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Dawson S, Johnson H, Huntley AL, Turner KM, McCahon D. Understanding non-recreational prescription medication-sharing behaviours: a systematic review. Br J Gen Pract 2024; 74:e183-e188. [PMID: 38373852 PMCID: PMC10904136 DOI: 10.3399/bjgp.2023.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/06/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Prescription medication sharing refers to the lending or borrowing of prescription medications where the recipient is someone other than the person for whom the prescription is intended. Sharing prescription medication can cause significant harm. Adverse consequences include an increased risk of side effects, delayed health seeking, and severity of disease. Prevalence estimates vary across different populations and people's reasons for, and perceptions of risks from, sharing are poorly understood. AIM To better understand prescription medication-sharing behaviours and practices - specifically, the prevalence, types of medications, reasons, perceived benefits and risks, and factors associated with medication sharing. DESIGN AND SETTING This systematic review included primary studies in any setting, focusing on people who engage in medication sharing. METHOD Electronic databases were searched from inception of databases to February 2023. RESULTS In total, 19 studies were included. Prevalence of lifetime sharing ranged from 13% to 78%. All 19 studies reported that analgesics were the most shared, followed by antibiotics (n = 12) and allergy medication (n = 9). Common reasons for sharing were running out of medication (n = 7), cost (n = 7), and emergency (n = 6). Perceived benefits included resolution of the problem and convenience. Perceived risks included adverse drug reactions and misdiagnosis. Characteristics associated with sharing included age, female sex, having asthma, and unused medicines stored at home. CONCLUSION Findings suggest that medication-sharing behaviour is common and involves a range of medicines for a variety of reasons. Data on the prevalence and predictors of prescription medication sharing are inconsistent. A better understanding of non-modifiable and potentially modifiable behavioural factors that contribute to sharing is needed to support development of effective interventions aimed at mitigating unsafe sharing practices.
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Affiliation(s)
- Shoba Dawson
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield
| | - Hans Johnson
- Bristol Medical School (Population Health Sciences), University of Bristol, Bristol
| | - Alyson L Huntley
- Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Bristol
| | - Katrina M Turner
- Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Bristol; National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol and NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol
| | - Deborah McCahon
- Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Bristol
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Xu K, Fang Q, Wang J, Hui A, Xuan S. Magnetic-Field-Induced Improvement of Photothermal Sterilization Performance by Fe 3O 4@SiO 2@Au/PDA Nanochains. MATERIALS (BASEL, SWITZERLAND) 2022; 16:387. [PMID: 36614727 PMCID: PMC9822472 DOI: 10.3390/ma16010387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
Due to the abuse of antibiotics, the sensitivity of patients to antibiotics is gradually reduced. This work develops a Fe3O4@SiO2@Au/PDA nanochain which shows an interesting magnetic-field-induced improvement of its photothermal antibacterial property. First, SiO2 was wrapped on Fe3O4 nanospheres assembled in a chain to form a Fe3O4@SiO2 nanocomposite with a chain-like nanostructure. Then, the magnetic Fe3O4@SiO2@Au/PDA nanochains were prepared using in situ redox-oxidization polymerization. Under the irradiation of an 808 nm NIR laser, the temperature rise of the Fe3O4@SiO2@Au/PDA nanochain dispersion was obvious, indicating that they possessed a good photothermal effect. Originating from the Fe3O4, the Fe3O4@SiO2@Au/PDA nanochain showed a typical soft magnetic behavior. Both the NIR and magnetic field affected the antimicrobial performance of the Fe3O4@SiO2@Au/PDA nanochains. Escherichia coli and Staphylococcus aureus were used as models to verify the antibacterial properties. The experimental results showed that the Fe3O4@SiO2@Au/PDA nanochains exhibited good antibacterial properties under photothermal conditions. After applying a magnetic field, the bactericidal effect was further significantly enhanced. The above results show that the material has a broad application prospect in inhibiting the growth of bacteria.
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Affiliation(s)
- Kezhu Xu
- School of Food and Biological Engineering, Hefei University of Technology, Hefei 230009, China
| | - Qunling Fang
- School of Food and Biological Engineering, Hefei University of Technology, Hefei 230009, China
| | - Jing Wang
- School of Food and Biological Engineering, Hefei University of Technology, Hefei 230009, China
| | - Ailing Hui
- School of Food and Biological Engineering, Hefei University of Technology, Hefei 230009, China
| | - Shouhu Xuan
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, University of Science and Technology of China, Hefei 230027, China
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Jaminola LI, Negre JM, Pepito VCF, Loreche AM, Dayrit MM. The policy environment of self-care: a case study of the Philippines. Health Policy Plan 2022; 38:205-217. [PMID: 36331518 PMCID: PMC9923374 DOI: 10.1093/heapol/czac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/04/2022] [Accepted: 11/04/2022] [Indexed: 11/06/2022] Open
Abstract
Self-care is the ability and empowerment of individuals to maintain health through informed health-care decisions, with or without the support of a health provider. High-income countries have made advances to their conceptualization, research and institutionalization of self-care, given its reported benefits to patients, the health system and economy. A similar undertaking in low- and middle-income countries (LMICs) with already fragile health systems is warranted as highlighted by the coronavirus disease 2019 pandemic. Our article therefore aimed to describe and analyse the policy environment of self-care using the Philippines as a case study, which may have relevance to other similar countries and settings that are transitioning towards Universal Health Care (UHC) to reform and strengthen their primary care systems. We conducted 13 key informant interviews and 2 focus group discussions among representatives from the government, the pharmaceutical retail/industry, community retail pharmacy, primary health physicians and health workers, an infirmary administrator and patients and/or patient advocates. We triangulated our qualitative data with findings from our policy review. We found a total of 13 relevant policies on self-care in the Philippines recently drafted and/or implemented from 2016 to 2021 that fall under the broad categories of unifying frameworks and road maps, capacity building and institutional streamlining, regulations and disease guidelines. Our case study highlights the role of the UHC Law as a driver for self-care and patient empowerment towards better health outcomes with its passage resulting in the promulgation of self-care-related policies. Our findings also suggest that changes in the local policy and built environment, and the formal educational and health systems, are needed to foster a culture of responsible self-care. There are notable exemplars in advancing self-care in the region, including Thailand, from which LMICs like the Philippines can draw lessons to make progress on institutionalizing self-care and, ultimately, realizing UHC and Health For All.
