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.Keywords: ORS/Zinc, Childhood diarrhoea, Prescription, Primary Health Car

Scholarly publishing depends on peer reviewers

The peer-review crisis is posing a risk to the scholarly peer-reviewed journal system. Journals have to ask many potential peer reviewers to obtain a minimum acceptable number of peers accepting reviewing a manuscript. Several solutions have been suggested to overcome this shortage. From reimbursing for the job, to eliminating pre-publication reviews, one cannot predict which is more dangerous for the future of scholarly publishing. And, why not acknowledging their contribution to the final version of the article published? PubMed created two categories of contributors: authors [AU] and collaborators [IR]. Why not a third category for the peer-reviewer?Scopu

The Prescription of Medicines for Childhood Acute Diarrhoea: A Retrospective Study at Four Secondary Healthcare Facilities in Lagos State, Nigeria

Background: Diarrhoea remains the second leading cause of mortality in children, with an estimated 205 children under the age of 5 dying daily in Nigeria. Combination therapy of ORS with zinc tablets is the cornerstone for its management. Secondary healthcare facilities (SHFs) represent the second level of contact for patients requiring professional care; hence an appropriate prescription for diarrhoea is crucial for the survival of under-fives. Objectives: To evaluate the prescription of medicines in the management of acute watery diarrhoea (AWD) in underfives at SHFs, and determine the appropriateness of the prescriptions. Method: A descriptive cross-sectional study was done at four randomly selected SHFs in Lagos State. A retrospective review of prescriptions for diarrhoea cases totaling 480, was done using records from the General Out-Patient Department from September 2018 to August 2019. A descriptive analysis was performed.Results: All cases reviewed were diagnosed as AWD occurring either alone (352; 73.3%) or in combination with malaria/fever (55; 11.5%), cough/URTI (23; 4.8%), and other conditions (50; 10.4%). Of the 352 AWD only cases, there were 121 (34.4%) prescriptions for ORS/Zinc as combined therapy without addition of antibiotics, 120 (34.1%) for antibiotics, and 134 (38.1%) for probiotics. Other prescriptions include analgesics (18.2%), injectables (9.7%) and antimalarials (8.8%). Conclusion: The study revealed suboptimal prescriptions of ORS/Zinc with the appropriateness of prescription at 34.4%. The prescription of antibiotics and other medicines which have no rehydration benefits was high