Determinants of antimicrobial use in diarrhoea management among under-five children in Zomba, Malawi

Diarrhoea is one of the most common infections that under-five children suffer from across the world. Antibiotics remains one of the common measures used to treat the infection, which has led to increased usage; nevertheless, the extent to which an individual is prompted to use antibiotics in managing diarrhoea in the Malawian setting is not clearly known. This study was aimed at establishing the factors that prompt mothers/caregivers to use antibiotics in treating childhood diarrhoea. Women/caregivers with under-five children who suffered from diarrhoea two weeks before the study were recruited for the interviews (n=269). One-on-one interviews were conducted using a structured questionnaire and two focus group discussions were carried out to generate qualitative data. Quantitative data was entered in CSPro version 7 and exported to STATA version 12 for analysis. The study established that caregivers use antibiotics in managing diarrhoea due to long distances to the health facility (OR 1.93, 95% CI: 1.03-3.65; P<0.04), unavailability of drugs at the facility (OR 1.12, 95% CI: 0.60-2.10; P<.71), quality of medical care at the health facility (OR 1.11, 95% CI: 0.57-2.15; P<.75) and previous knowledge of the diarrhoea condition (OR 0.90, 95% CI: 0.49-1.66; P<.74). As a result of these findings, Government of Malawi should consider widening access to health facilities to its citizens such that citizens are encouraged to always visit the healthy facilities. Healthy professionals should always encourage caregivers to refrain from engaging in self-medicational behavior as it has devastating effects on increased drug usage which contributes to anti-microbial resistance.   Key words: Diarrhoea, under five children, anti-microbial, resistance, self-medication, over the counter,  determinants, prescription.