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Kounnavong S, Yan W, Sihavong A, Sychareun V, Eriksen J, Hanson C, Chaleunvong K, Keohavong B, Vongsouvath M, Mayxay M, Brauner A, Stålsby Lundborg C, Machowska A. Antibiotic knowledge, attitudes and reported practice during pregnancy and six months after birth: a follow- up study in Lao PDR. BMC Pregnancy Childbirth 2022; 22:701. [PMID: 36096811 PMCID: PMC9465860 DOI: 10.1186/s12884-022-05018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background Antibiotics are important medicines to prevent maternal and child morbidity and mortality. Women’s knowledge and attitudes towards antibiotic use influence their practice. When they become mothers, this may be mirrored in the use of antibiotics for their newborn children. The current study aimed to assess knowledge, attitudes, and reported practice of pregnant women regarding antibiotic use and antibiotic resistance as well as their approach towards antibiotic use for their newborn babies. Methods This was a follow-up study with data collected via structured interviews between September 2019 and August 2020 in Feuang (rural) and Vangvieng (urban) districts in Vientiane province, Lao PDR. We identified and invited all women attending antenatal care in their third trimester of pregnancy in the selected areas. Using a structured questionnaire at third trimester of pregnancy we captured data on knowledge regarding antibiotic use and resistance. We collected information on attitudes and reported practice at two time points: (i) at third trimester of pregnancy and (ii) 6 months after birth. Univariate analysis and frequency distributions were used to study pattern of responses. Chi-square and Mann-Whitney tests were used to compare categorical and continuous variables respectively. P value < 0.05 was considered statistically significant. Results We surveyed 539 women with a mean age of 25 years. Two oral antibiotics, i) ampicillin and ii) amoxicillin were correctly identified by 68 and 47% of participants respectively. Only 24% of women (19% in Feuang and 29% in Vangvieng) answered correctly that antibiotics are effective against bacterial infections. The most prevalent response was “I don’t know” suggesting the questions were challenging. Significantly less women would use antibiotics from a previous illness for their child than for themselves (16% vs 29%), however they would be more willing to use antibiotics for their baby even in case of mild symptoms (29% vs 17% while pregnant). The majority of antibiotics were prescribed by healthcare providers and 46% of children with the common cold received antibiotics. Conclusions Women’s knowledge was sub-optimal, still, they manifested appropriate attitudes towards antibiotic use during pregnancy and for their child. Nearly half of children received antibiotics for the common cold. There is a need for context adapted programs aiming at improving women’s knowledge, as well as healthcare providers, emphasising rational antibiotic prescribing during pregnancy and for children.
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Affiliation(s)
- Sengchanh Kounnavong
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR
| | - Weirong Yan
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Amphoy Sihavong
- Vientiane Capital Health Department, Ministry of Health, Vientiane, Lao PDR
| | | | - Jaran Eriksen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases/Venhalsan, Stockholm South General Hospital, Stockholm, Sweden
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Kongmany Chaleunvong
- Institute of Research and Education Development, University of Health Sciences, Vientiane, Lao PDR
| | | | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Welcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Welcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Institute of Research and Education Development, UHS, Ministry of Health, Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Annelie Brauner
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Division of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Anna Machowska
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
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Nyande FK, Ricks E, Williams M, Jardien-Baboo S. Socio-cultural barriers to the delivery and utilisation of child healthcare services in rural Ghana: a qualitative study. BMC Health Serv Res 2022; 22:289. [PMID: 35241071 PMCID: PMC8892726 DOI: 10.1186/s12913-022-07660-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/18/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Over half of global deaths among children under five years of age occur in sub-Saharan Africa. Prompt and consistent access to and utilisation of child healthcare services improves child health outcomes. However, socio-cultural barriers impede the utilisation of child healthcare services among rural dwellers in Ghana. There is a paucity of studies that explore the experiences of nurses and caregivers regarding the socio-cultural barriers to the delivery and utilisation of child healthcare services in rural areas in Ghana such as the Nkwanta South Municipality. PURPOSE The purpose of this study was to explore the experiences of nurses and caregivers regarding the socio-cultural barriers that impede the delivery and utilisation of child healthcare services by caregivers for their children in the Nkwanta South Municipality, Ghana. METHODS Data were collected through semi-structured interviews conducted with a purposive sample of ten nurses and nine caregivers of children under five years of age who utilised the available child healthcare services in a rural setting. The consent of all participants was sought and given before interviews were conducted. Data analysis entailed coding and the generation of themes the codes. RESULTS The exploration of experiences of nurses and caregivers of children under-five years of age revealed that certain socio-cultural beliefs and practices, language barriers and reliance of caregivers on self-medication were the main socio-cultural barriers that impeded the delivery and utilisation of child healthcare services in the Nkwanta South Municipality. CONCLUSION Nurses and caregivers experienced several socio-cultural barriers which either delayed care seeking by caregivers for their sick children or interfered with the smooth and prompt delivery of needed child healthcare services by nurses. Some of the barriers negatively affected the interaction between nurses and caregivers with the tendency to affect subsequent child healthcare service utilisation. It is recommended that healthcare managers and nurses should foster close collaboration with caregivers and community leaders to address these socio-cultural barriers and facilitate prompt and consistent utilisation of child healthcare service in rural areas.
