Prescription of medications for acute diarrhea in infants in Antananarivo, Madagascar.

AIM: To evaluate the professional practices of physicians in Antananarivo in managing acute diarrhea in infants. METHODS: This prospective study was conducted from March 19 to April 21, 2012, as an anonymous survey of randomly selected general practitioners and pediatricians working in the public or private sector in the city of Antananarivo. RESULTS: The survey included 125 physicians: 105 general practitioners, 11 pediatricians, and 9 other specialist physicians (7.2%) with pediatric activity. Only 4.8% of the physicians questioned had not received training about diarrhea in the previous two years. One doctor in 4 (25.6%) did not prescribe oral rehydration solution. The reasons given were lack of signs of dehydration (50%) and recommendation of other beverages (15.5%). Zinc prescription was rare (9.6%). Early refeeding was recommended by 41.6% of physicians. Almost half (47.2%) routinely use antibiotics, and 86.4% prescribe antidiarrheal medications. CONCLUSION: The WHO recommendations for the treatment of acute diarrhea in children are not followed. Continuing and repeated medical education is necessary.

Helicobacter pylori infection in children in Madagascar: risk factors for acquisition.

AIM: The aim of our study was to assess the prevalence, risk factors for acquisition and the clinical characteristics of H. pylori infection in Malagasy children. METHODS: A 2 year prospective study was conducted among 434 children from a rural (group A) and an urban area (group B). H. pylori status was evaluated by an ELISA serological test. Various demographic and clinical characteristics were recorded and subjected to statistical analysis. RESULTS: The prevalence of H. pylori infection was 39.6% and increased significantly from 18.1% for children <1 year old to 61.5% for children >10 years old. It was significantly higher in group B (46.9%) than in group A (26.4%). Using multivariate logistic regression modelling, a significant association was found between H. pylori infection and drinking spring water. Exposure to antibiotics during the previous year had no observable effect on H. pylori. CONCLUSION: The overall prevalence of H. pylori infection among Malagasy children was 39.6%. A significant association between H. pylori infection and drinking spring water was found.