{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:15:21Z","timestamp":1793412921767,"version":"4.5.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T00:00:00Z","timestamp":1553126400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"DOI":"10.1186\/s12879-019-3899-1","type":"journal-article","created":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T14:02:51Z","timestamp":1553176971000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Apparent overuse of antibiotics in the management of watery diarrhoea in children in Abakaliki, Nigeria"],"prefix":"10.1186","volume":"19","author":[{"given":"Akinwale M.","family":"Efunshile","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obumneme","family":"Ezeanosike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chukwuemeka Chijioke","family":"Nwangwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pikka","family":"Jokelainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5186-4421","authenticated-orcid":false,"given":"Lucy J.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,3,21]]},"reference":[{"issue":"9","key":"3899_CR1","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1016\/S1473-3099(17)30276-1","volume":"17","author":"GBD Diarrhoeal Diseases Collaborators","year":"2017","unstructured":"GBD Diarrhoeal Diseases Collaborators. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the global burden of Disease study 2015. Lancet Infect Dis. 2017;17(9):909\u201348. \n                    https:\/\/doi.org\/10.1016\/S1473-3099(17)30276-1\n                    \n                  .","journal-title":"Lancet Infect Dis"},{"issue":"11","key":"3899_CR2","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1016\/S1473-3099(18)30362-1","volume":"18","author":"GBD 2016 Diarrhoeal Disease Collaborators","year":"2018","unstructured":"GBD 2016 Diarrhoeal Disease Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the global burden of Disease study 2016. Lancet Infect Dis. 2018;18(11):1211\u201328. \n                    https:\/\/doi.org\/10.1016\/S1473-3099(18)30362-1\n                    \n                  .","journal-title":"Lancet Infect Dis"},{"issue":"9888","key":"3899_CR3","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/S0140-6736(13)60844-2","volume":"382","author":"KL Kotloff","year":"2013","unstructured":"Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, et al. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the global enteric multicenter study, GEMS): a prospective, case-control study. Lancet. 2013;382(9888):209\u201322. \n                    https:\/\/doi.org\/10.1016\/S0140-6736(13)60844-2\n                    \n                  .","journal-title":"Lancet."},{"key":"3899_CR4","unstructured":"World Health Organization (WHO). The treatment of diarrhoea: a manual for physicians and other senior health workers. 4th revision. 2005. ISBN 92 4 159318 0. Accessed 28 Aug 2018."},{"key":"3899_CR5","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1016\/S0140-6736(13)60648-0","volume":"381","author":"ZA Bhutta","year":"2013","unstructured":"Bhutta ZA, Das JK, Walker N, Rizvi A, Campbell H, Rudan I, et al. Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost? Lancet. 2013;381:1417\u201329. \n                    https:\/\/doi.org\/10.1016\/S0140-6736(13)60648-0\n                    \n                  .","journal-title":"Lancet"},{"key":"3899_CR6","unstructured":"World Health Organization (WHO). Antibiotic resistance. WHO factsheets. \n                    http:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antibiotic-resistance\n                    \n                  . Accessed 28 Aug 2018."},{"key":"3899_CR7","doi-asserted-by":"publisher","first-page":"193","DOI":"10.12688\/f1000research.12328.1","volume":"7","author":"E Bruzzese","year":"2018","unstructured":"Bruzzese E, Giannattasio A, Guarino A. Antibiotic treatment of acute gastroenteritis in children. F1000Res. 2018;7:193. \n                    https:\/\/doi.org\/10.12688\/f1000research.12328.1\n                    \n                  .","journal-title":"F1000Res."