Drug Misuse in the Treatment of Diarrhea Among Children Under Five Years; a Sample from Baghdad


Abstract:Background: Diarrhea is a leading cause of childhood morbidity and mortality particularly in developing countries where an estimated five million deaths occur each year in children under five years of age. The unjustified use of medicines to treat simple episodes of diarrhea continues to divert attention, efforts and available resources away from appropriate treatment.Objective: The objective of this study is to figure out the extent of drug misuse in children under five years during an episode of diarrhea.Methods: A cross sectional study conducted in three major health facilities in Baghdad city (Child’s Central Teaching hospital, Children Welfare hospital and Al-Mansour training primary health care center). The data collection was done during the period from February through May 2012). A sample of 400 children (diagnosed by the pediatrician as having acute diarrheal diseases) was collected, with age ranging between (1-60 months) through a consecutive sampling technique. The mothers of children attending the outpatient departments of the health facilities were interviewed through a structured questionnaire that was developed based on relevant literatures.Results: Trimethoprim-sulfamethoxazole (TMP-SMX) was the most antimicrobial used in 39.75% followed by Metronidazole suspension 35.5% and gentamycin injection in 17.5% of the total. Duration of use of antimicrobials was 5 days or less in 73.5%, and more than 5 days in 26.5%. Anti –diarrheal drugs were used in 12.8% and anti emetics in 33.2% of the cases. The results also showed that oral rehydration solution (ORS) and Zinc tablets were not commonly used by the vast majority of mothers; where 15% of them use ORS and only 1.25% use zinc tablet. The prescription of medication was made by pharmacist in 34.5% of cases, nurses (23.75 %), relatives and friends (16%), private clinic doctors (15.5%) and PHCC (10.2%).Conclusion: Misuse of drugs in children with diarrhea is obvious. Illiterates and low educated mothers were more likely to use antimicrobials than highly educated mothers. Pharmacists were the major source of prescribing these drugs followed by nurses, relatives and friends. Key words: Drug misuse, children, diarrhea, Baghdad.