ArticlePloS one2018
Non-adherence to oral antibiotics for community paediatric pneumonia treatment in Malawi - A qualitative investigation.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Disruptions to safety and adaptations experienced by parents and caregivers who administered prescribed medicines to children at home: a systematic review using a framework synthesis.Frontiers in health services · 2026Pooled it
- Should my child be given antibiotics? A systematic review of parental decision making in rural and remote locations.Antimicrobial resistance and infection control · 2024Pooled it
- Amoxicillin for 3 or 5 Days for Chest-Indrawing Pneumonia in Malawian Children.The New England journal of medicine · 2020Trial
- Health care worker-reported barriers and potential facilitators of acute lower respiratory infection care deliver for children at Mchinji District Hospital in Malawi.IJID regions · 2026Article
- Taste Sensor Assessment of Bitterness in Medicines: Overview and Recent Topics.Sensors (Basel, Switzerland) · 2024Review
- 2021 Update on Pediatric Overuse.Pediatrics · 2022Review
- Adherence to oral amoxicillin dispersible tablets in children with community-acquired pneumonia enrolled in clinical trials in Malawi.Pneumonia (Nathan Qld.) · 2021Article
- Antibiotics for paediatric community-acquired pneumonia in resource-constrained settings.The European respiratory journal · 2020Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPneumonia remains the leading cause of paediatric infectious mortality globally. Treatment failure, which can result from non-adherence to oral antibiotics, can lead to poor outcomes and therefore improving adherence could be a strategy to reduce pneumonia related morbidity and mortality. However, there is little published evidence from low-resource settings for the drivers of non-adherence to oral antibiotics in children.
objectiveWe aimed to investigate reasons for adherence and non-adherence in children diagnosed and treated in the community with fast-breathing pneumonia in rural Malawi.
methodsWe conducted focus group discussions (FGDs) with caregivers of children known to have been diagnosed and treated with oral antibiotics for fast-breathing pneumonia in the community and key informant interviews with community healthcare workers (CHW). FGDs and interviews were conducted within communities in Chichewa, the local language. We used a framework approach to analyze the transcripts.
resultsWe conducted 4 FGDs with caregivers and 10 interviews with CHWs. We identified four themes, which were common across caregivers and CHWs: knowledge and understanding, effort, medication perceptions and community influences. Caregivers and CHWs demonstrated good knowledge of pneumonia and types of treatment, but caregivers showed confusion around dosing and treatment durations. Effort was needed to seek care, prepare medication and understand regimens, acting as a barrier to adherence. Perceptions of how well the treatment was working influenced adherence, with both quick recovery and slow recovery leading to non-adherence. Community influences were both supportive, with transport assistance for referrals and home visits to improve adherence, and detrimental, with pressure to share treatments.
conclusionAdherence to oral antibiotic treatment for fast-breathing pneumonia was understood to be important, however considerable barriers we described within this rural low-resource setting, such as the effort preparing and administering medication, community pressures to share drugs and potential complexity of regimens.
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