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Affiliation(s)
| | | | - Veincent Christian F Pepito
- School of Medicine and Public Health, Ateneo de Manila University, Ortigas Ave., Pasig City 1604, Philippines
| | - Arianna Maever Loreche
- *Corresponding author. School of Medicine and Public Health, Ateneo de Manila University, Ortigas Ave., Pasig City 1604, Philippines. E-mail:
| | - Manuel M Dayrit
- School of Medicine and Public Health, Ateneo de Manila University, Ortigas Ave., Pasig City 1604, Philippines
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Berdida DJE, Grande RAN, Lopez V, Ramirez SH, Manting MME, Berdida MME, Bañas CB. A national online survey of Filipinos' knowledge, attitude, and awareness of antibiotic use and resistance: A cross-sectional study. Nurs Forum 2022; 57:1299-1313. [PMID: 36161465 DOI: 10.1111/nuf.12803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/23/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Antibiotic resistance is one of the 21st century's most challenging clinical and public health issues. However, this health issue remains underreported in the Philippines. AIM This study examined Filipinos' knowledge, attitude, and awareness regarding antibiotic use and resistance and the associated predictive variables of antibiotic resistance. METHODS A cross-sectional design and Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used in this study. Convenience sampling of 3767 participants completed the Eurobarometer survey on antibiotic resistance from October 2021 to February 2022. χ2 and regression analysis were used to analyze the data. RESULTS Most participants were familiar with the popular types of available antibiotics. Males and healthcare workers had a higher percentage of correct responses on antibiotic resistance knowledge. Participants had moderate to high knowledge levels of antibiotic resistance. Age, educational attainment, profession, antibiotic use in the previous year, and household members taking antibiotics were significant predictors of the level of knowledge of antibiotic resistance. There was a significant difference in participants' sex, age, and educational attainment in their attitudes toward acquisition, hygienic practices, and the role of health professionals in antibiotic resistance. CONCLUSION Government agencies and policymakers should consider the identified predictors when establishing policies on antibiotic resistance. This will ensure that antibiotic use is safe and effective.
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Affiliation(s)
| | - Rizal Angelo N Grande
- Mental Health Nursing Department, College of Nursing, University of Ha'il, Ha'il City, Saudi Arabia
| | - Violeta Lopez
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Sheryl H Ramirez
- University Research Innovation and Extension, Universidad de Manila, Manila, Philippines
| | - Muhmin Michael E Manting
- Department of Biological Sciences, Mindanao State University-Iligan Institute of Technology, Iligan City, Lanao del Norte, Philippines
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Khan FU, Mallhi TH, Khan Q, Khan FU, Hayat K, Khan YH, Ahmad T, Fang Y. Assessment of antibiotic storage practices, knowledge, and awareness related to antibiotic uses and antibiotic resistance among household members in post-conflict areas of Pakistan: Bi-central study. Front Med (Lausanne) 2022; 9:962657. [PMID: 36160164 PMCID: PMC9494294 DOI: 10.3389/fmed.2022.962657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/11/2022] [Indexed: 12/04/2022] Open
Abstract
Background The storage of antimicrobials at home is frequently in-practice in various developing countries, resulting an irrational use, antibiotic resistance, and toxicities. This condition may worsen more in conflict zones where health facilities are limited. This study aimed to determine the storage and use of leftover antibiotics among households (HHs) along with knowledge and awareness about antibiotics and antibiotic resistance (ABR). Methods A descriptive cross-sectional study design was employed. Members of HHs were invited to participate in the survey while using a convenient sampling technique. The data were obtained using a validated questionnaire and analyzed through SPSS. Results A total of 96 HHs were randomly selected from two districts (n = 50, n = 46), with most of the participants being men between the ages of 18 and 28 (n = 45, 46.9%) years. The majority of HHs (n = 32, 33.3%) had six to eight total family members, with one to two chronic diseases (n = 63, 65.6%), individual families (n = 60, 62.5%), and with (n = 35, 36.5%) LRTIs (lower respiratory tract infections). The HHs were aware of the word "antibiotic" (n = 59, 61.5%) and gave correct replies to amoxicillin as an antibiotic (n = 42, 43.8%); on the other hand, HHs also thought of paracetamol as an antibiotic (n = 45, 47.9%). They identified the most common brands of antibiotics easily, and a majority of them (n = 69, 71.9%) had never heard of ABR before and had lower levels of awareness. The most stored antibiotic at home (n=38, 39.6%) was azithromycin (J01FA10). In addition, they had multiple needless (1-2, n = 62, 64.6%; 3-4, n = 29, 30.2%) and antibiotics in their houses. Age had a strong association (p = 0.017, H = 12) affected the mean knowledge scores related to antibiotic use. Association of education levels (p = 0.001, H = 52.8) and occupation (p = 0.04, H = 10) with proper antibiotics use were found to be significant. However, family members with more than one chronic illness (p = 0.09, H = 0.8) showed a significant relationship with their awareness of antibiotics. Conclusion Participants generally stored various antibiotics of different classes in their homes. Lack of knowledge related to the appropriate usage of antibiotics, use of leftover antibiotics, and awareness related to ABR were unknown to the participants.
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Affiliation(s)
- Faiz Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
- Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Center for Health Reform and Development Research, Xi'an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Qasim Khan
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad, Pakistan
| | - Farman Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
- Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Center for Health Reform and Development Research, Xi'an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
- Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Center for Health Reform and Development Research, Xi'an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
- Institute of Pharmaceutical Sciences, The University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Tawseef Ahmad
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad, Pakistan
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
- Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Center for Health Reform and Development Research, Xi'an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
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Basu S, Copana R, Morales R, Anugulruengkitt S, Puthanakit T, Maramba-Lazarte C, Williams P, Musembi J, Boga M, Issack M, Hokororo A, Falade AG, Trehan I, Molyneux E, Arscott-Mills T, Alemayehu T, Bryant PA. Keeping It Real: Antibiotic Use Problems and Stewardship Solutions in Low- and Middle-income Countries. Pediatr Infect Dis J 2022; 41:S18-S25. [PMID: 35134036 PMCID: PMC8815843 DOI: 10.1097/inf.0000000000003321] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 12/28/2022]
Abstract
Antimicrobial resistance is a global health threat and there is an urgent need to manage antibiotic use to slow its development. However, antimicrobial stewardship interventions in low- and middle-income countries (LMIC) have been limited in terms of their resourcing, feasibility and effectiveness in the face of greater challenges in child mortality. We sought to gather together examples of antibiotic use problems faced by clinicians in LMIC, many of which are unique to these settings, and real-world antimicrobial stewardship solutions identified, with the goal of learning broader lessons that might be applicable across LMIC.