},{"key":"3899_CR8","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003048","volume":"11","author":"SJ Allen","year":"2010","unstructured":"Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2010;11:CD003048. \n                    https:\/\/doi.org\/10.1002\/14651858.CD003048\n                    \n                   pub3.","journal-title":"Cochrane Database Syst Rev"},{"key":"3899_CR9","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1186\/1471-2334-10-253","volume":"10","author":"G Grandy","year":"2010","unstructured":"Grandy G, Medina M, Soria R, Ter\u00e1n C, Araya M. Probiotics in the treatment of acute rotavirus diarrhoea. A randomized, double-blind, controlled trial using two different probiotic preparations in Bolivian children. BMC Infect Dis. 2010;10:253. \n                    https:\/\/doi.org\/10.1186\/1471-2334-10-253\n                    \n                  .","journal-title":"BMC Infect Dis"},{"issue":"6","key":"3899_CR10","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1016\/S0022-3476(98)70398-1","volume":"132","author":"S Bhatnagar","year":"1998","unstructured":"Bhatnagar S, Singh KD, Sazawal S, Saxena SK, Bhan MK. Efficacy of milk versus yogurt offered as part of a mixed diet in acute noncholera diarrhea among malnourished children. J Pediatr. 1998;132(6):999\u20131003.","journal-title":"J Pediatr"},{"issue":"6","key":"3899_CR11","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1017\/S0950268810001780","volume":"139","author":"D Sur","year":"2011","unstructured":"Sur D, Manna B, Niyogi SK, Ramamurthy T, Palit A, Nomoto K, et al. Role of probiotic in preventing acute diarrhoea in children: a community-based, randomized, double-blind placebo-controlled field trial in an urban slum. Epidemiol Infect. 2011;139(6):919\u201326. \n                    https:\/\/doi.org\/10.1017\/S0950268810001780\n                    \n                  .","journal-title":"Epidemiol Infect"},{"key":"3899_CR12","doi-asserted-by":"publisher","first-page":"E58","DOI":"10.1017\/S0950268818003151","volume":"147","author":"AM Efunshile","year":"2019","unstructured":"Efunshile AM, Ezeanosike O, Onyekachi O, Ugwu MI, Konig B, Robertson LJ. Apparent absence of Giardia infections among children under 5-years of age with acute watery diarrhoea in Abakialiki, Nigeria. Epidemiol Infect. 2019;147:E58. \n                    https:\/\/doi.org\/10.1017\/S0950268818003151\n                    \n                  .","journal-title":"Epidemiol Infect"},{"issue":"4","key":"3899_CR13","doi-asserted-by":"publisher","first-page":"e134","DOI":"10.1097\/INF.0b013e31827d3b68","volume":"32","author":"MM Patel","year":"2013","unstructured":"Patel MM, Pitzer VE, Alonso WJ, Vera D, Lopman B, Tate J, et al. Global seasonality of rotavirus disease. Pediatr Infect Dis J. 2013;32(4):e134\u201347. \n                    https:\/\/doi.org\/10.1097\/INF.0b013e31827d3b68\n                    \n                  .","journal-title":"Pediatr Infect Dis J"},{"issue":"1","key":"3899_CR14","doi-asserted-by":"publisher","first-page":"49","DOI":"10.2471\/BLT.16.176123","volume":"95","author":"ET Rogawski","year":"2017","unstructured":"Rogawski ET, Platts-Mills JA, Seidman JC, John S, Mahfuz M, Ulak M, et al. Use of antibiotics in children younger than two years in eight countries: a prospective cohort study. Bull World Health Organ. 2017;95(1):49\u201361. \n                    https:\/\/doi.org\/10.2471\/BLT.16.176123\n                    \n                  .","journal-title":"Bull World Health Organ"},{"issue":"10051","key":"3899_CR15","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/S0140-6736(16)31529-X","volume":"388","author":"J Liu","year":"2016","unstructured":"Liu J, Platts-Mills JA, Juma J, Kabir F, Nkeze J, Okoi C, et al. Use of quantitative molecular diagnostic methods to identify causes of diarrhoea in children: a reanalysis of the GEMS case-control study. Lancet. 2016;388(10051):1291\u2013301. \n                    https:\/\/doi.org\/10.1016\/S0140-6736(16)31529-X\n                    \n                  .","journal-title":"Lancet."