Antibiotics Use and Its Knowledge in the Community: A Mobile Phone Survey during the COVID-19 Pandemic in Bangladesh

The general population has been excessively using antibiotics during the COVID-19 pandemic. Therefore, the use of antibiotics for any reported illnesses in the preceding four weeks and knowledge of antibiotics among the general population in the community were assessed for possible interventions. A mobile phone survey among a general population across eight administrative divisions of Bangladesh was conducted during January–March 2021. Reported illness episodes irrespective of COVID-19 in the preceding four weeks of the interview, use of antibiotics for the illnesses, and knowledge on antibiotics among the general population were recorded. Descriptive analyses were performed. We randomly interviewed 1854 participants, with a mean age of 28.5 years (range: 18–75 years); 60.6% were male. Among all participants, 86.3% (95% CI: 84.7–87.8) heard names of antibiotics, but only 12.1% reported unspecified harmful effects, and 3.5% reported antimicrobial resistance when antibiotics were taken without a physician’s prescription. Among 257 (13.9%) participants, who consumed medicines for their recent illness episode, 32.7% (95% CI: 27.2–38.6) reported using antibiotics. Of those who could recall the names of antibiotics prescribed (n = 36), the most frequently used was azithromycin (22.2%) followed by cefixime (11.1%) and ciprofloxacin (5.6%). Our findings show an increased antibiotic use for illnesses reported in the preceding four weeks and an elevated knowledge at the community level during the COVID-19 pandemic compared with the pre-pandemic period.

Can PIMS-TS lead to a facial nerve palsy?

Paediatric inflammatory multisystem syndrome—temporally associated with SARS-CoV-2 (PIMS-TS) is a recently described syndrome. We describe the case of a 17-year-old man presenting with a recent illness consistent with COVID-19 who presented with fever, chest pain and anterior uveitis. He was treated with aspirin, pulsed methylprednisolone and tocilizumab followed by oral steroids. On day 16 from initial presentation, he developed a facial nerve palsy. He was managed with ongoing steroids and the addition of valaciclovir. PIMS-TS is an under-recognised condition among adult physicians and may not be well known in adult neurology. It is important for adult physicians and neurologists to be aware of PIMS-TS and its possible sequelae.

Undernutrition among Institutionalized School-age Orphans in Harari Regional State, Eastern Ethiopia: A Cross-sectional Study

Background: Although orphans are at increased risk of undernutrition, studies assessing prevalence of undernutrition are limited to orphans residing with their relatives or on street. This study was conducted to assess magnitude of undernutrition and its associated factors among institutionalized school-age orphans in Harari Regional State, eastern Ethiopia. Methods: An institution based cross-sectional study was conducted among all school-age (6-12 years) orphans living in all orphan centers in Harari Regional State, eastern Ethiopia. Data were collected by using a structured pretested questionnaire supplemented with anthropometric measurements. Data were entered using EpiData 3.1 and analyzed using SPSS 22. Logistic regression models were fitted to identify factors associated with undernutrition. Statistical significance was declared at P-value <.05. Results: A total of 265 orphans residing in all orphan centers in the region were included. The prevalence of stunting, wasting, and underweight were 15.8% (95% CI: 11.9, 20.7), 10.9% (95% CI: 7.7, 15.3), and 8.7% (95% CI: 4.3, 10.5), respectively. Staying in orphan center for 6 to 10 years (AOR = 6.2; 95% CI: 2.6, 15.10), having recent illness (AOR = 3.9; 95% CI: 1.4, 10.4), and being aged 10 to 12 years (AOR = 11.2; 95% CI: 3.5, 35.4) were significantly associated with stunting whereas having recent illness (AOR = 4.3; 95% CI: 1.4, 7.3) and being aged 6 to 7 years (AOR: 10.4; 95% CI: 3.2, 33.6) were significantly associated with wasting. Underweight was more likely (AOR: 8.9; 95% CI: 2.7, 29.5) among children with recent illness. Conclusions: Almost 1 in 6, 1 in 9, and 1 in 11 institutionalized school-age orphans in Harari Regional State were stunted, wasted, and underweight respectively. Younger children and those with recent illness were more likely to be undernourished. Underlying reasons for undernutrition among orphans being cared in orphan centers should be further explored.

