INTRODUCTION

Currently, self-medication has been considered a method to accelerate the healing of certain diseases without the prescription of a doctor. The World Health Organization (WHO) mentions that despite several countries having regulations prohibiting the sale of medicines without a medical prescription, there is an 80% chance of obtaining them. This practice has become a bad habit in adults that is even replicated towards their children. Therefore, it is called self-medication by power, being more prevalent in the pediatric population, to treat mostly acute respiratory infections.^1,2

It should be noted that the administration of medications without a doctor's indication can generate several consequences such as the self-prescription of antibiotics, whose misuse would cause resistance in bacterial infections, and incorrect dosing causing adverse reactions. Also, it should be noted that the majority of respiratory infections are viral, so the use of multiple medications is unnecessary.^3-4

At the sociodemographic level, several factors could be associated with parents self-medicating their children, such as the socioeconomic level, age, education level of the head of the family, proximity to health centers, among others. In Spain, a study was conducted in the Emergency Service of a pediatric hospital, which found that having many children, mothers with primary education, and being the third sibling have a significant association with self-medication towards their children.^5,6

Some developing countries such as Turkey and Pakistan have found studies showing a high prevalence of self-medication in children with 63.5% and 77.25% respectively. However, in developed countries such as Spain, it has a lower prevalence of 32.8%.^5,7,8

On the other hand, studies have been found on the consequences of self-medication in children. In Congo, it was shown that 95.7% of mothers did not know how to give the correct dosage, and 55.1% would go to a hospital in case of sequel. Another study conducted in Ecuador showed that 79% of pediatric patients who self-medicated ended up in worse health condition, and 9.8% had a delay in reaching the diagnosis.^9,10

In Peru, it was reported that acute respiratory infections in health centers affect the pediatric age group more, with rhinopharyngitis and pharyngotonsillitis being more prevalent. These diseases are mostly upper respiratory tract infections, where depending on the disease, it is usually viral or bacterial. Therefore, it is important to have treatment supervised by a doctor who, under the clinical evaluation of the patient, will determine the possible etiological agent.^11-13

Also, self-medication in the Peruvian population varies from 40% to 60%. According to MINSA, self-medication hinders the correct diagnosis of diseases. It should be noted that the most common respiratory infections such as rhinopharyngitis and pharyngotonsillitis have a higher predisposition for the drugs used in their treatment to be acquired without a medical prescription. In a study conducted in the city of Chiclayo, Lambayeque, a prevalence of 70.7% of mothers, who self-medicated their children with antibiotics to relieve respiratory symptoms among the most frequent: fever and sore throat, was observed.^14-16

For this reason, the present study seeks to find the factors associated with self-medication in children with upper respiratory tract diseases at the Centro Materno Infantil Buenos Aires de Villa, Chorrillos, during the period from November 2022 to March 2023. This will allow us to understand how the behavior of self-medication in parents has evolved, to develop better management to decrease it.

MATERIAL AND METHODS

RESULTS

A total of 206 parents participated in the present study, of which 188 (91.3%) self-medicated their children, mostly females (91.5%).

Table 1shows that the majority of the parents, 112 (59.2%), were aged between 30 and 55 years, while 4 (40.8%) were outside this range. Furthermore, most of them had only one child, making a total of 114 (55.3%). In terms of educational level, the majority had completed primary and secondary education, totaling 148 (71.8%). On the other hand, most of the children were under 7 years old, corresponding to a total of 112 (54.4%). The majority of the children were first-born, making a total of 149 (71.8%).

Table 2shows that the birth order of the child has a p=0.006 and the parent's level of education has a p<0.001. According to the bivariate analysis, being the firstborn child had an adjusted prevalence ratio (APR) of 0.88 (95% ci: 0.83-0.93). Regarding the parent’s level of education, those who completed primary and secondary education had an APR=25 (95% ci: 1.08-1.44) compared to those who completed higher education.

Table 3, in the multivariate analysis, after adjusting for the variables, it was observed that according to the birth order, first-born children had an APR=0.86 (95% ci: 0.76-0.97). According to the education level, parents who had completed primary or secondary education had an APR=1.22 (95% ci: 1.01-1.40).

DISCUSSION

The present study analyzed the factors associated with self-medication in children with upper respiratory tract diseases at the Centro Materno Infantil Buenos Aires de Villa, Chorrillos. It was determined that 91.3% of parents self-medicated their children, mostly female. Furthermore, epidemiological variables such as educational level and birth order were statistically significant.

Regarding the prevalence of self-medication in children, it stands out at 91.3%. This result reflects an increase compared to the last national study by Brenis C. et al.¹⁴who conducted an analytical cross-sectional study, where a prevalence of 70% was reported. International studies showed a lower prevalence of self-medication in children, including Valenzuela M. et al.⁵in Spain with a result of 32.8%, as well as the study by Abiodun M. et al.¹⁷in Nigeria with 25.5%, Cruz J. et al.¹⁸in Colombia with 25%, Yuan J. et al.¹⁹in China with 24.21%, and Mukattash T. et al.²⁰in Jordan with 39.2%.

Regarding educational level, parents who studied primary and secondary education were 1.22 times more likely to self-medicate their children compared to those with higher education, with an APR=1.22 (95% CI: 1.01-1.40), showing a significant association with self-medication. This finding coincides with the study by Mukattash T. et al.²⁰, which showed that parents with lower education were more likely to self-medicate their children. Likewise, the study by Alonso A. et al.²¹in Mexico highlighted that parents with a middle educational level, equivalent to secondary education in our country, are more likely to self-medicate their children. Additionally, the study by Cruz J. et al.¹⁸showed that parents with higher education have a lower likelihood of self-medicating their children.

According to the birth order, first-born children showed a significant association with self-medication, being a protective factor. This finding coincides with the study by Valenzuela M. et al.⁵which shows that children born second or later are more likely to be self-medicated by their parents.

Regarding the age of the parent, the present study did not show a significant association with self-medication. This result is similar to the national study by Ojeda A.²², although in his study, only mothers aged 18 to 70 years participated, while in our research, parents of both sexes participated. Likewise, international studies such as Abiodun M. et al.¹⁷in Nigeria, Ukwishaka J. et al.²³in Rwanda, and Yuan J. et al.¹⁹in China did not show a significant association. In contrast, the study by Alonso A. et al.²¹in Mexico showed that parents over 35 years old are more likely to self-medicate their children, and the study by Mukattash T. et al.²⁰in Jordan demonstrated that parents over 50 years old are more likely to self-medicate their children.

With respect to the age of the child, the present study did not find a significant association with self-medication. This finding is consistent with the results obtained by Simon B, et al.⁶in Tanzania and Yuan J, et al.¹⁹in China. In contrast, the study by Agudelo S. et al.²in Colombia showed that children aged 6 to 15 years are more likely to be self-medicated by their parents.

Regarding the number of children, the present study did not find a significant association with self-medication. This finding is consistent with the study by Brenis C. et al.¹⁴. In contrast, Valenzuela M, et al.⁵, showed that parents with more than one child are more likely to self-medicate their children. Similarly, Alonso A, et al.²¹in Mexico, Ukwishaka J, et al.²³in Rwanda, and Mukattash T, et al.²⁰in Jordan found similar results.

The limitation of the present study was during data collection, as some parents did not have the availability of time to respond to the survey since the study was conducted in an Emergency Department.