{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:41:40Z","timestamp":1790775700432,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["OPP1111236"],"award-info":[{"award-number":["OPP1111236"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["OPP1116751"],"award-info":[{"award-number":["OPP1116751"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite antibiotic prescription being recommended for dysentery and suspected cholera only, diarrhea still triggers unwarranted antibiotic prescription. We evaluated antibiotic-prescribing practices and their predictors among children aged 2\u201359 months in the Vaccine Impact on Diarrhea in Africa (VIDA) Study performed in The Gambia, Mali, and Kenya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>VIDA was a prospective case-control study (May 2015\u2013July 2018) among children presenting for care with moderate-to-severe diarrhea (MSD). We defined inappropriate antibiotic use as prescription or use of antibiotics when not indicated by World Health Organization (WHO) guidelines. We used logistic regression to assess factors associated with antibiotic prescription for MSD cases who had no indication for an antibiotic, at each site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>VIDA enrolled 4840 cases. Among 1757 (36.3%) who had no apparent indication for antibiotic treatment, 1358 (77.3%) were prescribed antibiotics. In The Gambia, children who presented with a cough (adjusted odds ratio [aOR]: 2.05; 95% confidence interval [95% CI]: 1.21\u20133.48) were more likely to be prescribed an antibiotic. In Mali, those who presented with dry mouth (aOR: 3.16; 95% CI: 1.02\u20139.73) were more likely to be prescribed antibiotics. In Kenya, those who presented with a cough (aOR: 2.18; 95% CI: 1.01\u20134.70), decreased skin turgor (aOR: 2.06; 95% CI: 1.02\u20134.16), and were very thirsty (aOR: 4.15; 95% CI: 1.78\u20139.68) were more likely to be prescribed antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Antibiotic prescription was associated with signs and symptoms inconsistent with WHO guidelines, suggesting the need for antibiotic stewardship and clinician awareness of diarrhea case-management recommendations in these settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac980","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T18:34:12Z","timestamp":1672252452000},"page":"S32-S40","source":"Crossref","is-referenced-by-count":24,"title":["Antibiotic-Prescribing Practices for Management of Childhood Diarrhea in 3 Sub-Saharan African Countries: Findings From the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015\u20132018"],"prefix":"10.1093","volume":"76","author":[{"given":"Alex O","family":"Awuor","sequence":"first","affiliation":[{"name":"Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR) , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Billy","family":"Ogwel","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR) , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Powell","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA"},{"name":"Department of Pediatrics, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R","family":"Verani","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Centers for Disease Control and Prevention , Nairobi , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samba O","family":"Sow","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins du Mali (CVD-Mali) , Bamako , Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Jahangir","family":"Hossain","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit\u2013The Gambia at the London School of Hygiene & Tropical Medicine , Banjul , The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B","family":"Ochieng","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR) , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Juma","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR) , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie P","family":"Jamka","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA"},{"name":"Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Roose","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA"},{"name":"Department of Pediatrics, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanogo","family":"Doh","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins du Mali (CVD-Mali) , Bamako , Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily L","family":"Deichsel","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA"},{"name":"Department of Pediatrics, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma","family":"Onwuchekwa","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins du Mali (CVD-Mali) , Bamako , Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adama Mamby","family":"Keita","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins du Mali (CVD-Mali) , Bamako , Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Antonio","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit\u2013The Gambia at the London School of Hygiene & Tropical Medicine , Banjul , The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joquina Chiquita M","family":"Jones","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit\u2013The Gambia at the London School of Hygiene & Tropical Medicine , Banjul , The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed M A","family":"Zaman","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit\u2013The Gambia at the London School of Hygiene & Tropical Medicine , Banjul , The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Badji","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit\u2013The Gambia at the London School of Hygiene & Tropical Medicine , Banjul , The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene N","family":"Kasumba","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA"},{"name":"Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilruba","family":"Nasrin","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA"},{"name":"Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A","family":"Platts-Mills","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia , Charlottesville, Virginia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric R","family":"Houpt","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia , Charlottesville, Virginia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M","family":"Berendes","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciara E","family":"Sugerman","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , 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