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Affiliation(s)
- Saurav Basu
- From the Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Raul Copana
- Department of Pediatrics, Faculty of Medicine, San Simon University, Cochabamba, Bolivia
- Intensive Care Unit, Manuel A. Villarroel Childrens Hospotal, Cochabamba, Bolivia
| | - Ronaldo Morales
- Clinical Pharmacokinetics Center, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Suvaporn Anugulruengkitt
- Department of Pediatrics and
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanyawee Puthanakit
- Department of Pediatrics and
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Cecilia Maramba-Lazarte
- Division of Infectious and Tropical Diseases (INTROP), Department of Pediatrics, University of the Philippines College of Medicine-Philippine General Hospital, Manila, Philippines
- Department of Pharmacology and Toxicology, University of the Philippines, College of Medicine, Manila, Philippines
| | - Phoebe Williams
- Kenya Medical Research Institute (KEMRI/Wellcome Trust Research Programme), Department of Paediatrics, Kilifi, Kenya
- School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - John Musembi
- School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Mwanamvua Boga
- School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Mohammad Issack
- Bacteriology Department, Central Health Laboratory, Victoria Hospital, Quatre-Bornes, Mauritius
| | - Adolfine Hokororo
- Department of Paediatrics and Child Health, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Adegoke G. Falade
- Department of Paediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Indi Trehan
- Departments of Pediatrics, Global Health, and Epidemiology, University of Washington, Seattle, Washington
| | - Elizabeth Molyneux
- Paediatric and Child Health Department, College of Medicine, Blantyre, Malawi
| | | | - Tinsae Alemayehu
- American Medical Center, and St. Paul’s Hospital Millennium Medical College, Department of Infectious Diseases and Travel Medicine, Addis Ababa, Ethiopia
| | - Penelope A. Bryant
- Consultant in Paediatric Infectious Diseases and Medical Lead, Hospital-in-the-Home, The Royal Children’s Hospital
- Group Leader and Clinician-Scientist Fellow, Clinical Paediatrics, Murdoch Children's Research Institute and
- Department of Paediatrics, University of Melbourne Parkville, Victoria, Australia
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Song S, Kim S, Shin S, Lee Y, Lee E. Evaluation of Prescription Medication Sharing Among Adults in South Korea: A Cross-Sectional Survey. Front Pharmacol 2022; 13:773454. [PMID: 35185558 PMCID: PMC8854370 DOI: 10.3389/fphar.2022.773454] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/17/2022] [Indexed: 12/01/2022] Open
Abstract
Background: Prescription medication sharing is an inappropriate medication use behavior that can lead to medication errors and adverse drug events, posing a public health threat. The reported prevalence of prescription medication lending and borrowing varies by country, ranging from 6%–23% and 5%–52%, respectively. However, research on medication sharing is scant in Asian countries. Therefore, this study aimed to describe the rate of prescription medication sharing practices and investigate the associated behavioral factors, types of shared medications, and reasons for sharing among adults in South Korea. Methods: A cross-sectional study was conducted using an online self-administered survey of 1,000 adults (aged 19–69 years; November 2020). A stratified sampling method was used to select survey participants from a nationwide consumer panel, which ensured a representative distribution of the Korean population by age, gender, and region. Descriptive and logistic regression analyses were used to evaluate the information related to sharing behavior. Results: A total of 1,000 respondents participated in this study. The mean age of the respondents was 44.7 years (standard deviation [SD], 13.4), ranging from 20 to 69 years. The rate of medication sharing was 52.4%. The most prevalently shared medications were analgesic, antipyretic, and antimigraine medications. Prescription medications were shared mostly between family and relatives. Older age was a predictive factor for sharing analgesics. Lower educational level was a predictive factor for sharing ophthalmic medications. Conclusions: Approximately one in two respondents in our study have experienced medication sharing in their lifetime. Future studies are needed to establish evidence-based strategies for patient education and improve the medication use process. Healthcare professionals should assess patients’ needs for accessing medications and be ready to educate and guide them with specific action plans. Policymakers should consider patient empowerment strategies including public education and campaigns to avoid potential adverse outcomes of medication sharing.
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Affiliation(s)
- Seulki Song
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea
- Department of Pharmacy, Veterans Health Service Medical Center, Seoul, South Korea
| | - Seungyeon Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea
- Transdisciplinary Department of Medicine and Advanced Technology, Seoul National University Hospital, Seoul, South Korea
| | - Sangyoon Shin
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea
| | - Young Lee
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, South Korea
- Department of Applied Statistics, Chung-Ang University, Seoul, South Korea
| | - Euni Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea
- *Correspondence: Euni Lee,
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The challenges of combatting antimicrobial resistance in the Philippines. THE LANCET MICROBE 2022; 3:e246. [DOI: 10.1016/s2666-5247(22)00029-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/18/2022] Open
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Ornos EB, Quebral EB, Ceriales J, Tantengco OG. Inappropriate antibiotic dispensing and use: A public health threat in the Philippines. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.354417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ben Mabrouk A, Larbi Ammari F, Werdani A, Jemmali N, Chelli J, Mrabet HE, Rassas A, Sfar MH, El Mhamdi S, Mahjoub B. Parental self-medication with antibiotics in a Tunisian pediatric center. Therapie 2021; 77:477-485. [PMID: 34776255 DOI: 10.1016/j.therap.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/31/2021] [Accepted: 10/12/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Self-medication of antibiotics among children is a very common problem in Tunisia. Its prevalence isn't well established. The aims of this study are to evaluate parents' knowledge concerning antibiotic use, and identify the factors associated with this problem. PATIENTS AND METHODS We conducted a cross-sectional study over a one year period (between August 2019 and July 2020). Data collection was performed using a questionnaire guided interview. We included parents of children consulting or hospitalized in the pediatric department of the university hospital Taher Sfar in Mahdia. RESULTS A total of 354 parents were included with an average age of 36.4±9.2 years. The average knowledge score was 2±1.3 points. In fact, 61.6% of the parents had poor knowledge about antibiotics. The frequency of non-prescription antibiotics use among children was 20.6%. Amoxicillin was the most used antibiotic (72.6%). Sore throat, important fever and flu-like symptoms were the main symptoms justifying non-prescription antibiotic use among our pediatric population in 60.3%, 34.2% and 23.3% of cases respectively. The main reason of self-medication was the fact that the same antibiotic was once prescribed to treat the same symptoms (58.9%). The used antibiotic came from an old prescription for the same child in 57.5% of the cases and was recommended by the pharmacist in 39.7% of the cases. After multivariate analysis, the factors associated with parental self-medication with antibiotics were: the advanced parent's age, the ability to name an antibiotic and knowledge's score>2. CONCLUSION Our study confirmed that parental knowledge about antibiotic use is low. In fact, the government should from one hand, organize antibiotic delivery and prohibit off the counter sells and in the other hand promote the education of the public through different procedures to stop this major health problem.