},{"issue":"5","key":"3899_CR16","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1542\/peds.2011-2736","volume":"129","author":"CL Johnson","year":"2012","unstructured":"Johnson CL, Versalovic J. The human microbiome and its potential importance to pediatrics. Pediatrics. 2012;129(5):950\u201360. \n                    https:\/\/doi.org\/10.1542\/peds.2011-2736\n                    \n                  .","journal-title":"Pediatrics."},{"issue":"2","key":"3899_CR17","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1586\/eri.10.1","volume":"8","author":"EJ Anderson","year":"2010","unstructured":"Anderson EJ. Prevention and treatment of viral diarrhea in pediatrics. Expert Rev Anti-Infect Ther. 2010;8(2):205\u201317. \n                    https:\/\/doi.org\/10.1586\/eri.10.1\n                    \n                  .","journal-title":"Expert Rev Anti-Infect Ther"},{"key":"3899_CR18","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1186\/1743-422X-10-302","volume":"10","author":"L Sai","year":"2013","unstructured":"Sai L, Sun J, Shao L, Chen S, Liu H, Ma L. Epidemiology and clinical features of rotavirus and norovirus infection among children in Ji'nan, China. Virol J. 2013;10:302. \n                    https:\/\/doi.org\/10.1186\/1743-422X-10-302\n                    \n                  .","journal-title":"Virol J"},{"key":"3899_CR19","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/BF02731121","volume":"72","author":"R Bharathiraja","year":"2005","unstructured":"Bharathiraja R, Sridharan S, Chelliah LR, Suresh S, Senguttuvan M. Factors affecting antibiotic prescribing pattern in pediatric practice. Indian J Pediatr. 2005;72:877\u20139. \n                    https:\/\/doi.org\/10.1007\/BF02731121\n                    \n                  .","journal-title":"Indian J Pediatr"},{"issue":"6","key":"3899_CR20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038641","volume":"7","author":"A Pathak","year":"2012","unstructured":"Pathak A, Mahadik K, Dhaneria SP, Sharma A, Eriksson B, Lundborg CS. Surveillance of antibiotic consumption using the \u201cfocus of infection\u201d approach in 2 hospitals in Ujjain, India. PLoS One. 2012;7(6):e38641. \n                    https:\/\/doi.org\/10.1371\/journal.pone.0038641\n                    \n                  .","journal-title":"PLoS One"},{"key":"3899_CR21","first-page":"9","volume":"7","author":"RA Mahdi Al","year":"2014","unstructured":"Al Mahdi RA. Disastrous...Umbrella therapy. Sudan journal of rational use of. Medicine. 2014;7:9 \n                    http:\/\/apps.who.int\/medicinedocs\/documents\/s22206en\/s22206en.pdf\n                    \n                  . Accessed 28 Aug 2018.","journal-title":"Medicine"},{"issue":"1 Pt 2","key":"3899_CR22","doi-asserted-by":"publisher","first-page":"28","DOI":"10.4269\/ajtmh.1992.47.28","volume":"47","author":"RL Guerrant","year":"1992","unstructured":"Guerrant RL, Schorling JB, McAuliffe JF, de Souza MA. Diarrhea as a cause and an effect of malnutrition: diarrhea prevents catch-up growth and malnutrition increases diarrhea frequency and duration. Am J Trop Med Hyg. 1992;47(1 Pt 2):28\u201335.","journal-title":"Am J Trop Med Hyg"},{"key":"3899_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-014-0075-5","volume":"40","author":"PC Manyike","year":"2014","unstructured":"Manyike PC, Chinawa JM, Ubesie A, Obu HA, Odetunde OI, Chinawa AT. Prevalence of malnutrition among pre-school children in south-East Nigeria. Ital J Pediatr. 2014;40:75. \n                    https:\/\/doi.org\/10.1186\/s13052-014-0075-5\n                    \n                  .","journal-title":"Ital J Pediatr"},{"key":"3899_CR24","unstructured":"Onyire NB, Anyanwu OU, Orji MI, Ezeonu CT. Prevalence of malnutrition in hospital children in Federal Teaching Hospital Abakaliki, Ebonyi state, south eastern Nigeria. Abia State University, medical Students' Association Journal. 2014;9(1)."},{"key":"3899_CR25","doi-asserted-by":"publisher","first-page":"k936","DOI":"10.1136\/bmj.k936","volume":"360","author":"Z Kmietowicz","year":"2018","unstructured":"Kmietowicz Z. One in five GP prescriptions for antibiotics is inappropriate. BMJ. 2018;360:k936. \n                    https:\/\/doi.org\/10.1136\/bmj.k936\n                    \n                  .","journal-title":"BMJ."