Pattern of antibiotics use and health seeking behavior among low income urban under five children in Bangladesh

Abstract

Background: Access to affordable health care is limited in low income settings. Inappropriate use of antibiotics, both overuse & underuse can influence several factors related to child health and overall development. The objective of the study was to explore the pattern of antibiotics use and health-seeking behavior among low income under five urban children in Bangladesh. Methods and materials: During February 2018 to April 2019, the study conducted a cross sectional study among 516 low income urban under five children's’ parents in Bangladesh. We used a semi structured questionnaire to collect information related to pattern of antibiotics use and health seeking behaviors among the low income urban community. The bi-variate and multivariate analysis was done to see the associated risk factor of antibiotics use and health seeking behaviors among the mothers of <5 children. Results: The majority (437/516) of the respondents were female. One-third of them had no formal education and 64% had only 5 years of education. Around one-fourth of children frequently or always suffered from some kind of illness. Common illness among low-income under-five children was identified as cold and fever (73%) diarrhea (22%), loss of appetite (31%). The study also identified that one third (168/516) of the children were suffering from severe malnutrition. More than half of the respondents (52%) first health care center is local drug store where they go and tell about the health problem and get medicine. Though, the majority (89%) of the drug sellers in Bangladesh do not have formal medical education. More than half (56%) of the respondents acquired from the local pharmacy and 45% (237/516) of antibiotics were obtained from local drug sellers without a prescription by a qualified physician. Irrational use of antibiotics found a significant association with the educational background (p = 0.004), social-economic condition (p = 0.03) and treatment dependency (p = 0.05) at the local drug store. Conclusion: More hospital and community clinic is required to provide basic health services to low-income urban population. Policy implementation is necessary to stop unnecessary and irrational use of antibiotics in Bangladesh.