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Ali HT, Barakat M, Abdelhalim AR, Al-Kurd IN, Muhammad MKE, Sharkawy MM, Elbahnasawy M, Amer SA. Unravelling the dilemma of self-medication in Egypt: a cross-sectional survey on knowledge, attitude, and practice of the general Egyptian population. BMC Public Health 2024; 24:652. [PMID: 38429721 PMCID: PMC10905903 DOI: 10.1186/s12889-024-17913-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Self-medication (SM) is a rising public health issue, especially in developing countries. It can be associated with various problems such as the delayed seeking of medical advice, drug interactions, and serious events such as antimicrobial drug resistance. We aimed to evaluate the Egyptian general population's knowledge, attitudes, and practices of SM. METHODS We employed a cross-sectional design between February 7th and March 8th, 2023 using a self-administered questionnaire available in Arabic. The questionnaire was developed based on previous studies and included four domains: sociodemographic data, knowledge, attitude, and practice of SM. We utilized both online (Google Forms) and paper surveys, utilizing convenience and snowball sampling methods. Data were analyzed using R Statistical Software (v4.1.3; R Core Team 2022). RESULTS 1630 Egyptian individuals (838 females and 792 males) from the seven provinces were enrolled, with a median age of 25 years (IQR: 22-40). Around 55.97% and 48.28% of the participants had good knowledge and favorable attitudes regarding SM respectively, while 62.8% had practiced SM in the previous three months. The most frequently used medications were painkillers (60.74%) followed by antibiotics (32.13%) and antipyretics (28.61%). The pharmacist's recommendation was the source of SM for 53.61% while 31.53% used old medications at home. Most participants (59.08%) practiced SM because they thought they had simple or minor symptoms. The multivariate regression analysis revealed that females had significantly higher knowledge of SM than males (aOR: 2.10; 95%CI: 1.64-2.71; p-value < 0.001), with no significant differences in practice (aOR: 1.24; 95%CI: 0.99 - 1.56; p-value = 0.065). Individuals working or studying in the medical field were significantly more knowledgeable about SM (aOR: 4.30; 95%CI: 3.27-5.69; p-value < 0.001) and more likely to practice SM (aOR: 1.65; 95%CI: 1.26-2.17; p-value < 0.001). The odds of SM decreased with favorable attitudes (aOR: 0.44; 95%CI: 0.36-0.55; p-value < 0.001) while surprisingly, knowledge level was not significantly contributing to SM practice (aOR: 1.15; 95%CI: 0.90-1.48; p-value = 0.268). CONCLUSIONS SM is prevalent in Egypt, highlighting the importance of raising awareness and encouraging physician consultation as a priority. Governments, healthcare organizations, and educational institutions need to collaborate to provide the necessary support and resources.
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Affiliation(s)
| | - Mostafa Barakat
- Qena Faculty of Medicine, South Valley University, Qena, 83621, Egypt
| | | | | | | | | | - Mohamed Elbahnasawy
- Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Samar Ahmed Amer
- Department of Public Health and Community Medicine, Family Medicine, Membership at Royal College of General Practice [INT], Ministry Of Health (MOH) Saudi Arabia, Zagazig University, EgyptLondon, UK
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Azzam A, Khaled H, Mosa M, Refaey N, AlSaifi M, Elsisi S, Elagezy FK, Mohsen M. Epidemiology of clinically isolated methicillin-resistant Staphylococcus aureus (MRSA) and its susceptibility to linezolid and vancomycin in Egypt: a systematic review with meta-analysis. BMC Infect Dis 2023; 23:263. [PMID: 37101125 PMCID: PMC10134521 DOI: 10.1186/s12879-023-08202-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/28/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality worldwide. For the establishment of national strategies to combat MRSA infection in each country, accurate and current statistics characterizing the epidemiology of MRSA are essential. The purpose of this study was to determine the prevalence of MRSA among Staphylococcus aureus clinical isolates in Egypt. In addition, we aimed to compare different diagnostic methods for MRSA and determine the pooled resistance rate of linezolid and vancomycin to MRSA. To address this knowledge gap, we conducted a systematic review with meta-analysis. METHODS A comprehensive literature search from