},{"issue":"02","key":"3899_CR26","doi-asserted-by":"publisher","first-page":"165","DOI":"10.4236\/health.2014.62026","volume":"6","author":"LGB Savadogo","year":"2014","unstructured":"Savadogo LGB, Ilboudo B, Kinda M, Boubacar N, Hennart P, Dramaix M, et al. Antibiotics prescribed to febrile under-five children outpatients in urban public health services in Burkina Faso. Health. 2014;6(02):165\u201370. \n                    https:\/\/doi.org\/10.4236\/health.2014.62026\n                    \n                  .","journal-title":"Health."},{"key":"3899_CR27","doi-asserted-by":"publisher","first-page":"93","DOI":"10.2147\/PHMT.S144796","volume":"8","author":"AM Tekleab","year":"2017","unstructured":"Tekleab AM, Asfaw YM, Weldetsadik AY, Amaru GM. Antibiotic prescribing practice in the management of cough or diarrhea among children attending hospitals in Addis Ababa: a cross-sectional study. Pediatric Health Med Ther. 2017;8:93\u20138. \n                    https:\/\/doi.org\/10.2147\/PHMT.S144796\n                    \n                  .","journal-title":"Pediatric Health Med Ther"},{"key":"3899_CR28","first-page":"103","volume":"12","author":"JJ Gwimile","year":"2012","unstructured":"Gwimile JJ, Shekalaghe SA, Kapanda GN, Kisanga ER. Antibiotic prescribing practice in management of cough and\/or diarrhoea in Moshi municipality, northern Tanzania: cross-sectional descriptive study. Pan Afr Med J. 2012;12:103.","journal-title":"Pan Afr Med J"},{"issue":"2","key":"3899_CR29","doi-asserted-by":"publisher","first-page":"141","DOI":"10.2471\/BLT.17.199687","volume":"96","author":"V Tangcharoensathien","year":"2018","unstructured":"Tangcharoensathien V, Chanvatik S, Sommanustweechai A. Complex determinants of inappropriate use of antibiotics. Bull World Health Organ. 2018;96(2):141\u20134. \n                    https:\/\/doi.org\/10.2471\/BLT.17.199687\n                    \n                  .","journal-title":"Bull World Health Organ"},{"issue":"4","key":"3899_CR30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123479","volume":"10","author":"T Mahapatra","year":"2015","unstructured":"Mahapatra T, Mahapatra S, Banerjee B, Mahapatra U, Samanta S, Pal D, et al. Predictors of rational management of diarrhea in an endemic setting: observation from India. PLoS One. 2015;10(4):e0123479. \n                    https:\/\/doi.org\/10.1371\/journal.pone.0123479\n                    \n                  .","journal-title":"PLoS One"},{"key":"3899_CR31","doi-asserted-by":"publisher","first-page":"492","DOI":"10.7205\/MILMED.170.6.492","volume":"170","author":"MS Riddle","year":"2005","unstructured":"Riddle MS, Tribble DR, Jobanputra NK, Jones JJ, Putnam SD, Frenck RW, et al. Knowledge, attitudes, and practices regarding epidemiology and management of travelers' diarrhea: a survey of front-line providers in Iraq and Afghanistan. Military Med. 2005;170:492\u20135.","journal-title":"Military Med"},{"key":"3899_CR32","doi-asserted-by":"publisher","unstructured":"Ogunleye OO, Fadare JO, Yinka-Ogunleye AF, Anand Paramadhas BD, Godman B. Determinants of antibiotics prescribing among doctors in a Nigerian urban tertiary hospital. Hosp Pract. 2018:1\u20136. \n                    https:\/\/doi.org\/10.1080\/21548331.2018.1475997\n                    \n                  .","DOI":"10.1080\/21548331.2018.1475997"},{"issue":"6","key":"3899_CR33","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1016\/S0196-0644(03)00602-4","volume":"42","author":"DJ Karras","year":"2003","unstructured":"Karras DJ, Ong S, Moran GJ, Nakase J, Kuehnert MJ, Jarvis WR, et al. Antibiotic use for emergency department patients with acute diarrhea: prescribing practices, patient expectations. and patient satisfaction Ann Emerg Med. 2003;42(6):835\u201342.","journal-title":"and patient satisfaction Ann Emerg Med"},{"issue":"4","key":"3899_CR34","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/S0277-9536(02)00422-7","volume":"57","author":"A Radyowijati","year":"2003","unstructured":"Radyowijati A, Haak H. Improving antibiotic use in low-income countries: an overview of evidence on determinants. Soc Sci Med. 2003;57(4):733\u201344.","journal-title":"Soc Sci Med"},{"issue":"Pt 2","key":"3899_CR35","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1099\/jmm.0.078923-0","volume":"64","author":"Y Nami","year":"2015","unstructured":"Nami Y, Haghshenas B, Abdullah N, Barzegari A, Radiah D, Rosli R, et al. Probiotics or antibiotics: future challenges in medicine. J Med Microbiol. 