Determinants of growth measurements in rural Cambodian infants: a cross-sectional study

Background Inappropriate feeding and hygiene practices and poor environment are associated with malnutrition. We aimed to investigate the contributions of feeding, hygiene practices and recent illness to the nutritional status of rural Cambodian infants and any sex-specific differences. Methods In a cross-sectional study, nested within an ongoing birth cohort, trained fieldworkers conducted anthropometry and collected information from the main caregiver during home visits. Multivariable linear regression was used to investigate associations with nutritional status as length-for-age z-scores (LAZ) and weight-for-length z-scores (WLZ). Results A total of 156 children, 87 (55.8%) male, ages 0–11 months were enrolled. The prevalence of acute malnutrition (WLZ &lt;−2) in males and females was 2.3% (2/87) and 5.8% (4/69), respectively, and 23.0% (20/87) of males and 14.5% (10/69) of females were stunted (LAZ &lt;−2). WLZ but not LAZ decreased with age. WLZ was independently negatively associated with increasing age (β-coefficient −0.14 [95% confidence interval {CI} −0.20 to −0.08], p&lt;0.001), and regular use of feeding bottles (β-coefficient −0.46 [95% CI −0.83 to −0.10], p=0.014), and positively with handwashing with soap (β-coefficient 0.40 [95% CI 0.05 to 0.75), p=0.027). Conclusions The prevalence of acute malnutrition was low, but stunting was prevalent without evidence of a sex difference. Non-linear growth faltering was associated with increasing age and hygiene/feeding practices.

Who’s Listening? Predictors of Concern about COVID-19 and Preventative Health Behaviors

BACKGROUND: The coronavirus disease 2019 (COVID-19) has spread rapidly across the globe. Based on recommendations from health organizations, many individuals have made significant changes to their daily lives to prevent the spread of the disease. OBJECTIVE/METHOD: This study sought to identify demographic and psychosocial factors associated with concern about COVID-19 and engagement in preventative health behaviors suggested to reduce the transmission of COVID-19 (social distancing, handwashing, cleaning/disinfecting, avoiding touching face, and wearing facemasks). From March 20 to 23, 2020, a US national sample (N=1019) completed an online survey. RESULTS: Recent illness, religiosity, germ aversion, and pathogen disgust sensitivity were the most consistent predictors of COVID-19 concern and preventative health behaviors. CONCLUSION: Findings have implications for the development of interventions intended to increase preventative health behaviors.

Prevalence, patterns and predictors of self-medication with anti-malarial drugs among Cameroonian mothers during a recent illness episode

Artemisinin-based combination therapies (ACTs) are recommended as treatment of choice for malaria. Although the resistance to artemisinin and its derivatives has not yet been officially reported in Africa, there is growing concern that it may reach the continent. Self-medication is common among African populations and may explained drug resistance. Unfortunately, a few studies have addressed this issue in Cameroon. This study seeks to appraise the prevalence, patterns and predictors of antimalarial self-medication. A household-based cross-sectional study was conducted in 2016 in the town of Douala. Interviews and pretested semi-structured questionnaires were administered for collecting information from 213 mothers of under-fives. The prevalence of self-medication was 49.30%. The main reasons were “habit” (38.75%), “Lack of money” (22.48%) and “Lightness of symptoms” (13.18 %). Pharmacy (47.80%) and street medicine stores (30.19%) were the commonest drug providers. Nearly 20% of women had not respected posology although treatment was right and taken promptly. Age, level of education and curiosity on treatment were risk factors of self-medication. Our study confirms that malaria self-medication is common among women and the influence of some factors. Hence, strategies for information, education and communication should be scaled up to efficiently address self-medication in the area.Journal of Medical and Biomedical Sciences (2018) 7(1), 29 - 39

The Impact of Recurrent Clostridium difficile Infection on Patients’ Prevention Behaviors

OBJECTIVETo determine the impact of recurrent Clostridium difficile infection (RCDI) on patient behaviors following illness.METHODSUsing a computer algorithm, we searched the electronic medical records of 7 Chicago-area hospitals to identify patients with RCDI (2 episodes of CDI within 15 to 56 days of each other). RCDI was validated by medical record review. Patients were asked to complete a telephone survey. The survey included questions regarding general health, social isolation, symptom severity, emotional distress, and prevention behaviors.RESULTSIn total, 119 patients completed the survey (32%). On average, respondents were 57.4 years old (standard deviation, 16.8); 57% were white, and ~50% reported hospitalization for CDI. At the time of their most recent illness, patients rated their diarrhea as high severity (58.5%) and their exhaustion as extreme (30.7%). Respondents indicated that they were very worried about getting sick again (41.5%) and about infecting others (31%). Almost 50% said that they have washed their hands more frequently (47%) and have increased their use of soap and water (45%) since their illness. Some of these patients (22%–32%) reported eating out less, avoiding certain medications and public areas, and increasing probiotic use. Most behavioral changes were unrelated to disease severity.CONCLUSIONHaving had RCDI appears to increase prevention-related behaviors in some patients. While some behaviors are appropriate (eg, handwashing), others are not supported by evidence of decreased risk and may negatively impact patient quality of life. Providers should discuss appropriate prevention behaviors with their patients and should clarify that other behaviors (eg, eating out less) will not affect their risk of future illness.Infect Control Hosp Epidemiol. 2017;38:1351–1357