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Affiliation(s)
- Asma Ben Mabrouk
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia.
| | - Fatma Larbi Ammari
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia; Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia
| | - Amina Werdani
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Pediatric Department, 5100 Mahdia, Tunisia
| | - Nesrine Jemmali
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Pediatric Department, 5100 Mahdia, Tunisia
| | - Jihene Chelli
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia; Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia
| | - Houcem Elomma Mrabet
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia
| | - Ahmed Rassas
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Pediatric Department, 5100 Mahdia, Tunisia
| | - Mohamed Habib Sfar
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia; Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia
| | - Sana El Mhamdi
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Community and Preventive Medicine Department, 5100 Mahdia, Tunisia
| | - Bahri Mahjoub
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Pediatric Department, 5100 Mahdia, Tunisia
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11
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Pham-Duc P, Sriparamananthan K. Exploring gender differences in knowledge and practices related to antibiotic use in Southeast Asia: A scoping review. PLoS One 2021; 16:e0259069. [PMID: 34699559 PMCID: PMC8547692 DOI: 10.1371/journal.pone.0259069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022] Open
Abstract
Inappropriate use of antibiotics has been one of the main contributors to antimicrobial resistance, particularly in Southeast Asia. Different genders are prone to different antibiotic use practices. The objective of this scoping review is to understand the extent and type of evidence available on gender differences in antibiotic use across Southeast Asia. The search strategy for this scoping review involved PubMed, Semantic Scholar, BioMed Central and ProQuest. Two-level screening was applied to identify the final sample of relevant sources. Thematic content analysis was then conducted on the selected final sources to identify recurring themes related to gender differences in antibiotic use and a narrative account was developed based on the themes. Recommendations for next steps regarding reducing inappropriate antibiotic use and gender considerations that need to be made when developing future interventions were also identified. Research on gender and antibiotic use remains scarce. Studies that discuss gender within the context of antibiotic use often mention differences between males and females in knowledge, attitudes and/or behaviour, however, do not explore reasons for these differences. Gender differences in antibiotic use were generally examined in terms of: (i) knowledge of antibiotic use and antimicrobial resistance and (ii) practices related to antibiotic use. Evidence indicated that differences between males and females in knowledge and practices of antibiotic use varied greatly based on setting. This indicates that gender differences in antibiotic use are greatly contextual and intersect with other sociodemographic factors, particularly education and socioeconomic status. Educational interventions that are targeted to meet the specific needs of males and females and delivered through pharmacists and healthcare professionals were the most common recommendations for reducing inappropriate use of antibiotics in the community. Such targeted interventions require further qualitative research on factors influencing differences in knowledge and practices related to antibiotic use among males and females. In addition, there is also a need to strengthen monitoring and regulation practices to ensure accessibility to affordable, quality antibiotics through trusted sources.
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Affiliation(s)
- Phuc Pham-Duc
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi, Vietnam.,Institute of Environmental Health and Sustainable Development, Hanoi, Vietnam
| | - Kavitha Sriparamananthan
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi, Vietnam.,Institute of Environmental Health and Sustainable Development, Hanoi, Vietnam.,Veterinarians Without Borders/ Vétérinaires Sans Frontières, Ottawa, Ontario, Canada
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12
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Assessment of Knowledge, Attitude, and Practice of Antibiotic Use among the Population of Boyolali, Indonesia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168258. [PMID: 34444015 PMCID: PMC8394957 DOI: 10.3390/ijerph18168258] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 12/24/2022]
Abstract
Misuse and overuse of antibiotics are potential causes of the increasing prevalence of antibiotic resistance (ABR). Having information about the knowledge, attitude, and practices concerning antibiotics use by the public might help control ABR growth. Therefore, this cross-sectional study aimed to investigate the levels and associated factors of knowledge, attitude, and practice (KAP) of antibiotics use among the public. A questionnaire was designed and validated, which consisted of a total of 51 questions with four sections: demographics (6), knowledge (20), attitude (12), and practice (13) to measure KAP. Univariate analysis (using Mann-Whitney U and Kruskal-Wallis analysis) was applied to assess the differences in the mean scores of KAP. Linear regression analysis was performed to identify factors associated with KAP. Finally, using Spearman analysis we have examined the correlation between responses to the KAP. The sample size of this study was 575, with a 99.96% response rate. Regarding knowledge, 73.12% of respondents stated that antibiotics could be used to treat viral infections, and 63.35% of respondents answered that antibiotics could reduce fever. Concerning attitude, 50% of respondents had considered stopping taking antibiotics as soon as symptoms had disappeared. In analyzing practice, we found 40% of respondents obtained antibiotics from a pharmacy without a prescription from a physician, a nurse, or a midwife. Statistical analysis revealed that KAP about antibiotic use was significantly associated with gender, area of residence, level of education, and monthly income (p < 0.05). Our findings concluded that men, respondents with low income, those with low-level education, and those living in rural areas are more prone to excessive use of antibiotics without knowing the adverse effects of improper use and how it can contribute to high ABR. So it is urgently necessary to strengthen policies on antibiotics use, including drug provision, distribution, and sales. In addition, people with low KAP should be a priority consideration in education outreach initiatives.
