Management of Acute Respiratory Infections in Children under Five by Self-medication and Prescription of Antibiotics in Bukavu

Abstract

Acute respiratory infections (ARI) are one of the top 10 killer diseases in children. In developing countries, the treatment is often initiated by self-medication (SM) before going to the hospital in case of a complication. This study assessed the level of self-medication and the adequacy of hospital prescribing patterns of antibiotics for the management of acute respiratory infections in children under five. It was a cross-sectional survey conducted in 2018, including a face-to-face interview with 227 children’s mothers for self-medication and a review of 1162 medical files available at the pediatrics wards of Panzi General Hospital and University Clinic in Bukavu.  Of 227 mothers interviewed, 168(74%) self-medicated children with six antibiotics, mainly amoxicillin (67%), and Cotrimoxazole (60%), principally to avoid medical consultation fees and to mitigate the early signs of the disease. However, among them, 49.8% rushed to the hospital after a complication. Of the 1162 medical files reviewed, 248(21.34%) are ARI cases of which 53% males and 47% females. Under 2 years constitute 85%. Dominant ARIs were acute pharyngitis (19.1%), acute otitis media (15.3%), bronchial superinfection (23.3%), and pneumonia (16.3%). The mortality rate attributable to ARIs was 17.5% (14/80). The antibiotics used in hospital include gentamicin (67%) in combination with cefotaxime, ampicillin, and azithromycin. The unprofessional dispensing of antibiotics in community pharmacies encouraged the high level of self-medication.