Prescribing practices in the management of childhood diarrhoea in primary health care centres in a sub-urban community in Nigeria

Background: Childhood diarrhoea remains the second leading cause of morbidity and mortality among children under the age of five. Oral rehydration therapy and zinc tablets are the cornerstone for its management both at home and in the health facilities. Primary health care is the first level of contact of individuals and communities with the health care system and appropriate prescription is crucial for sustainable health benefits. This study assessed the prescribing pattern for childhood diarrhoea management and determined the appropriateness of treatment for acute watery diarrhoea without comorbidities in Primary Health Care (PHC) facilities in a sub-urban community in Nigeria.Methods: This descriptive study was done in 19 PHC facilities in Ikorodu Local Government Area of Lagos State, Nigeria. A retrospective review of 1271 prescriptions for diarrhoeal cases of children between 6 to 59 months was done using the records from the Outpatient Department register for a period of one year. Descriptive analysis was done. Results: From the cases reviewed, 1239 (97.5%) had acute watery diarrhoea (AWD), either alone 819 (64.4%), or with malaria/fever 347 (27.3%), cough/URTI 59 (4.6%), and other conditions 14 (1.1%). For cases of AWD alone, there were 499 (60.9%) prescriptions for ORS/Zinc, 249 (30.4%) for antibiotics and 203 (28.4%) for antimalarials. Antibiotic and antimalarial injections were also included in the prescriptions.Conclusion: This study found the prescription pattern for childhood diarrhoea to be inadequate with suboptimal prescriptions of ORS/Zinc. The prescriptions of antibiotics and antimalarials for acute watery diarrhoea was high and unnecessary

Knowledge; Awareness; and Practice of the Use of Peak Flow Meters by Physicians in the Management of Asthma in Children

The peak flow meter (PFM) is a useful device in asthma monitoring and in determining the severity of symptoms. Against the background of reported under utilisation of PFMs in the management of asthma and prescription for home use; and the paucity of such data in developing countries; this study was carried out to assess the knowledge; awareness; and practice of physicians on the use of PFMs in the management of children with asthma. The work was a prospective cross-sectional study involving 67 doctors working in the paediatric departments of two government hospitals in Lagos State; Nigeria. The number of doctors varied as not all responded to all the questions. The figures therefore correspond with the number of doctors that responded to the particular issue/question addressed. The survey was conducted with a self-administered structure questionnaire. Information obtained included the availability of PFMs in consulting rooms; knowledge of their use; benefits; frequency of prescription; and constraints in prescribing PFMs for the home management of asthma. Only 13 (20.0) of the doctors (n=65) used the peak expiratory flow rate (PEFR) regularly in the diagnosis of asthma. The designation of the respondents and the years of experience in the management of asthma were significantly related to the frequency of prescription of the PFM (p=0.007; p=0.003 respectively).Non-availability was the highest constraint to PFM use (75.0); followed by the cost of the PFM (51.7). This study revealed that the physicians' knowledge about the PFM was suboptimal. The meters were rarely used in diagnosis nor prescribed for home management by physicians attending to asthmatic children at the two referral hospitals. The cost and availability of the PFM should be addressed by the hospital management