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Affiliation(s)
- Felix Kwasi Nyande
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
- Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa.
| | - Esmeralda Ricks
- Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Margaret Williams
- Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Sihaam Jardien-Baboo
- Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
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Pham-Duc P, Sriparamananthan K. Exploring gender differences in knowledge and practices related to antibiotic use in Southeast Asia: A scoping review. PLoS One 2021; 16:e0259069. [PMID: 34699559 PMCID: PMC8547692 DOI: 10.1371/journal.pone.0259069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022] Open
Abstract
Inappropriate use of antibiotics has been one of the main contributors to antimicrobial resistance, particularly in Southeast Asia. Different genders are prone to different antibiotic use practices. The objective of this scoping review is to understand the extent and type of evidence available on gender differences in antibiotic use across Southeast Asia. The search strategy for this scoping review involved PubMed, Semantic Scholar, BioMed Central and ProQuest. Two-level screening was applied to identify the final sample of relevant sources. Thematic content analysis was then conducted on the selected final sources to identify recurring themes related to gender differences in antibiotic use and a narrative account was developed based on the themes. Recommendations for next steps regarding reducing inappropriate antibiotic use and gender considerations that need to be made when developing future interventions were also identified. Research on gender and antibiotic use remains scarce. Studies that discuss gender within the context of antibiotic use often mention differences between males and females in knowledge, attitudes and/or behaviour, however, do not explore reasons for these differences. Gender differences in antibiotic use were generally examined in terms of: (i) knowledge of antibiotic use and antimicrobial resistance and (ii) practices related to antibiotic use. Evidence indicated that differences between males and females in knowledge and practices of antibiotic use varied greatly based on setting. This indicates that gender differences in antibiotic use are greatly contextual and intersect with other sociodemographic factors, particularly education and socioeconomic status. Educational interventions that are targeted to meet the specific needs of males and females and delivered through pharmacists and healthcare professionals were the most common recommendations for reducing inappropriate use of antibiotics in the community. Such targeted interventions require further qualitative research on factors influencing differences in knowledge and practices related to antibiotic use among males and females. In addition, there is also a need to strengthen monitoring and regulation practices to ensure accessibility to affordable, quality antibiotics through trusted sources.
