BMJ Paediatrics Open (Sep 2024)
Antibiotic prescribing practices according to the AWaRe classification among children under 5 of age attending public primary care centres in four West African countries: a cross-sectional study (AIRE project, 2021–2022)
- Valéry Ridde,
- S Shepherd,
- Valériane Leroy,
- L Barry,
- M Bah,
- A Maïga,
- S Diallo,
- G Noel,
- T Sidibé,
- V Ridde,
- F Bah,
- Désiré Kargougou,
- A Baldé,
- D Diarra,
- D Zongo,
- F Lamontagne,
- M Traoré,
- A Ouedraogo,
- A Ouattara,
- V Leroy,
- R Becquet,
- L Catala,
- Ibrahima Sory Diallo,
- S Sani,
- Emelyne Gres,
- Cédric Besnier,
- Abdoul Aziz Diakité,
- Zineb Zair,
- Solange Ouédraogo Yugbaré,
- Gildas Boris Hedible,
- Abdoul Guaniyi Sawadogo,
- Jacques Séraphin Kolié,
- Bertrand Meda,
- Sandrine Busière,
- Franck Lamontagne,
- S Yugbaré Ouédraogo,
- VM Sanon Zombré,
- M Sama Cherif,
- I S Diallo,
- D F Kaba,
- A A Diakité,
- A Sidibé,
- H Abarry Souleymane,
- F Tidjani IssaganaDikouma,
- H Agbeci,
- D L Dahourou,
- S Desmonde,
- E Gres,
- G B Hedible,
- L Peters Bokol,
- J Tavarez,
- Z Zair,
- S Louart,
- A Cousien,
- V Briand,
- V Journot,
- S Lenaud,
- C N’Chot,
- B Seri,
- C Yao,
- G Anago,
- D Badiane,
- M Kinda,
- D Neboua,
- P S Dia,
- N di Mauro,
- K Nyoka,
- W Taokreo,
- OB Coulidiati Lompo,
- M Vignon,
- P Aba,
- N Diallo,
- M Ngaradoum,
- S Léno,
- A T Sow,
- A Soumah,
- B Baldé,
- K C Millimouno,
- M Haba,
- M Soumah,
- M Guilavogui,
- M N Sylla,
- S F Dounfangadouno,
- T I Bah,
- C Gnongoue,
- S Gaye,
- JPY Guilavogui,
- A O Touré,
- J S Kolié,
- A S Savadogo,
- F Sangala,
- T Konare,
- A Coulibaly,
- A Keita,
- H Traoré,
- I Sangaré,
- I Koné,
- S Diarra,
- V Opoue,
- F K Keita,
- M Dougabka,
- B Dembélé,
- M S Doumbia,
- G D Kargougou,
- S Keita,
- S Bouille,
- S Calmettes,
- K H Harouna,
- B Moutari,
- I Issaka,
- S O Assoumane,
- S Dioiri,
- M Sidi,
- K Sani Alio,
- S Amina,
- R Agbokou,
- M G Hamidou,
- S M Sani,
- A Mahamane,
- Aboubacar Abdou,
- B Ousmane,
- I Kabirou,
- I Mahaman,
- I Mamoudou,
- M Baguido,
- R Abdoul,
- A Sahabi,
- F Seini,
- Z Hamani,
- L-Y B Meda,
- Mactar Niome,
- X Toviho,
- I Sanouna,
- P Kouam,
- S Busière,
- F Triclin,
- A Hema,
- M Bayala,
- L Tapsoba,
- J B Yaro,
- S Sougue,
- R Bakyono,
- A G Sawadogo,
- Y A Lompo,
- B Malgoubri,
- F Douamba,
- G Sore,
- L Wangraoua,
- S Yamponi,
- S I Bayala,
- S Tiegna,
- S Kam,
- S Yoda,
- M Karantao,
- D F Barry,
- O Sanou,
- N Nacoulma,
- N Semde,
- I Ouattara,
- F Wango,
- Z Gneissien,
- H Congo,
- Y Diarra,
- B Ouattara,
- F Diabate,
- O Goita,
- S Gana,
- S Sylla,
- D Coulibaly,
- N Sakho,
- K Kadio,
- J Yougbaré,
- S Tougouma,
- A Dicko,
- Z Nanema,
- I Balima,
- S E Coulibaly,
- H Baldé,
- E Duparc Haba,
- Y Sangare,
- B Traore,
- A E Dagobi,
- S Salifou,
- B Gana MoustaphaChétima,
- I H Abdou
Affiliations
- Valéry Ridde
- Ceped, Université Paris Cité, IRD, Paris, France
- S Shepherd
- Valériane Leroy
- Center for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse, Université Paul Sabatier, Toulouse, France
- L Barry
- Queen’s University Belfast, Belfast, UK
- M Bah
- National Eye Care Programme, Gambia
- A Maïga
- 1Faculty of Medicine Pharmacy and Odonto-Stomatology, University of Bamako, Bamako, Mali
- S Diallo
- 1Hôpital Foch Pharmacy, Suresnes, France
