Study finds high childhood antibiotic exposure in low-resource countries
A study this week in Clinical Infectious Diseases reveals high levels of childhood antibiotic exposure in low- and middle-income countries (LMICs).
For the study, Swiss and British researchers used the Demographic and Health Survey, which collects nationally representative household-level data on the health of women and children, to estimate the average number of antibiotic treatments received in the first 5 years of life in 45 LMICs. The 2-week point prevalence of fever, diarrhea, or cough and antibiotic treatment for these illnesses were estimated for ages 0 to 59 months and aggregated to estimate cumulative illness and antibiotic treatment for each country.
The researchers also estimated treatment rates and the contribution to total antibiotic use attributable to medical care, informal care, and self-medication.
The 45 countries contributed 438,140 child-observations. On average, 38.7% of children had experience illness in the 2 weeks before the survey, and 38.4% of children with illness received antibiotics, including 42.7% of febrile and 32.9% of non-febrile illnesses. Within countries, the proportion of sick children ranged from 10% in Niger to 72% in Jordan.
Across the 45 countries, the researchers estimate that children experienced an average of 50.6 illnesses over their first 5 years and received an average of 18.5 antibiotic treatments. The average number of antibiotic treatments ranged from 3.7 in Niger to 38.6 in the Republic of the Congo. A median of 68.7% of antibiotic treatments were attributable to medical care, 9% to informal care, and 16.9% to episodes for which no care was sought.
The study authors say a substantial proportion of the documented antibiotic use is likely inappropriate, and that the findings highlight the challenges in balancing access and excess antibiotic use in LMICs.
"Context-specific policies and tools to support appropriate empiric treatment and guideline adherence, limit inappropriate use, and stewardship programs that address health systems and informal drug sources are needed," they wrote. "Countries should consider care-seeking and community treatment practices to identify opportunities and ideal intervention points to support optimal antibiotic use."
Mar 23 Clin Infect Dis abstract
Imported Crimean Congo hemorrhagic fever case confirmed in UK
UK officials today reported an imported Crimean Congo hemorrhagic fever (CCHF) case involving a woman who had traveled to central Asia, according to a news release from the UK Health Security Agency (UKHSA).
The woman was diagnosed at Cambridge University Hospitals and is receiving specialty care at the Royal Free Hospital in London.
Hers is the country's third CCHF case, following imported cases in 2012 and 2014. CCHF is a viral disease typically transmitted by ticks and livestock in endemic nations. Its principal vectors are Hyalomma ticks.
Susan Hopkins, MB BCh, chief medical advisor at UKHSA, said in the release, "CCHF is usually spread by tick bites in countries where the disease is endemic; it does not spread easily between people, and the overall risk to the public is very low." She added that UK officials are contacting those who had close contact with the patient.
Mar 25 UKHSA news release
H9N2 avian flu infects 1 more person in China
China has reported one more H9N2 avian flu infection, in a young girl from Anhui province, Hong Kong's Centre for Health Protection (CHP) said in its latest avian influenza update.
The patient is a 2-year-old girl whose symptoms began on Jan 29. There were no other details, such as whether the patient had contact with poultry before she got sick.
Her illness is part of a small but steady stream of infections in China involving H9N2, a strain that is known to circulate in poultry in parts of Asia. Infections are most common in children, who often have mild disease.
Mar 22 CHP avian influenza update
Three countries report new polio cases
Niger, Nigeria, and Yemen reported a total of seven new polio cases this week, all involving circulating vaccine-derived poliovirus type 2 (cVDPV2), according to an update yesterday from the Global Polio Eradication Initiative (GPEI).
Niger confirmed 2 cVDPV2 cases whose onsets occurred last year, in Diffa and Tillabery regions, bringing its 2021 cVDPV2 total to 17. Nigeria's 2 cVDPV2 cases were in Niger and Nasarawa states, bringing its number of 2022 cases to 5. Nigeria recorded 415 cVDPV2 in 2021.
Yemen reported 3 new cVDPV2 cases, 1 each in Lahij, Marib, and Sa'dah governorates, bringing its number of 2022 cVDPV2 cases to 16. It has also recorded 3 cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) this year.
Mar 24 GPEI update