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13
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Memon I, Alrashid AA, Alshammari HS, Rehman DES, Feroz Z, Nagro A, Alotaibi R, Alsalmi M, Khan MA, Alkushi A, Zaidi SF. Assessing the Effects of Basic Medical Science Courses on the Knowledge and Attitude towards Antibiotic Usage among Pre-Professional Students in Saudi Arabia. PHARMACY 2021; 9:pharmacy9020108. [PMID: 34070925 PMCID: PMC8261635 DOI: 10.3390/pharmacy9020108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/10/2021] [Accepted: 05/20/2021] [Indexed: 11/19/2022] Open
Abstract
The curriculum of medical schools includes courses on antibiotics. Therefore, it is worth exploring information related to the knowledge and attitudes about antibiotics. In this cross-sectional study the questionnaire was administered to the undergraduates in two phases, before and after attending the basic medical science courses. The data were collected on demographic variables, source of antibiotics, level of knowledge, and changes in attitude statements. Data analysis was implemented using SPSS. The mean age of participants was 19.87 and 20.15 in phases I and II, respectively. Most of the participants’ parents had education at the university level and a monthly income above 15,000 SAR. Generally, students had good knowledge and attitude about antibiotics. A significant improvement in students’ knowledge in phase-II was noticed in “level of knowledge” (p-value = 0.044), “paracetamol is considered an antibiotic” (p-value < 0.001) and “overuse of antibiotics can cause antibiotics resistance” (p-value = 0.003). The overall knowledge and attitude of pre-professional students were good in both phases, but their attitude did not improve at a significant level in phase-II. There is a need to put more focus on antimicrobial therapy in their training.
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Affiliation(s)
- Ismail Memon
- Basic Science Department, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (D.S.R.); (Z.F.); (A.A.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- Correspondence: (I.M.); (S.F.Z.)
| | - Azzam Abdulaziz Alrashid
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (A.A.A.); (H.S.A.)
| | - Hamad Saadi Alshammari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (A.A.A.); (H.S.A.)
| | - Dur-e-Shewar Rehman
- Basic Science Department, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (D.S.R.); (Z.F.); (A.A.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Zeeshan Feroz
- Basic Science Department, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (D.S.R.); (Z.F.); (A.A.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Abdulaziz Nagro
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (A.N.); (R.A.); (M.A.); (M.A.K.)
| | - Rakan Alotaibi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (A.N.); (R.A.); (M.A.); (M.A.K.)
| | - Muath Alsalmi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (A.N.); (R.A.); (M.A.); (M.A.K.)
| | - Muhammad Anwar Khan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (A.N.); (R.A.); (M.A.); (M.A.K.)
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia
| | - Abdulmohsen Alkushi
- Basic Science Department, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (D.S.R.); (Z.F.); (A.A.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Syed Faisal Zaidi
- Department of Pharmacology, School of Medicine, Batterjee Medical College for Sciences and Technology, Jeddah 21442, Saudi Arabia
- Correspondence: (I.M.); (S.F.Z.)
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14
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Hicks JP, Latham SM, Huque R, Das M, Newell J, Abdullah SM, Al Azdi Z, Jahan I, Rassi C, Hamade P, Shafique M, Islam MS, King R. Antibiotic practices among household members and their domestic animals within rural communities in Cumilla district, Bangladesh: a cross-sectional survey. BMC Public Health 2021; 21:406. [PMID: 33632193 PMCID: PMC7908663 DOI: 10.1186/s12889-021-10457-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/12/2021] [Indexed: 12/19/2022] Open
Abstract
Background Antibiotic resistance is a global threat to human health, and inappropriate use of antibiotics in humans and animals is widely considered to be a key driver of antibiotic resistant infections. Antibiotic use in humans and animals is growing rapidly in low- and, particularly, middle-income countries. However, there is little detailed understanding about practices related to the use of antibiotics in humans and animals within community settings in such countries. Here we aimed to understand the antibiotic practices of rural households across Cumilla district, Bangladesh, in relation to household members and their domestic animals. Methods In 2018 we conducted a cross-sectional survey using representative cluster sampling methods. We collected self-reported information from 682 female and 620 male household heads, with women also asked about their children’s antibiotic practices. Results Only 48% (95% CI: 40, 56%) of women and men had heard of antibiotics, and among those women and men who were aware of antibiotics and the children of those women 70% (95% CI: 64, 76%) reported having previously taken antibiotics, while among these individuals who reported previously taking antibiotics 21% (95% CI: 18, 25%) said they had done so most recently within the last month. Risky/inappropriate antibiotic practices in humans and animals were often reported. For example, among women and men who were aware of antibiotics and the children of those women 52% (95% CI: 40, 63%) reported previously taking antibiotics for a “cough/cold”, despite antibiotics being typically inappropriate for use against viral upper respiratory tract infections. Among poultry-owning respondents who were aware of antibiotics 11% (95% CI: 8, 15%) reported previously giving healthy poultry antibiotics, mainly for growth/prophylaxis, while among cattle-owning respondents who were aware of antibiotics and reported previously giving their cattle feed 20% (95% CI: 9, 37%) said the feed had contained antibiotics at least sometimes. Conclusions Our results highlight the need for context-adapted interventions at both the community level and the health systems level to reduce inappropriate antibiotic use among humans and domestic animals in rural Bangladesh. Successfully reducing inappropriate use of antibiotics among humans and animals is a required and critical step in tackling antimicrobial resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10457-w.
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Affiliation(s)
- Joseph Paul Hicks
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK.
| | - Sophia M Latham
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, Cheshire, CH64 7TE, UK
| | - Rumana Huque
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh.,Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mahua Das
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK
| | - Jane Newell
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - S M Abdullah
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh.,Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Zunayed Al Azdi
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh
| | - Ishrat Jahan
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh
| | - Christian Rassi
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Prudence Hamade
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Muhammad Shafique
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Mohammad Saiful Islam
- Faculty of Surgery and Professor of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK
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15
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Blaser MJ, Melby MK, Lock M, Nichter M. Accounting for variation in and overuse of antibiotics among humans. Bioessays 2021; 43:e2000163. [PMID: 33410142 DOI: 10.1002/bies.202000163] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 01/10/2023]
Abstract
Worldwide, antibiotic use is increasing, but many infections against which antibiotics are applied are not even caused by bacteria. Over-the-counter and internet sales preclude physician oversight. Regional differences, between and within countries highlight many potential factors influencing antibiotic use. Taking a systems perspective that considers pharmaceutical commodity chains, we examine antibiotic overuse from the vantage point of both sides of the therapeutic relationship. We examine patterns and expectations of practitioners and patients, institutional policies and pressures, the business strategies of pharmaceutical companies and distributors, and cultural drivers of variation. Solutions to improve antibiotic stewardship include practitioners taking greater responsibility for their antibiotic prescribing, increasing the role of caregivers as diagnosticians rather than medicine providers, improving their communication to patients about antibiotic treatment consequences, lessening the economic influences on prescribing, and identifying antibiotic alternatives.
