Self-medication practices by caretakers for children under five years in Tororo District.

Abstract

BACKGROUND Majority of caretakers in Uganda prefer to initiate treatment for children with common childhood illness at home. Inappropriate and unregulated use of medicinal agents by self-medication has been widely attributed to detrimental outcomes like inappropriate treatment, adverse drug events and antimicrobial resistance. Self-medication practices in children under-five has not been well studied in Uganda despite widespread reports of irrational drug use in most communities in developing countries.

Objectives: To determine the prevalence of self-medication, establish common self-medication practices undertaken by caretakers for children less than five years and to determine the reported treatment outcomes of self-medication for children less than five years of age in Tororo district Uganda.

Methods: This was a cross sectional study involving caretakers of children under five in Tororo district of Uganda. From each of the four counties in Tororo district, multistage cluster sampling was used to select four villages. Through consecutive recruitment, a caretaker- child pair was purposively chosen from a selected household meeting the criteria. The demographic data and drug use information by caretakers for the selected child was recorded on a structured questionnaire following an interview. A total of 456 caretakers were enrolled, two participants were excluded from the study. Two focus group discussions and eight key informant interviews were conducted for qualitative data. Quantitative data was obtained by a structured tool and analysed by SPSS 12.0 software. Qualitative data was analysed manually with data grouped into themes.

RESULTS Prevalence of self-medication in children under five years was 30.1%. Self-medication significantly increased among children aged three to five years (OR 1.66, 0.57-1.99, p-value 0.02) and a high socioeconomic status of caretakers was significantly associated with self-medication use (OR 1.71, 0.37-1.97, p-value 0.01). Self-medication was practiced commonly for symptoms of cough 60%, fever 51.6%, vomiting 19% and diarrhoea 10%. Some caretakers self-medicated children for severe symptoms of wheezing 3.6% and convulsions 1.5%. Analgesics/antipyretics 73%, antibiotics 48%and antimalarials 43% were the main classes of drugs used for self-medication. Cough was the symptom for which most drugs including antibiotics 56.4% and antimalarials 44% were used. More than half of caretakers 54% acquired drugs from local drug shops. Leftover drugs from previous treatment served a source of medicines for 17.5% of the children. Dosage estimation by caretakers was mainly by reference to old prescription notes 52%.The main reasons for self-medication of children by caretakers was to initiate early treatment in their children 20%. A poor treatment outcome following self-medication was reported by caretakers in 57 % of children. Among these, 24% had no change in symptoms, 16.8% of the children were hospitalized, and 8% of caretakers reported new symptoms occurred following self-medication of their children.

Conclusion: Despite low prevalence of self-medication, those caretakers who practiced self-medication exhibited inappropriate and irrational drug use patterns with more than half reporting poor treatment outcomes in their children.

Recommendations: In view of above findings, advocacy for health education of communities on symptom recognition and appropriate early management in children should be strengthened.