Children with diarrhoea don’t necessarily need antibiotics, Muhas researchers say

Dar es Salaam. The ‘rampant’ use of antibiotics in treating children who are diagnosed with diarrhoea causes more harm, scientists from Muhimbili University of Health and Allied Sciences (Muhas) say.

Globally, there are nearly 1.7 billion cases of childhood diarrhoeal diseases every year, says the World Health Organization (WHO). A significant proportion of diarrhoeal disease can be prevented through safe drinking-water and adequate sanitation and hygiene, says the global health agency.

During a Muhas-Havard Collaborative symposium on Wednesday, January 22, the researchers emphasized that children with diarrhoea should be treated with Zinc, Oral Rehydration Salts (ORS) and proper feeding instead of subjecting them to what they termed as ‘injudicious use of antibiotics.”

Presenting findings during the symposium themed: The landscape of diarrhoeal diseases in children in Tanzania; and the way forward, a senior specialist in children’s health from Muhas, Dr Rodrick Kisenge, said antibiotics such as metronidazole, erythromycin, azithromycin, niloxamide and ciprofloxacin are rampantly used; and wrongly.

“Acute watery diarrhoea in children is mostly caused by viral infections or organisms that don’t have to be treated by antibiotics for the patient to heal,’’ he said.

Antibiotics can be recommended in children diagnosed with bloody diarrhoea, however, studies show that 44 percent of children with non-bloody diarrhoea in low income countries are reported to receive antibiotics as part of treatment.

Dr Kisenge said, “Unwise use of antibiotics causes alterations in the bacteria that live inside the body and this can aggravate the diarrhoea, nutritional problems and lead to antibiotic resistance.”

“The only situations in which children with diarrhoea are treated with antibiotics are when a child has severe acute malnutrition, cholera, dysentery or when the same child has been diagnosed with pneumonia,’’ he explained.

He challenged a previous study trial involving nearly 200,000 children in Malawi, Tanzania and Niger, which advocated mass distribution of antibiotics. It suggested that antibiotics should be administered to children on a mass scale as a strategy to cut down deaths of newborns and infants.

According to Dr Kisenge, the study, published 2018 in the New England Journal of Medicine, would have fueled antibiotic resistance if it were incorporated into policy and practice.

Reports indicate that the World Health Organization (WHO) did not recommend the study but commissioned seven countries including Tanzania to conduct a trial whose preliminary findings disapproved the use of antibiotics, such as Azithromycin on a large scale in children.

Speaking during the symposium, a senior professor in children’s health from Muhas, Karim Manji urged healthcare providers across the country to abstain from irrational prescription of antibiotics in order to save Tanzania and the world from the crisis of antibiotic resistance.

“It is important that healthcare providers be provided with important information regarding the use of antibiotics. This is a great step towards saving lives, streamlining the use of antibiotics and reducing the risk of resistance,’’ said Prof Manji.

Scaling up interventions such as use of ORS and proper nutrition, and reducing the prevalence of stunting would address the deaths attributed to diarrhoea in children under the age of five, by 2030, says the Executive Director of Ifakara Health Institute (IHI) Dr Honorati Masanja.

Presenting a topic: Reduction of diarrhoea specific mortality in children in Tanzania from 1985 to present during the symposium, Dr Masanja noted that universal coverage of interventions such as handwashing has the potential to reduce the mortality caused by diarrhoea by 90 percent.