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Affiliation(s)
- Martin J Blaser
- Center for Advanced Biotechnology and Medicine, Rutgers University, Piscataway, New Jersey, USA
| | - Melissa K Melby
- Department of Anthropology, University of Delaware, Newark, Delaware, USA
| | - Margaret Lock
- Department of Social Studies of Medicine and Department of Anthropology, McGill University, Montreal, Quebec, Canada
| | - Mark Nichter
- School of Anthropology, Mel and Enid Zuckerman College of Public Health, Department of Family Medicine, University of Arizona, Tucson, Arizona, USA
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16
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Karuniawati H, Hassali MAA, Suryawati S, Ismail WI, Taufik T, Wiladatika A. Public practices towards antibiotics: A qualitative study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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17
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Fletcher-Miles H, Gammon J. A scoping review on the influential cognitive constructs informing public AMR behavior compliance and the attribution of personal responsibility. Am J Infect Control 2020; 48:1381-1386. [PMID: 32067811 DOI: 10.1016/j.ajic.2020.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Antibiotic resistance is a growing threat to public health. Despite various attempts at educating the public on antimicrobial resistance (AMR) and judicial antibiotic use, fallacies and misconceptions remain. To successfully promote behavior change, various cognitive constructs pertaining to antibiotic behavior need to be identified and targeted. METHODS Using the Arksey and O'Malley (2005) methodological framework, a credible reflexive examination of literature was conducted, permitting identification of a breadth of literature that pertained to the influence of cognitive constructs on public antimicrobial behavior. RESULTS From 393 abstracts identified, 67 full articles were screened, and 43 papers were chosen for review. Three themes were identified (1) sociodemographic influences; (2) knowledge, misconceptions, and fallacies; and (3) public attitudes and the social influence of friends and family. Geographical location, education level, cognitive dissonance, and social norms were found to influence AMR cognition, resulting in disproportionate risk assessments that are facilitated by social information brokering. CONCLUSIONS Public AMR resilience, responsibility, and behavior compliance are influenced by cognitive constructs, which are liable to the appropriation of misconceptions, fallacies, and social behavior models obtained via information brokering. A cohesive multidisciplinary participatory approach to AMR management and interventional design that applies the influence of cognitive constructs to inform public AMR behavior compliance is recommended.
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Affiliation(s)
- Hayley Fletcher-Miles
- College of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom.
| | - John Gammon
- College of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom
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18
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Magat EM, Balanag GA, CariÑo AM, Fellizar A, Ortin TS, Guevarra L, Albano PM. Clostridioides difficile antibody response of colorectal cancer patients versus clinically healthy individuals. BIOSCIENCE OF MICROBIOTA FOOD AND HEALTH 2020; 39:123-127. [PMID: 32775130 PMCID: PMC7392905 DOI: 10.12938/bmfh.2020-010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/04/2020] [Indexed: 01/04/2023]
Abstract
Dysbiosis, defined as an imbalance in the gut microbiota caused by too few beneficial bacteria and an overgrowth of bad bacteria, yeast, and/or parasites, is now being associated
with several diseases, including the development of colorectal carcinoma (CRC). In this study, the potential association of Clostridioides difficile (formerly
Clostridium difficile) with CRC was investigated. Plasma samples obtained from preoperative histologically confirmed CRC patients (n=39) and
their age- and sex-matched clinically healthy controls (n=39) were analyzed for antibodies to toxin B of C. difficile (anti-tcdB) by enzyme-linked
immunosorbent assay (ELISA). A significantly greater number (p=0.012) of CRC cases (n=26/39, 66.7%) had anti-tcdB IgG levels above the cutoff value compared with
controls (n=12/39, 30.8%). Eight cases (8/39, 20.5%) and none of the controls registered anti-tcdB IgA levels above the cutoff value (p=0.0039). Anti-tcdB IgG and
IgA levels were not shown to be significantly associated with tumor grade or tumor stage. Anti-tcdB IgG showed 66.7% sensitivity and 69.2% specificity. For anti-tcdB IgA,
sensitivity and specificity were 20.5% and 100%, respectively. The positive predictive values for anti-tcdB IgA and IgG were 100% and 68.4%, respectively. The anti-tcdB IgA and IgG
negative predictive values were 55.7% and 67.5%, respectively. The results suggest the potential association of C. difficile with CRC and anti-tcdB levels,
particularly the IgA level. Hence, anti-tcdB antibodies can be candidate serologic markers for CRC.