- G Noel
- 4Centre Paul Strauss, Radiotherapy, Strasbourg, France;
- T Sidibé
- 1Hôpital Foch, Pharmacy, Suresnes, France
- V Ridde
- 1University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- F Bah
- 1Epidemiology, Columbia University, New York City, USA
- Désiré Kargougou
- ALIMA, The Alliance for International Medical Action, Bamako, Mali
- A Baldé
- 2Jean Piaget University Guinea-Bissau, Bissau, Guinea-Bissau
- D Diarra
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria
- D Zongo
- 1University Bordeaux, ISPED, INSERM U897 Research Centre ‘Epidemiology and Biostatistics’, Bordeaux, France
- F Lamontagne
- Université de Sherbrooke, Sherbrooke
- M Traoré
- Institut National de Santé Publique, Côte d`Ivoire
- A Ouedraogo
- Centre Muraz, Bobo-Dioulasso, Burkina Faso
- A Ouattara
- 1STD Diagnostic Laboratory, department of bacteriology and virology, Pasteur Institute of Côte d’Ivoire
- V Leroy
- INSERM U. 330, Université Victor Segalen Bordeaux 2, Bordeaux, France
- R Becquet
- INSERM, unité 897, Centre de recherche ‘Epidémiologie et Biostatistique,’ Bordeaux, France
- L Catala
- 1Internal Use Pharmacy- Bégin Military Teaching Hospital, Val-De-Marne, Saint-Mandé, France
- Ibrahima Sory Diallo
- Institut de Nutrition et de Santé pour Enfants, Conakry, Guinea
- S Sani
- 8Azienda Ospedaliera Livorno, USL Toscana Nord-Ovest, Italy
- Emelyne Gres
- National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD), Bordeaux Population Health Research Centre, Université de Bordeaux, Bordeaux, France
- Cédric Besnier
- Center for Epidemiology and Research in Population Health (CERPOP), UMR 1295, Inserm, University Paul Sabatier Toulouse 3, Toulouse, France
- Abdoul Aziz Diakité
- Gabriel Touré University Hospital Center, Bamako, Mali
- Zineb Zair
- Center for Epidemiology and Research in Population Health (CERPOP), UMR 1295, Inserm, University Paul Sabatier Toulouse 3, Toulouse, France
- Solange Ouédraogo Yugbaré
- CHU de Bogodogo, Ouagadougou, Burkina Faso
- Gildas Boris Hedible
- Center for Epidemiology and Research in Population Health (CERPOP), UMR 1295, Inserm, University Paul Sabatier Toulouse 3, Toulouse, France
- Abdoul Guaniyi Sawadogo
- Tdh, Terre des hommes, Ouagadougou, Burkina Faso
- Jacques Séraphin Kolié
- ALIMA, The Alliance for International Medical Action, Conakry, Guinea
- Bertrand Meda
- Solthis, Solidarité Thérapeutique et Initiatives pour la Santé, Niamey, Niger
- Sandrine Busière
- Tdh, Terre des hommes, Dakar, Senegal
- Franck Lamontagne
- Solthis, Solidarité Thérapeutique et Initiatives pour la Santé, Paris, France
- S Yugbaré Ouédraogo
- VM Sanon Zombré
- M Sama Cherif
- I S Diallo
- D F Kaba
- A A Diakité
- A Sidibé
- H Abarry Souleymane
- F Tidjani IssaganaDikouma
- H Agbeci
- D L Dahourou
- S Desmonde
- E Gres
- G B Hedible
- L Peters Bokol
- J Tavarez
- Z Zair
- S Louart
- A Cousien
- V Briand
- V Journot
- S Lenaud
- C N’Chot
- B Seri
- C Yao
- G Anago
- D Badiane
- M Kinda
- D Neboua
- P S Dia
- N di Mauro
- K Nyoka
- W Taokreo
- OB Coulidiati Lompo
- M Vignon
- P Aba
- N Diallo
- M Ngaradoum
- S Léno
- A T Sow
- A Soumah
- B Baldé
- K C Millimouno
- M Haba
- M Soumah
- M Guilavogui
- M N Sylla
- S F Dounfangadouno
- T I Bah
- C Gnongoue
- S Gaye
- JPY Guilavogui
- A O Touré
- J S Kolié