inception to October 2022 of the following databases was performed: MEDLINE [PubMed], Scopus, Google Scholar, and Web of Science. The review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement. Based on the random effects model, results were reported as proportions with a 95% confidence interval (CI). Analyses of the subgroups were conducted. A sensitivity analysis was conducted to test the robustness of the results. RESULTS A total of sixty-four (64) studies were included in the present meta-analysis, with a total sample size of 7171 subjects. The overall prevalence of MRSA was 63% [95% CI: 55-70]. Fifteen (15) studies used both PCR and cefoxitin disc diffusion for MRSA detection, with a pooled prevalence rate of 67% [95% CI: 54-79] and 67% [95% CI: 55-80], respectively. While nine (9) studies used both PCR and Oxacillin disc diffusion for MRSA detection, the pooled prevalences were 60% [95% CI: 45-75] and 64% [95% CI: 43-84], respectively. Furthermore, MRSA appeared to be less resistant to linezolid than vancomycin, with a pooled resistance rate of 5% [95% CI: 2-8] to linezolid and 9% [95% CI: 6-12] to vancomycin, respectively. CONCLUSION Our review highlights Egypt's high MRSA prevalence. The cefoxitin disc diffusion test results were found to be consistent with PCR identification of the mecA gene. A prohibition on antibiotic self-medication and efforts to educate healthcare workers and patients about the proper use of antimicrobials may be required to prevent further increases.
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Affiliation(s)
- Ahmed Azzam
- Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Cairo, Egypt.
| | - Heba Khaled
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Maha Mosa
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Neveen Refaey
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Mohammed AlSaifi
- Department of Orthopedic and Trauma, Faculty of Medicine, 21 September University for Medicine and Applied Sciences, Sana, Yemen
| | - Sarah Elsisi
- Department of Clinical Pharmacy Surgery, Alexandria Main University Hospital, Alexandria, Egypt
| | - Fatma Khaled Elagezy
- Department of Biotechnology, Faculty of Fisheries and Aquaculture Sciences, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | - May Mohsen
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Azzam A, Elkafas H, Khaled H, Ashraf A, Yousef M, Elkashef AA. Prevalence of Vancomycin-resistant enterococci (VRE) in Egypt (2010-2022): a systematic review and meta-analysis. J Egypt Public Health Assoc 2023; 98:8. [PMID: 37037955 PMCID: PMC10086090 DOI: 10.1186/s42506-023-00133-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/12/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Vancomycin-resistant Enterococci (VRE) represent a critical medical and public health concerns due to their association with serious nosocomial infections and a high risk of mortality. We aimed to reveal the pooled prevalence of VRE and antimicrobial resistance profiles among enterococci clinical isolates in Egypt. METHODS A PubMed, Scopus, Google Scholar, and Web of Science literature search was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Only published studies documenting the prevalence of VRE between 2010 and 2022 were included. Using the random effects model and the 95% confidence intervals, the pooled estimate of VRE was calculated by MedCalc Version 20.113. Cochran's Q and I2 tests were used to evaluate the degree of heterogeneity, and publication bias was examined by visually examining the funnel plot and its associated tests (Begg's and Egger's tests). RESULTS The pooled prevalence of VRE among enterococci clinical isolates in Egypt was estimated to be 26% (95% CI 16.9 to 36.3). E. faecalis had a greater pooled prevalence than E. faecium, with 61.22% (95% CI 53.65 to 68.53) and 32.47% (95% CI 27 to 38.2), respectively. The VanA gene is more frequent than the VanB gene among VRE, with a pooled prevalence of 63.3% (95% CI 52.1 to 73.7) and 17.95% (95% CI 7.8 to 31), respectively. The pooled resistance rate of linezolid was substantially lower than that of ampicillin and high-level gentamicin (HLG) 5.54% (95% CI 2.33 to 10%), 65.7% (95% CI 50.8 to 79.2%), and 61.1% (95% CI 47.4 to 73.9), respectively. CONCLUSION The prevalence of VRE is alarmingly high in Egypt. It is imperative that antimicrobial stewardship activities and infection control programs are strictly adhered to and implemented to prevent further escalation of the problem.
