ArticlePneumonia (Nathan Qld.)2016
Non-adherence to community oral-antibiotic treatment in children with fast-breathing pneumonia in Malawi- secondary analysis of a prospective cohort study.
Article in Pneumonia (Nathan Qld.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Trial
- Amoxicillin for 3 or 5 Days for Chest-Indrawing Pneumonia in Malawian Children.The New England journal of medicine · 2020Trial
- Community-acquired pneumonia in Indonesian children: insights into diagnosis, treatment compliance, and healthcare provider challenges.Archives of public health = Archives belges de sante publique · 2025Article
- Article
- Compliance to antibiotic therapy at paediatric out-patient clinic.Journal of family medicine and primary care · 2022Article
- 2021 Update on Pediatric Overuse.Pediatrics · 2022Review
- Antibiotics non-adherence and its associated factors among households in southern Ethiopia.SAGE open medicine · 2022Article
- Adherence to oral amoxicillin dispersible tablets in children with community-acquired pneumonia enrolled in clinical trials in Malawi.Pneumonia (Nathan Qld.) · 2021Article
- Article
- Non-adherence to oral antibiotics for community paediatric pneumonia treatment in Malawi - A qualitative investigation.PloS one · 2018Article
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7 authors.
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Abstract
backgroundDespite significant progress, pneumonia is still the leading cause of infectious deaths in children under five years of age. Poor adherence to antibiotics has been associated with treatment failure in World Health Organisation (WHO) defined clinical pneumonia; therefore, improving adherence could improve outcomes in children with fast-breathing pneumonia. We examined clinical factors that may affect adherence to oral antibiotics in children in the community setting in Malawi.
methodsWe conducted a sub-analysis of a prospective cohort of children aged 2-59 months diagnosed by community health workers (CHW) in rural Malawi with WHO fast-breathing pneumonia. Clinical factors identified during CHW diagnosis were investigated using multivariate logistic regression for association with non-adherence, including concurrent diagnoses and treatments. Adherence was measured at both 80% and 100% completion of prescribed oral antibiotics.
resultsEight hundred thirty-four children were included in our analysis, of which 9.5% and 20.0% were non-adherent at 80% and 100% of treatment completion, respectively. A concurrent infectious diagnosis (OR: 1.76, 95% CI: 0.84-2.96/OR: 1.81, 95% CI: 1.21-2.71) and an illness duration of >24 h prior to diagnosis (OR: 2.14, 95% CI: 1.27-3.60/OR: 1.88, 95% CI: 1.29-2.73) had higher odds of non-adherence when measured at both 80% and 100%. Older age was associated with lower odds of non-adherence when measured at 80% (OR: 0.41, 95% CI: 0.21-0.78).
conclusionNon-adherence to oral antibiotics was not uncommon in this rural sub-Saharan African setting. As multiple diagnoses by the CHW and longer illness were important factors, this provides an opportunity for further investigation into targeted interventions and refinement of referral guidelines at the community level. Further research into the behavioural drivers of non-adherence within this setting is needed.
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