-
https://uu.diva-port... (primary) (Raw object)
-
visa fler...
-
https://uu.diva-port... (Preview)
-
https://urn.kb.se/re...
-
visa färre...
Abstract
Ämnesord
Stäng
- This thesis aimed to systematically map trends in reported antibiotic use (RAU) among sick under-five children across low- and middle-income countries (LMICs) in 2005-2017, and, to understand the contextual determinants of antibiotic prescribing in Eastern Uganda. Based on 132 national surveys from 73 LMICs, and using Bayesian linear regression models, trends in RAU among sick under-five children (with symptoms of fever, diarrhoea or cough with fast/difficult breathing) across LMICs in 2005-2017 were mapped by WHO region, World Bank country income group, symptom complaint (Study-I), and by the following user characteristics: rural/urban residence, maternal education, household wealth and source of care (Study-II). To provide context, Study-III investigated patterns and contextual determinants of antibiotic prescribing for febrile under-five outpatients (FUO) attending 37 primary and secondary healthcare facilities across Bugisu, a sub-region in Eastern Uganda, based on a healthcare facility survey, and a two-year retrospective review of outpatient registers from January 2019-December 2020. To further strengthen the understanding of contextual determinants of antibiotic prescribing, in Study-IV, 10 focus group discussions and 10 in-depth interviews were conducted with 85 healthcare providers across primary and secondary healthcare facilities in Bugisu, and analysed using thematic analysis.A modest (17%) relative increase in RAU for sick under-five children across LMICs in 2005-2017 was found, with about 43% of the children reportedly receiving antibiotics for their illness in 2017. Low-income, African, and South-East Asian countries consistently recorded the lowest RAU for sick under-five children. Within LMICs, RAU for sick under-five children increased across all user groups in 2005-2017 but remained lowest among the poorest children, those living in rural areas, and having mothers with the lowest education levels. In Bugisu, 62.2% of FUO in surveyed healthcare facilities received antibiotic prescriptions. Amoxicillin and co-trimoxazole accounted for two-thirds of all antibiotic prescriptions. Cotrimoxazole and ampicillin/cloxacillin were prescribed, despite not being indicated in any of the reported conditions in Study-III. Among other interrelated factors across multiple levels of the health system, availability of antibiotics and diagnostics within healthcare facilities, caregiver demands, and governance at national and sub-national levels were important health worker considerations in antibiotic prescribing for febrile under-five patients.These studies suggest that inequitable access to antibiotics remains a challenge between and within LMICs. Yet, misuse and wastage of antibiotics persists in the same populations with the greatest lack of access to antibiotics and formal healthcare services. A health systems strengthening approach is required to improve antibiotic stewardship and overall quality of care in LMICs.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- antibiotic
- child
- low- and middle-income countries
- LMICs
- fever
- under-five
- Uganda
- primary healthcare
- health systems
- Social Medicine
- Socialmedicin
- International Health
- Internationell hälsa
- Epidemiologi
- Epidemiology
- Family Medicine
- Allmänmedicin
- Pediatrik
- Pediatrics
Publikations- och innehållstyp
- vet (ämneskategori)
- dok (ämneskategori)
Hitta via bibliotek
Till lärosätets databas