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Affiliation(s)
- Ahmed Azzam
- Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Ain Helwan, Cairo, Egypt.
| | - Hoda Elkafas
- Department of Pharmacology and Toxicology, Egyptian Drug Authority, Formerly National Organization for Drug Control and Research, Cairo, 35521, Egypt
| | - Heba Khaled
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Ahmed Ashraf
- Faculty of Pharmacy, Minia University, Minia, Egypt
| | | | - Aya Awny Elkashef
- Department of Botany & Microbiology, Faculty of Science, Arish University, North Sinai, Egypt
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Ahmed I, King R, Akter S, Akter R, Aggarwal VR. Determinants of antibiotic self-medication: A systematic review and meta-analysis. Res Social Adm Pharm 2023; 19:1007-1017. [PMID: 37019706 DOI: 10.1016/j.sapharm.2023.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Decreasing the prevalence of antibiotic self-medication among the public requires proper understanding of the risk factors involved. However, the determinants of antibiotic self-medication are not well defined. OBJECTIVES To identify patient and health system-related determinants of antibiotic self-medication among the public. METHODS A systematic review of quantitative observational studies and qualitative studies was undertaken. PubMed, Embase, and Web of Science were searched to identify studies on determinants of antibiotic self-medication. The data were analyzed using meta-analysis, descriptive analysis, and thematic analysis. RESULTS Sixty-eight studies were included in the review. From meta-analyses, male sex (pooled odds ratio [POR]: 1.52, 95% confidence interval [CI]: 1.19-1.75), lack of satisfaction with healthcare services/physicians (POR: 3.53, 95% CI: 2.26-4.75) were associated with antibiotic self-medication. In subgroup analysis, lower age was directly associated with self-medication in high-income countries (POR: 1.61, 95% CI: 1.10-2.36). In low- and middle-income countries, people with greater knowledge of antibiotics were less likely to self-medicate (POR: 0.2, 95% CI: 0.08-0.47). Patient-related determinants identified from descriptive and qualitative studies included previous experience with antibiotics and similar symptoms, perceived low severity of disease, intention to save time and get better quickly, cultural beliefs about curative power of antibiotics, advice from family/friends, and having home stock of antibiotics. Health system-related determinants included high cost of consulting physicians and low cost of self-medication, lack of access to physician/medical care, lack of trust/confidence in physicians, greater trust in pharmacists, long distance of physicians/healthcare facilities, long waiting time at healthcare facilities, easy access to antibiotics from pharmacies, and convenience associated with self-medication. CONCLUSIONS Patient and health system-related determinants are associated with antibiotic self-medication. Interventions to decrease antibiotic self-medication should incorporate community programs along with appropriate policies and healthcare reforms targeting these determinants with specific attention to population at high risk of self-medication.
