ArticleNPJ primary care respiratory medicine2018
Recurrent lower respiratory illnesses among young children in rural Kyrgyzstan: overuse of antibiotics and possible under-diagnosis of asthma. A qualitative FRESH AIR study.
Article in NPJ primary care respiratory medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 16 citations in OpenAlex.
- Improving asthma case detection among children and adolescents through clinic-based screening in primary care health facilities in Uganda: a cluster randomised trial.BMJ open respiratory research · 2026Trial
- Childhood asthma in Uganda: experiences of healthcare providers and caregivers in diagnosis and management. A FRESH AIR qualitative study.NPJ primary care respiratory medicine · 2026Article
- Microbiological aetiology of paediatric respiratory tract infections in Kyrgyzstan.BMC infectious diseases · 2025Article
- Influences on use of antibiotics without prescription by the public in low- and middle-income countries: a systematic review and synthesis of qualitative evidence.JAC-antimicrobial resistance · 2024Review
- The Feasibility of C-Reactive Protein Point-of-Care Testing to Reduce Overuse of Antibiotics in Children with Acute Respiratory Tract Infections in Rural Kyrgyzstan: A Pilot Study.Pediatric health, medicine and therapeutics · 2024Article
- The effect of immunomodulatory therapy with recombinant human interferon alpha-2β on blood cytokine levels in children with recurrent episodes of acute obstructive bronchitis.Clinical and experimental immunology · 2023Article
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
- Evaluation of rational prescribing in paediatrics.BMJ paediatrics open · 2021Article
- No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study.BMC health services research · 2020Article
- Systematic scoping review protocol of methodologies of chronic respiratory disease surveys in low/middle-income countries.NPJ primary care respiratory medicine · 2019Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Lower respiratory tract illnesses (LRT-illnesses) in children under 5 years (U5s) are a leading cause of morbidity, hospitalisations and mortality worldwide, particularly in low-income countries. It is pertinent to understand possible inconsistent management. This study explored perceptions and practices among caregivers and health professionals on recurrent LRT-illnesses in U5s. Semi-structured interviews with 13 caregivers to U5s with recurrent LRT-illnesses and with 22 primary care health professional interviews in two rural provinces in Kyrgyzstan were triangulated. Data were thematically analysed. The majority (8/13) of caregivers described their young children as having recurrent coughing, noisy breathing and respiratory distress of whom several had responded positively to acute salbutamol and/or had been repeatedly hospitalised for LRT-illness. Family stress and financial burdens were significant. The health professionals classified young children with recurrent LRT-illnesses primarily with pneumonia and/or a multitude of bronchitis diagnoses. Broad-spectrum antibiotics and supportive medicine were used repeatedly, prescribed by health professionals or purchased un-prescribed by the caregivers at the pharmacy. The health professionals had never applied the asthma diagnosis to U5s nor had they prescribed inhaled steroids, and none of the interviewed caregivers' U5s were diagnosed with asthma. Health professionals and caregivers shared a common concern for the children's recurrent respiratory illnesses developing into a severe chronic pulmonary condition, including asthma. In conclusion, the study identified an inconsistent management of LRT-illnesses in U5s, with exorbitant use of antibiotics and an apparently systemic under-diagnosis of asthma/wheeze. When the diagnosis asthma is not used, the illness is not considered as a long-term condition, requiring preventer/controller medication.
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