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Rational use of antibiotics by community health workers and caregivers for children with suspected pneumonia in Zambia: a cross-sectional mixed methods study

Overview of attention for article published in BMC Public Health, August 2016
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About this Attention Score

  • Good Attention Score compared to outputs of the same age (69th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (55th percentile)

Mentioned by

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5 tweeters
facebook
1 Facebook page

Citations

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18 Dimensions

Readers on

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159 Mendeley
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Title
Rational use of antibiotics by community health workers and caregivers for children with suspected pneumonia in Zambia: a cross-sectional mixed methods study
Published in
BMC Public Health, August 2016
DOI 10.1186/s12889-016-3541-8
Pubmed ID
Authors

Kirstie Graham, Chomba Sinyangwe, Sarala Nicholas, Rebecca King, Samuel Mukupa, Karin Källander, Helen Counihan, Mark Montague, James Tibenderana, Prudence Hamade

Abstract

Antibiotic resistance is an issue of growing global concern. One key strategy to minimise further development of resistance is the rational use of antibiotics, by providers and patients alike. Through integrated community case management (iCCM), children diagnosed with suspected pneumonia are treated with antibiotics; one component of an essential package to reduce child mortality and increase access to health care for remote populations. Through the use of clinical algorithms, supportive supervision and training, iCCM also offers the opportunity to improve the rational use of antibiotics and limit the spread of resistance in resource-poor contexts. This study provides evidence on antibiotic use by community health workers (CHWs) and caregivers to inform iCCM programmes, safeguarding current treatments whilst maximising access to care. 1497 CHW consultations were directly observed by non-clinical researchers, with measurement of respiratory rate by CHWs recorded by video. Videos were used to conduct a retrospective reference standard assessment of respiratory rate by experts. Fifty-five caregivers whose children were prescribed a 5-day course of antibiotics for suspected pneumonia were followed up on day six to assess adherence through structured interviews and pill counts. Six focus group discussions and nine in depth interviews were conducted with CHWs and caregivers to supplement quantitative findings. The findings indicate that CHWs adhered to treatment guidelines for 92 % of children seen, prescribing treatment corresponding to their assessment. However, only 65 % of antibiotics prescribed were given for children with experts' confirmed fast breathing pneumonia. Qualitative data indicates that CHWs have a good understanding of pneumonia diagnosis, and although caregivers sometimes applied pressure to receive drugs, CHWs stated that treatment decisions were not influenced. 46 % of caregivers were fully adherent and gave their child the full 5-day course of dispersible amoxicillin. If caregivers who gave treatment for 3 to 5 days were considered, adherence increased to 76 %. CHWs are capable of prescribing treatment corresponding to their assessment of respiratory rate. However, rational use of antibiotics could be strengthened through improved respiratory rate assessment, and better diagnostic tools. Furthermore, a shorter course of dispersible amoxicillin could potentially improve caregiver adherence, reducing risk of resistance and cost.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 159 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
United States 1 <1%
Unknown 157 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 29 18%
Student > Bachelor 26 16%
Researcher 23 14%
Student > Ph. D. Student 13 8%
Student > Postgraduate 7 4%
Other 28 18%
Unknown 33 21%
Readers by discipline Count As %
Medicine and Dentistry 45 28%
Nursing and Health Professions 20 13%
Social Sciences 12 8%
Pharmacology, Toxicology and Pharmaceutical Science 12 8%
Agricultural and Biological Sciences 8 5%
Other 24 15%
Unknown 38 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 November 2016.
All research outputs
#3,721,215
of 13,698,348 outputs
Outputs from BMC Public Health
#4,110
of 9,428 outputs
Outputs of similar age
#78,351
of 261,895 outputs
Outputs of similar age from BMC Public Health
#8
of 18 outputs
Altmetric has tracked 13,698,348 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 9,428 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.1. This one has gotten more attention than average, scoring higher than 56% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 261,895 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 18 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.