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Affiliation(s)
- Edrienne Myenna Magat
- The Graduate School, University of Santo Tomas, España Blvd., Manila, Philippines.,Research Center for the Natural and Applied Sciences, University of Santo Tomas, España Blvd., Manila, Philippines
| | - Gregg Austine Balanag
- The Graduate School, University of Santo Tomas, España Blvd., Manila, Philippines.,Research Center for the Natural and Applied Sciences, University of Santo Tomas, España Blvd., Manila, Philippines
| | - Ana Maria CariÑo
- The Graduate School, University of Santo Tomas, España Blvd., Manila, Philippines.,Research Center for the Natural and Applied Sciences, University of Santo Tomas, España Blvd., Manila, Philippines.,Quirino State University, Quirino, Philippines
| | - Allan Fellizar
- The Graduate School, University of Santo Tomas, España Blvd., Manila, Philippines.,Research Center for the Natural and Applied Sciences, University of Santo Tomas, España Blvd., Manila, Philippines.,Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines
| | - Teresa Sy Ortin
- The Graduate School, University of Santo Tomas, España Blvd., Manila, Philippines.,Benavides Cancer Institute, University of Santo Tomas Hospital, España Blvd., Manila, Philippines
| | - Leonardo Guevarra
- Research Center for the Natural and Applied Sciences, University of Santo Tomas, España Blvd., Manila, Philippines.,Department of Biochemistry, University of Santo Tomas, España Blvd., Manila, Philippines
| | - Pia Marie Albano
- The Graduate School, University of Santo Tomas, España Blvd., Manila, Philippines.,Research Center for the Natural and Applied Sciences, University of Santo Tomas, España Blvd., Manila, Philippines.,Department of Biological Sciences, University of Santo Tomas, España Blvd., Manila, Philippines
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19
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Birault F, Mignot S, Caunes N, Boutin P, Bouquet E, Pérault-Pochat MC, Thirioux B. The Characteristics of Care Provided to Population(s) in Precarious Situations in 2015. A Preliminary Study on the Universal Health Cover in France. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093305. [PMID: 32397452 PMCID: PMC7246706 DOI: 10.3390/ijerph17093305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 12/14/2022]
Abstract
Background: The French Universal Health Cover (CMU) aims to compensate for inequalities between precarious and non-precarious populations, enabling the former to access to free healthcare. These measures rely on the principle that precarious populations' health improves if healthcare is free. We designed a study to examine whether CMU fails to compensate for inequalities in reimbursed drugs prescriptions in precarious populations. Material and method: This retrospective pharmaco-epidemiological study compared the Defined Daily Dose relative to different reimbursed drugs prescribed by general practitioners (GPs) to precarious and non-precarious patients in France in 2015. Data were analysed using Mann-Whitney tests. Findings: 6 out of 20 molecules were significantly under-reimbursed in precarious populations. 2 were over-reimbursed. The 12 remaining molecules did not differ between groups. Interpretation: The under-reimbursement of atorvastatin, rosuvastatin, tamsulosine and timolol reflects well-documented epidemiological differences between these populations. In contrast, the equal reimbursement of amoxicillin, pyostacine, ivermectin, salbutamol and tiopropium is likely an effect of lack of compensation for inequalities. Precarious patients are more affected by diseases that these molecules target (e.g., chronic bronchitis, bacterial pneumonia, cutaneous infections). This could also be the case for the equal and under-reimbursement of insulin glargine and metformin (targeting diabetes), respectively, although this has to be considered with caution. In conclusion, the French free healthcare cover does not fail to compensate for all but only for some selective inequalities in access to reimbursed drugs prescriptions. These results are discussed with respect to the interaction of the doctor-patient relationship and the holistic nature of primary care, potentially triggering burnout and empathy decrease and negatively impacting the quality of care in precarious populations.
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Affiliation(s)
- François Birault
- Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, 86000 Poitiers, France; (S.M.); (N.C.); (P.B.)
- Maison de Santé Pluriprofessionnelle des Couronneries, 115 r des Couronneries, 86000 Poitiers, France
- Correspondence:
| | - Stéphanie Mignot
- Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, 86000 Poitiers, France; (S.M.); (N.C.); (P.B.)
- Service de Gynécologie Obstétrique, Université, CHU de Poitiers, 86000 Poitiers, France
| | - Nicole Caunes
- Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, 86000 Poitiers, France; (S.M.); (N.C.); (P.B.)
- Maison de Santé Pluriprofessionnelle des Couronneries, 115 r des Couronneries, 86000 Poitiers, France
| | - Philippe Boutin
- Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, 86000 Poitiers, France; (S.M.); (N.C.); (P.B.)
- Maison de Santé Pluriprofessionnelle des Couronneries, 115 r des Couronneries, 86000 Poitiers, France
| | - Emilie Bouquet
- Service de Pharmacologie Clinique et Vigilances, Université, CHU de Poitiers, 86021 Poitiers, France; (E.B.); (M.-C.P.-P.)
| | - Marie-Christine Pérault-Pochat
- Service de Pharmacologie Clinique et Vigilances, Université, CHU de Poitiers, 86021 Poitiers, France; (E.B.); (M.-C.P.-P.)
- Service de Pharmacologie Clinique et Vigilances, INSERM U1084-LNEC/INSERM CIC1402, Université, CHU de Poitiers, 86021 Poitiers, France
| | - Bérangère Thirioux
- Unité de Recherche Clinique Intersectionnelle en Psychiatrie à Vocation Régionale Pierre Deniker, Centre Hospitalier Henri Laborit, 86021 Poitiers, France;
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20
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Mitchell MEV, Alders R, Unger F, Nguyen-Viet H, Le TTH, Toribio JA. The challenges of investigating antimicrobial resistance in Vietnam - what benefits does a One Health approach offer the animal and human health sectors? BMC Public Health 2020; 20:213. [PMID: 32046713 PMCID: PMC7014660 DOI: 10.1186/s12889-020-8319-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/04/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The One Health concept promotes the enhancement of human, animal and ecosystem health through multi-sectorial governance support and policies to combat health security threats. In Vietnam, antimicrobial resistance (AMR) in animal and human health settings poses a significant threat, but one that could be minimised by adopting a One Health approach to AMR surveillance. To advance understanding of the willingness and abilities of the human and animal health sectors to undertake investigations of AMR with a One Health approach, we explored the perceptions and experiences of those tasked with investigating AMR in Vietnam, and the benefits a multi-sectorial approach offers. METHODS This study used qualitative methodology to provide key informants' perspectives from the animal and human health sectors. Two scenarios of food-borne AMR bacteria found within the pork value chain were used as case studies to investigate challenges and opportunities for improving collaboration across different stakeholders and to understand benefits offered by a One Health approach surveillance system. Fifteen semi-structured interviews with 11 participants from the animal and six from the human health sectors at the central level in Hanoi and the provincial level in Thai Nguyen were conducted. RESULTS Eight themes emerged from the transcripts of the interviews. From the participants perspectives on the benefits of a One Health approach: (1) Communication and multi-sectorial collaboration; (2) Building comprehensive knowledge; (3) Improving likelihood of success. Five themes emerged from participants views of the challenges to investigate AMR: (4) Diagnostic capacity; (5) Availability and access to antibiotics (6) Tracing ability within the Vietnamese food chain; (7) Personal benefits and (8) Managing the system. CONCLUSION The findings of this study suggest that there is potential to strengthen multi-sectorial collaboration between the animal and human health sectors by building upon existing informal networks. Based on these results, we recommend an inclusive approach to multi-sectorial communication supported by government network activities to facilitate partnerships and create cross-disciplinary awareness and participation. The themes relating to diagnostic capacity show that both sectors are facing challenges to undertake investigations in AMR. Our results indicate that the need to strengthen the animal health sector is more pronounced.
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Affiliation(s)
- Marisa E V Mitchell
- International Livestock Research Institute (ILRI), 298 Kim Ma, Ba Dinh, Hanoi, Vietnam.
- Faculty of Arts and Social Sciences, University of Sydney, Sydney, Australia.
