Pilot study on the current management of children with COVID-19 In hospitals in Bangladesh : findings and implications
Loading...
Date
Authors
Nusrat, Nadia
Haque, Mainul
Chowdhury, Kona
Adnan, Nihad
Lutfor, Afzalunnessa Binte
Karim, Enamul
Hassan, Mahmuda
Rabbany, Arif
Begum, Dilara
Mohammad Nazmul Hasan
Journal Title
Journal ISSN
Volume Title
Publisher
Bangladesh Academy of Sciences
Abstract
OBJECTIVE : The focus on COVID-19 in children in low- and middle-income countries including Bangladesh
has been on addressing key issues including poor vaccination rates as well as mental health issues, domestic
violence and child labour. However, the focus on optimally managing children in hospitals is changing with
new variants and concerns with the development of hyperinflammatory syndromes. There are also concerns
with the overuse of antimicrobials to treat patients with COVID-19 in hospitals enhancing resistance rates.
The Bangladesh Paediatric Association have developed guidelines to improve patient care building on national
guidance. Consequently, there is a need to document the current management of children with COVID-19 in
Bangladesh and use the findings for future guidance. METHODS : Rapid analysis of the management of children
with COVID-19 among eight private and public hospitals in Bangladesh with varying numbers of in-patient beds
using purposely developed case report forms (CRFs). The CRFs were piloted before full roll-out. RESULTS : Overall
low numbers of children in hospital with COVID-19 (4.3% of in-patient beds). The majority were male (59.6%)
and aged 5 years or under (63.5%). Reasons for admission included respiratory distress/ breathing difficulties
with 94.2% of COVID-19 cases confirmed. All children were prescribed antibiotics empirically, typically those
on the Watch list of antibiotics and administered parenterally, with only a small minority switched to oral therapy
before discharge. There was appreciable prescribing of Vitamins (C and D) and zinc and encouragingly limited
prescribing of other antimicrobials (antivirals, antimalarials and antiparasitic medicines). Length of stay was
typically 5 to 10 days. CONCLUSION : Encouraging to see low hospitalisation rates and limited use of antimicrobials
apart from antibiotics. Concerns with high empiric use of antibiotics and limited switching to oral formulations
can be addressed by instigating antimicrobial stewardship programmes. We will be monitoring this.
Description
Keywords
Antimicrobials, Bangladesh, Children, Guidelines, Hospitals, Vitamins, COVID-19 pandemic, Coronavirus disease 2019 (COVID-19)
Sustainable Development Goals
Citation
Nasrut, N., Haque, M., Chowdhury, K., et al. 2021, 'Pilot study on the current management of children with COVID-19 In hospitals in Bangladesh; findings and implications', Bangladesh Journal of Medical Science, vol. 20, pp. S188-S198.