Prevalence of antibiotic use for diarrhea among 1.3 million under-five years children: A multicounty retrospective analysis from 2006–2018

Abstract

Background This paper aims to estimate the prevalence of antibiotic use for diarrhea among under-five children (u5c) in low- and middle-income countries (LMICs) using data from 112 Demographic Health Surveys (DHS) conducted between 2006 and 2018. The focus is on understanding the extent of antibiotic usage for managing diarrhea, a condition characterized by frequent loose or watery bowel movements that can lead to severe dehydration. Methods and findings A cross-sectional study design was employed in the DHS. The prevalence of antibiotic use for diarrhea among under-five children was estimated by analyzing DHS data from 2006 to 2018 and using the R statistical programming language. Out of a total of 12,69,944 children under five included in this study, 1,80,067 children had diarrhea and 19,502 children had bloody diarrhea. The overall prevalence of diarrhea estimated at ~14% (prevalence = 0.142; 95% CI = 0.141, 0.142). Among the children with diarrhea, 47,755 child received antibiotic treatment, resulting a prevalence of ~27% (prevalence = 0.27, 95% CI = 0.26, 0.27) globally. Central Asia had the highest prevalence of antibiotic use at ~55% (prevalence = (967/1748) = 0.55, 95% CI = 0.52, 0.59), followed by the Europe region with a prevalence of ~44% (prevalence = (5483/12502) = 0.44, 95% CI = 0.43, 0.45). In the South East and Central Asia region, DHS conducted between 2006 and 2018, showed the highest prevalence of antibiotic use in DHS 2007 (~44%), DHS 2012 (~49%), DHS 2016 (~40%) and DHS 2017 (~65%). The linear trend analysis showed an upward trend for using antibiotic of diarrhea in the South East and Central Asia region. Conclusions The Central Asia region had the highest proportion of antibiotic use, with an estimated prevalence of ~55% (95% CI = 0.52, 0.59). The Europe region followed closely with a prevalence of ~44% (95% CI = 0.43, 0.45). The South East Asia region had the lowest prevalence of antibiotic use estimated at ~23% (95% CI = 0.22, 0.24), with a gradual increasing trend.