2015;64(Pt 2):137\u201346. \n                    https:\/\/doi.org\/10.1099\/jmm.0.078923-0\n                    \n                  .","journal-title":"J Med Microbiol"},{"issue":"Suppl. 2","key":"3899_CR36","first-page":"S81","volume":"46","author":"A Guarino","year":"2008","unstructured":"Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R, et al. European Society for Paediatric Gastroenterology, hepatology, and nutrition\/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. J Pediatr Gastroenterol Nutr. 2008;46(Suppl. 2):S81\u2013S122.","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"17","key":"3899_CR37","doi-asserted-by":"publisher","first-page":"1864","DOI":"10.1001\/jama.2016.4151","volume":"315","author":"KE Fleming-Dutra","year":"2016","unstructured":"Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM Jr, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864\u201373. \n                    https:\/\/doi.org\/10.1001\/jama.2016.4151\n                    \n                  .","journal-title":"JAMA"},{"key":"3899_CR38","volume-title":"Centers for Disease Control and Protection","author":"CDC","year":"2017","unstructured":"CDC. Antibiotic Use in the United States, 2017: Progress and Opportunities. \n                    https:\/\/www.cdc.gov\/antibiotic-use\/stewardship-report\/index.html\n                    \n                  . In: Centers for Disease Control and Protection. Atlanta, GA: US Department of Health and Human Services, CDC; 2017."},{"issue":"2","key":"3899_CR39","doi-asserted-by":"publisher","first-page":"264","DOI":"10.9745\/GHSP-D-16-00021","volume":"4","author":"M El-Khoury","year":"2016","unstructured":"El-Khoury M, Banke K, Sloane P. Improved childhood diarrhea treatment practices in Ghana: a pre-post evaluation of a comprehensive private-sector program. Glob Health Sci Pract. 2016;4(2):264\u201375. \n                    https:\/\/doi.org\/10.9745\/GHSP-D-16-00021\n                    \n                  .","journal-title":"Glob Health Sci Pract"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-3899-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12879-019-3899-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-3899-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:06:19Z","timestamp":1584662779000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-019-3899-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,21]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["3899"],"URL":"https:\/\/doi.org\/10.1186\/s12879-019-3899-1","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,21]]},"assertion":[{"value":"18 September 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 March 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Approval for the study was provided by the Review and Ethics Committee (REC) of the Federal Teaching Hospital, Abakaliki (REC protocol number 07\/10\/2016\u201307\/10\/2016; REC approval number 07\/10\/2016\u201307\/11\/2016; FETHA\/REC\/VOL1\/2016\/435). An informed consent form was signed by parents\/guardians of the children prior to enrolment in the study; information in the form made clear that participation in the study was voluntary and participants could opt out of the study at any time without prejudice to the quality of treatment received by their children. Questionnaire data were coded to be anonymous such that it is not possible to identify individual patients.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Publisher\u2019s Note"}}],"article-number":"275"}}