Acute respiratory illness among Tunisian infants and use of antibiotics: Insights from 2006 and 2018 Multiple Indicator Cluster Surveys

<bold>Introduction:</bold> Tunisia has made substantial and steady progress in the field of health, enabling considerable improvements in the population-health in general and child health in particular. <bold>Aim:</bold> This study examines the percentage of infants<5years with acute respiratory illness (ARI) symptoms in the last two weeks and focuses on the use antibiotics. <bold>Methods:</bold> Our work was based on the Tunisian Multiple Indicator Cluster Surveys (MICS) conducted in 2006(June-August)and 2018(march-May). To collect information about infants<5years, mothers/caretakers were interviewed. A child was considered to have an ARI if he had, during the specified period a coughing and difficult breathing which symptoms were perceived to be due to a chest problem, or both a chest problem and a blocked nose. <bold>Results:</bold> The number of households surveyed were respectively 8681 and 11225 in 2006 and 2018. The response rate increased from 95.4% to 97.8. The number of infants included went from 3053 in 2006 to 3420 in 2018. The percentage of infants with ARI symptoms in the last two weeks decreased from 6.1% to 6%. The percentage was higher in urban areas in 2006 (6.3vs5.6) and in the rural areas in 2018(7.7% vs. 5%). The age group most affected was 6 to 11 months along the years, with a percentage of 9.8% in 2006 and 8.4% in 2018. In 20018, the percentage of children with ARI symptoms in the last two weeks who had received antibiotics was 65.4%, with a sex ratio (m/f) of 1.08. Infants in urban areas were most affected : 71.4%. <bold>Conclusion:</bold> Our study showed the high percent of ARI in Tunisian infants and highlights the excessive use of antibiotics.