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Global child health
Antibiotics in non-bloody diarrhoea
Managing infectious diarrhoea is essentially uncomplicated. In only a small proportion of children, those with bloody diarrhoea (shigella, cholera amoebiasis) and associated toxicity or sepsis are antibiotics indicated. In other situations, they can prolong the illness and complicate recovery. We know the practice continues, but to date, there has been little data on its extent which is why Auta’s meta-analysis of routinely available Demographic Health Survey (DHS) data from a number of Sub Saharan African Countries is so welcome. Using a random effects model to allow for intercountry heterogeneity, they estimated that 23.1% (95% CI 19.5% to 26.7%) of children under 5 years old with non-bloody diarrhoea were prescribed antibiotics. Family wealth and higher maternal education was associated with higher rates of antibiotic treatment and, in broad terms, children in western Africa were more likely to be treated than those in the East, differences that probably reflect long standing parental expectation and medical practices. See page 518.
Acute lymphoblastic leukaemia: treatment completion in China
Until 2003, most children with ALL in China either failed to start or abandoned treatment, financial restrictions being the the most common reason. That year marked …
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