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Affiliation(s)
- Phuc Pham-Duc
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi, Vietnam.,Institute of Environmental Health and Sustainable Development, Hanoi, Vietnam
| | - Kavitha Sriparamananthan
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi, Vietnam.,Institute of Environmental Health and Sustainable Development, Hanoi, Vietnam.,Veterinarians Without Borders/ Vétérinaires Sans Frontières, Ottawa, Ontario, Canada
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Rakhmani AN, Arisanti N, Dhamayanti M, Wiwaha G, Mutyara K, Setiawati EP. A Qualitative Study on Family Role in the Care and Prevention of Acute Respiratory Infection Among Children in Primary Health Care. Glob Pediatr Health 2020; 7:2333794X20969273. [PMID: 33241081 PMCID: PMC7672729 DOI: 10.1177/2333794x20969273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 08/30/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
Background. Acute Respiratory Infection (ARI) is a common reason that parents seek help to primary health care. In 2016, almost 65% (64.4%) pneumonia and less than 36% (35.6%) non-pneumonia cases were found among the children in Malang. Members of families have important roles to play in individual's health, especially the children. The aim of this study was to explore the roles of family members in the care and prevention of children with ARI. Method. This was a qualitative study, with a phenomenological approach involving 12 informants. An in-depth interview was conducted on each informant having children with recurrent ARI during a space of 3 months in the primary health care. Information collected from the interviews were transcribed and analyzed into different themes. Results. The 4 themes identified include ARI in children, parent roles, influences of family members, and family problems. Different styles of parenting were established between the fathers and mothers also between the mothers and grandmothers on preventing ARI. The behavior of other family members impact both on the risk and prevention of ARI. Some of the identified problems capable of affecting children's health include inability to control the children, unstable income and the stressed condition of most mothers. Conclusion. Behavior of family members impacts on the prevention of ARI among the children. Problems within the family could affect the mothers' or caregivers' psychology, which might in turn impact on the care given to the children infected with ARI or in preventing it.
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Affiliation(s)
- Alidha Nur Rakhmani
- Universitas Brawijaya, Malang, Jawa Timur, Indonesia.,Primary Care Medicine Residency Program, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Nita Arisanti
- Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia
| | | | - Guswan Wiwaha
- Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia
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Sato M, Oshitani H, Tamaki R, Oyamada N, Sato K, Nadra AR, Landicho J, Alday PP, Lupisan SP, Tallo VL. Factors affecting mothers' intentions to visit healthcare facilities before hospitalisation of children with pneumonia in Biliran province, Philippines: a qualitative study. BMJ Open 2020; 10:e036261. [PMID: 32847907 PMCID: PMC7451295 DOI: 10.1136/bmjopen-2019-036261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Despite a substantial reduction in the mortality rate of children under 5 years in the past 25 years, pneumonia remains the single-largest infectious cause of child deaths worldwide. This study explored the chronological order of visited healthcare facilities and practitioners, and the factors affecting mothers' intention to seek care before the hospitalisation of children with pneumonia. METHODS AND ANALYSIS A qualitative research design was employed using theory of planned behaviour as a framework for the analysis. Using purposive sampling technique, 11 mothers, whose children under 5 years old were hospitalised with severe pneumonia, were recruited for individual semi-structured interviews. Their socio-demographic information was analysed using descriptive statistics. RESULTS Mothers brought their sick children to multiple facilities, and 1 to 19 days had passed before hospitalisation. We identified four major factors determining mothers' intentions: (1) doing something useful for the sick child, (2) expecting the child to receive the necessary assessment and treatment, (3) accepting advice to visit a healthcare facility and be referred to a hospital and (4) considering issues and benefits associated with hospitalisation. Mothers noticed their children's unusual symptoms and monitored them while applying home remedies. They also took their children to traditional healers despite knowing that the treatments were not necessarily effective. Mothers expected children to be checked by health professionals and listened to advice from family members regarding the facilities to visit, and from healthcare staff to be referred to a hospital. Financial issues and the double burden of housework and caring for the hospitalised child were mothers' major concerns about hospitalisation. CONCLUSION Children were hospitalised after several days because they visited multiple healthcare facilities, including traditional healers. Improving care quality at healthcare facilities and reducing financial and mothers' burden may reduce the hospitalisation delay for children with pneumonia.
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Affiliation(s)
- Mari Sato
- Department of Virology, Tohoku University, Sendai, Miyagi, Japan
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University, Sendai, Miyagi, Japan
| | - Raita Tamaki
- Japan International Cooperation Agency, Nairobi, Kenya
| | - Nobuko Oyamada
- Department of Maternal Nursing, Tohoku University, Sendai, Miyagi, Japan
| | - Kineko Sato
- Department of Maternal Nursing, Tohoku University, Sendai, Miyagi, Japan
| | | | - Jhoys Landicho
- Epidemiology and Biostatics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Portia P Alday
- Epidemiology and Biostatics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Socorro P Lupisan
- Epidemiology and Biostatics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Veronica L Tallo
- Epidemiology and Biostatics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
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