Pharmacy based treatment increasing risk of complications in measles cases

Affan Islam, a four month and 12-day old child suffering from measles, has been admitted to the Bangladesh Shishu Hospital and Institute for the past 10 days. When the child developed a fever, his family initially sought treatment from a pharmacy. He was given antibiotics to reduce the fever. Later, when his condition deteriorated, he was first admitted to the DNCC Dedicated COVID Mahakhali Hospital. When he needed intensive care, he was transferred to the children’s hospital.

The child’s mother, Rina Akter, a teacher from Keraniganj, said, “Even though I am educated, I have no explanation for why I gave my son medicine from a pharmacy. Because of our mistake, the child came back from the brink of death. We have been suffering so much. A lot of money is also being spent.”

The guardians and family members of many children affected by measles have provided similar accounts. They said that even when children developed fever, cold, cough and rashes, many parents did not take them to doctors and instead bought medicines from nearby pharmacies. In most cases, children were given antibiotics along with regular syrups to reduce fever. When the children later developed post measles complications and their physical condition deteriorated, their families rushed them to major hospitals.

Fima Akter, 6, from Gazipur, was initially given medicine bought from a pharmacy to reduce her fever. After developing post measles pneumonia, she was taken to the local Tajuddin Ahmad Medical College Hospital. She was brought to Dhaka Medical College Hospital three days ago. The child’s father, Kalam Matbar, is a CNG auto rickshaw driver. He considers the medicine shop seller, who is also the owner, to be a doctor. He said, “Whenever we get sick, we always take medicine from the pharmacy doctor. We also get better. There is no problem. Everyone in the area takes medicine from him.”

Mirza Mohammad Ziaul Islam, director of Bangladesh Shishu Hospital and Institute, said, “Patients come to the hospital after receiving treatment from pharmacies and when their condition worsens. We regularly receive such patients. Parents do this to save money and avoid the hassle of hospitals. But this increases various risks for patients and causes permanent damage to different organs. At the same time, such use of antibiotics without a prescription from a registered doctor makes patients antibiotic resistant.”

According to the Bangladesh Bureau of Statistics’ Health and Morbidity Status Survey 2025, dependence on pharmacies and informal healthcare providers is very high when people seek treatment for illness in the country. Some 51.2 percent of people seek treatment themselves from nearby pharmacies. Another 4.9 percent go to unqualified practitioners. Only 11.2 percent seek treatment at government facilities.

The survey included 189,986 people and 47,040 households. Data for the survey was collected from November 2024 to January 2025.

A World Health Organization report published in 2024 also said that Bangladesh has a large number of pharmacies, creating opportunities to obtain antibiotics without prescriptions. The report identified inappropriate use of antibiotics as a major problem. According to WHO data, children under five make up a large proportion of those affected during measles outbreaks. Children under two dies in higher numbers. During measles outbreaks, health authorities have also advised parents to take suspected measles patients to healthcare facilities quickly.

Abid Hossain Molla, senior consultant of the pediatric department at BIRDEM General Hospital, said, “Children are mainly affected by measles. Children have comparatively weaker immune systems. Measles also further weakens the immune system. If treatment for measles is delayed, a child can deteriorate quickly. Treatment for measles should not be taken from a pharmacy, nor should treatment for any disease.”

The former head of the pediatric department at Dhaka Medical College also said, “If treatment is taken from a pharmacy, there will first be mistakes in diagnosing the disease and providing treatment. Even if there are signs of complications, they will not be detected in time. Second, the risk will increase because the child will be delayed in receiving proper treatment. In some cases, this can even lead to death.”

Asked why patients go to pharmacies, public health expert Mohammad Iqbal said, “The pharmacy worker is familiar because he is from the same area. It is easy to communicate with him. You can openly tell him about your problems. But doctors at hospitals cannot give patients much time. In addition, hospitals require patients to go through various procedures, which takes time. It also allows them to avoid doctors’ fees, testing costs and transportation expenses.”

Dr. SM Ziauddin Haider, special assistant to the prime minister for health affairs, said, “Many children have died from measles, while not a single child’s death from a preventable disease is desirable. People’s healthcare seeking behavior and delays in coming to hospitals are also causes of measles deaths. If hospitals become more patient friendly and a referral system is introduced, this problem can be overcome to a great extent. The government has started working toward that.”

According to Directorate General of Health Services data, the number of deaths from measles and measles symptoms has reached 1,108 since March this year. Of them, four people died from measles in the latest 24-hour period, from 8 am Tuesday to 8 am Wednesday. In the past 24 hours, 1,339 people with measles and measles symptoms were admitted to hospitals. The number of people affected by measles and measles symptoms this year has reached 213,251. Dhaka Division has recorded the highest number of cases and deaths.