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia.
| | - Robyn Alders
- Centre on Global Health Security, Chatham House, Royal Institute of International Affairs, London, UK
- Development Policy Centre, Australian National University, Canberra, ACT, Australia
- Kyeema Foundation, Brisbane, Australia
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, USA
| | - Fred Unger
- International Livestock Research Institute (ILRI), 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
| | - Hung Nguyen-Viet
- International Livestock Research Institute (ILRI), 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi, Vietnam
| | - Trang Thi Huyen Le
- International Livestock Research Institute (ILRI), 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
| | - Jenny-Ann Toribio
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
- School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, Australia
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21
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Zaidi SF, Alotaibi R, Nagro A, Alsalmi M, Almansouri H, Khan MA, Khan A, Memon I. Knowledge and Attitude Towards Antibiotic Usage: A Questionnaire-Based Survey Among Pre-Professional Students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia. PHARMACY 2020; 8:pharmacy8010005. [PMID: 31935856 PMCID: PMC7151657 DOI: 10.3390/pharmacy8010005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/15/2019] [Accepted: 12/31/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction: Knowledge and attitudes towards proper antibiotic usage among students in medical and other health allied fields play a vital role in limiting the pandemic of antibiotic resistance. This study aimed to assess knowledge and attitudes toward antibiotic usage among pre-professional students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia. Methods: A self-administered cross-sectional survey of 347 first year students was conducted at the College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences using a validated questionnaire. Results: Nearly 63% of the students had a moderate level of knowledge. Two third of the students (69.7%) correctly knew that antibiotics are indicated for the treatment of bacterial infections. However, about 36% of the students incorrectly thought that antibiotics are also used to treat viral infections, while 28.5% were not sure. Only 38.8% of the students were aware of antibiotic resistance phenomena in relation to the overuse of antibiotics. Furthermore, only 27.3% correctly knew that penicillin is an antibiotic, and 74.4% were not sure if Paracetamol is an antibiotic. With regard to attitudes, 25.7% believed that taking antibiotics when having cold symptoms could help them to recover faster, while 39.6% expected antibiotics to be prescribed for common cold symptoms. Conclusion: The students have misconception regarding antibiotic use indications. Therefore, awareness campaigns are needed to promote student's use of antibiotics in young generations particularly among the pre-professional health sciences students.
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Affiliation(s)
- Syed Faisal Zaidi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia
- Correspondence: or
| | - Rakan Alotaibi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
| | - Abdulaziz Nagro
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
| | - Muath Alsalmi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
| | - Hidaya Almansouri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
| | - Muhammad Anwar Khan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia
| | - Aslam Khan
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia
- College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
| | - Ismail Memon
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia
- College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia
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Alhomoud F. 'Sharing may not be caring' - Prescription medication sharing among adults in Saudi Arabia. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2019; 28:255-266. [PMID: 31763741 DOI: 10.1111/ijpp.12592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/31/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of the current study was to describe prescription medication sharing behaviours (i.e. borrowing and lending) among adults living in Saudi Arabia. METHODS This cross-sectional survey was conducted in Saudi Arabia during December 2018. The eligibility criteria were an ability to communicate in Arabic or English and aged ≥18 years. An online survey was distributed to a convenience sample, supplemented by snowballing, by email and social media via an Internet link leading to a web-based survey platform in QuestionPro to assess their medication sharing behaviours. Bivariate and multivariate analyses were used to assess the associations. KEY FINDINGS A total of 667 completed the questionnaire. The prevalence of borrowing and lending prescription medication was found to be 14% and 16% in 2018 (past year), respectively. Twenty per cent of participants revealed that they had given a medication prescribed for one child to another child in their care, and 75% reported having leftover prescription medicine at home. The majority (90%) had borrowed or lent on one to three occasions. A wide range of medications were borrowed and lent mainly between immediate family members. Different reasons have been identified for medicine borrowing or lending behaviours. CONCLUSIONS Borrowing and lending prescription medications are a common practice in the Saudi population. Further research is warranted into the development of successful approaches or interventions to reduce medication sharing behaviour.
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Affiliation(s)
- Faten Alhomoud
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Irawati L, Alrasheedy AA, Hassali MA, Saleem F. Low-income community knowledge, attitudes and perceptions regarding antibiotics and antibiotic resistance in Jelutong District, Penang, Malaysia: a qualitative study. BMC Public Health 2019; 19:1292. [PMID: 31615486 PMCID: PMC6794866 DOI: 10.1186/s12889-019-7718-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/30/2019] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Understanding community perspectives on antibiotics and antibiotic resistance (ABR) is a key component in designing educational interventions to combat ABR at the community level in Malaysia. Therefore, this study aimed to explore community residents' knowledge, attitudes and perceptions regarding antibiotics and ABR in Jelutong District, Penang, Malaysia. Moreover, it intended to identify areas of focus to be addressed when designing an educational intervention to increase residents' knowledge and change their attitudes and perceptions. METHODS A qualitative approach was adopted to gain a deeper understanding of community residents' knowledge, attitudes and perceptions regarding antibiotics and ABR. A purposive sampling was employed. Twenty-two residents (aged ≥18 years) were interviewed with the aid of a semi-structured interview guide. All interviews were audio recorded, transcribed verbatim and thematically analysed. RESULTS The majority of the participants asserted that antibiotics could be effective against viral infections. Moreover, many participants were unaware that antibiotics have adverse effects. Some acquired antibiotics from a community pharmacy without a prescription, took antibiotics given to them by their family or friends, or took leftover antibiotics prescribed for a previous illness. A few indicated that they would request antibiotics from their physician when they had viral infections. More than half of the participants discontinued taking antibiotics when their symptoms improved. The majority stated that ABR occurs when the body becomes used to antibiotics. Most participants were unaware of the causes, consequences and prevention of ABR. In fact, they were not concerned about it. As a result, only a few perceived themselves as having responsibility for preventing this problem. CONCLUSIONS The community residents had misconceptions about antibiotics and ABR, negative attitudes towards antibiotics and negative perceptions of ABR. The areas of focus that need to be addressed when designing an educational intervention to increase the general public knowledge and change their attitudes and perceptions are the appropriate use of antibiotics and their adverse effects; the importance of adhering to antibiotic therapy; and the definition, causes, consequences and prevention of ABR.
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Affiliation(s)
- Lyna Irawati
- Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Alian A. Alrasheedy
- Unaizah College of Pharmacy, Qassim University, Buraydah, Qassim Saudi Arabia
| | | | - Fahad Saleem
- Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan
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