- A S Savadogo
- F Sangala
- T Konare
- A Coulibaly
- A Keita
- H Traoré
- I Sangaré
- I Koné
- S Diarra
- V Opoue
- F K Keita
- M Dougabka
- B Dembélé
- M S Doumbia
- G D Kargougou
- S Keita
- S Bouille
- S Calmettes
- K H Harouna
- B Moutari
- I Issaka
- S O Assoumane
- S Dioiri
- M Sidi
- K Sani Alio
- S Amina
- R Agbokou
- M G Hamidou
- S M Sani
- A Mahamane
- Aboubacar Abdou
- B Ousmane
- I Kabirou
- I Mahaman
- I Mamoudou
- M Baguido
- R Abdoul
- A Sahabi
- F Seini
- Z Hamani
- L-Y B Meda
- Mactar Niome
- X Toviho
- I Sanouna
- P Kouam
- S Busière
- F Triclin
- A Hema
- M Bayala
- L Tapsoba
- J B Yaro
- S Sougue
- R Bakyono
- A G Sawadogo
- Y A Lompo
- B Malgoubri
- F Douamba
- G Sore
- L Wangraoua
- S Yamponi
- S I Bayala
- S Tiegna
- S Kam
- S Yoda
- M Karantao
- D F Barry
- O Sanou
- N Nacoulma
- N Semde
- I Ouattara
- F Wango
- Z Gneissien
- H Congo
- Y Diarra
- B Ouattara
- F Diabate
- O Goita
- S Gana
- S Sylla
- D Coulibaly
- N Sakho
- K Kadio
- J Yougbaré
- S Tougouma
- A Dicko
- Z Nanema
- I Balima
- S E Coulibaly
- H Baldé
- E Duparc Haba
- Y Sangare
- B Traore
- A E Dagobi
- S Salifou
- B Gana MoustaphaChétima
- I H Abdou
- DOI
- https://doi.org/10.1136/bmjpo-2024-002833
- Journal volume & issue
-
Vol. 8,
no. 1
Abstract
Objective To describe antibiotic prescribing practices using the WHO AWaRe (Access, Watch, Reserve) classification in West African children under 5 years of age attending public primary health centres (PHCs).Design Cross-sectional study.Setting The AIRE project implemented the systematic use of pulse oximetry into integrated management of childhood illness consultations in West African countries (Burkina Faso, Guinea, Mali and Niger). We described antibiotic prescriptions for outpatient children at 16 PHCs and for severe cases referred at district hospitals.Patients Between 14 June 2021 and 19 June 2022, 15 854 outpatients were included: 968 neonates and young infants (0–28 days) and 14 886 children (2–59 months). Among them, 78 (8.1%) neonates and young infants and 385 (2.6%) children were hospitalised. We evaluated 58 hospitalised neonates and young infants and 275 hospitalised children, respectively.Main outcome measures Frequency of antibiotic prescriptions according to the AWaRe classification recommended by WHO.Results At the PHC level, proportions of neonates and young infants with ≥1 antibiotic prescription were 83%, 62%, 71% and 59% in Burkina Faso, Guinea, Mali and Niger, respectively. A total of 805 antibiotics were prescribed (85% Access and 13% Watch). The proportions of children with ≥1 antibiotic prescription reached 71%, 66%, 63% and 36% in Burkina Faso, Guinea, Mali and Niger, respectively. Out of the 9630 antibiotics prescribed, 93% were Access (mainly amoxicillin), and 7% Watch. At the hospital level, Watch antibiotics were mainly prescribed for severe cases referred. No Reserve antibiotics were prescribed.Conclusions High proportions of antibiotics were prescribed to outpatient children included, the appropriateness of which needs further study. Nevertheless, in every country, the proportion prescribed in the Access group reached the minimum threshold of 60% of all antibiotic prescriptions, as recommended by WHO.Trial registration number PACTR202206525204526.