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Bert F, Previti C, Calabrese F, Scaioli G, Siliquini R. Antibiotics Self Medication among Children: A Systematic Review. Antibiotics (Basel) 2022; 11:1583. [PMID: 36358240 PMCID: PMC9687075 DOI: 10.3390/antibiotics11111583] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 09/29/2023] Open
Abstract
The phenomenon of bacterial antimicrobial resistance (AMR) is a rapidly growing global problem. Overuse and misuse of antibiotics as well as self-prescription are among the most important causes contributing to the growth of antibiotic resistance in humans. This systematic review describes the phenomenon of antibiotics self-medication (ASM) in children. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist by searching PubMed, Scopus, and Web of Science until July 2022. Published English language studies containing information regarding parents knowledge, attitudes, and behaviors in self-administration of antibiotics in children were included. A total of 702 articles were identified, and 57 were selected. A higher prevalence of ASM among children was found in the Middle-East (34%), Africa (22%), Asia (20%) and South America (17%), while the lowest prevalence was found in Europe (8%). High distance from hospital, and low income, such as having more than one child, are related with an increased risk of ASM in children. Fever and cough can also promote the misuse of antibiotics by parents. A greater attention to the regulation of the sale of antimicrobial drugs can certainly limit the risk of self-medicating behavior.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
- Hygiene and Infection Control Unit, ASL TO3, 10098 Turin, Italy
| | - Christian Previti
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Francesco Calabrese
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Giacomo Scaioli
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Roberta Siliquini
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
- AOU City of Health and Science of Turin, 10126 Turin, Italy
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Schmiege D, Falkenberg T, Moebus S, Kistemann T, Evers M. Associations between socio-spatially different urban areas and knowledge, attitudes, practices and antibiotic use: A cross-sectional study in the Ruhr Metropolis, Germany. PLoS One 2022; 17:e0265204. [PMID: 35271648 PMCID: PMC8912211 DOI: 10.1371/journal.pone.0265204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/18/2022] [Indexed: 12/02/2022] Open
Abstract
Inappropriate and excessive antibiotic use fuels the development of antibiotic resistance. Determinants of antibiotic use, including knowledge and attitudes, are manifold and vary on different spatial scales. The objective of this study was to examine the associations between socio-spatially diverse urban areas and knowledge, attitudes, practices and antibiotic use within a metropolitan city. A cross-sectional survey was conducted in the general population in socio-spatially different areas in Dortmund, Germany, in February and March 2020. Three urban areas were chosen to represent diverse socio-spatial contexts (socio-spatially disadvantaged: A, intermediate: B, socio-spatially disadvantaged: C). Participants were selected via simple random sampling. The questionnaire comprised knowledge and attitude statements and questions around antibiotic use and handling practices. Differences between the areas were examined by estimating odds ratios (OR) and corresponding 95% confidence intervals by multiple logistic regression. Overall, 158 participants were included. Participants of Area C showed the lowest proportions of correct knowledge statements, indicated more often attitudes contrary to common recommendations, lower risk awareness and reported more often antibiotic use (C: 40.8%; A: 32.7%; B: 26.5%) and potential mishandling practices (C: 30.4%; A: 9.6%; B: 17.3%). The multiple logistic regression confirmed these differences. Around 42.3% (C), 33.3% (A) and 20.0% (B) of the diseases mentioned for which an antibiotic was used are mainly caused by viral pathogens. A common misconception across all areas was the perception of antibiotic resistance as an individual rather than a universal issue. This study reveals distinct differences between socio-spatially diverse urban areas within a metropolitan city, regarding knowledge, attitudes and practices around antibiotics and ABR. Our findings confirm that enhanced efforts are required to better inform the population about the adequate use and handling of antibiotics. This study emphasizes the need for future interventions to be tailored to the specific local socio-economic context.
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Affiliation(s)
- Dennis Schmiege
- Department of Geography, University of Bonn, Bonn, Germany
- Institute for Hygiene and Public Health, GeoHealth Centre, University Hospital Bonn, Bonn, Germany
- Institute for Urban Public Health, Essen University Hospital, University of Duisburg-Essen, Duisburg, Germany
- Center for Development Research, University of Bonn, Bonn, Germany
- * E-mail:
| | - Timo Falkenberg
- Institute for Hygiene and Public Health, GeoHealth Centre, University Hospital Bonn, Bonn, Germany
- Center for Development Research, University of Bonn, Bonn, Germany
| | - Susanne Moebus
- Institute for Urban Public Health, Essen University Hospital, University of Duisburg-Essen, Duisburg, Germany
| | - Thomas Kistemann
- Department of Geography, University of Bonn, Bonn, Germany
- Institute for Hygiene and Public Health, GeoHealth Centre, University Hospital Bonn, Bonn, Germany
- Center for Development Research, University of Bonn, Bonn, Germany
| | - Mariele Evers
- Department of Geography, University of Bonn, Bonn, Germany
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Ashraf S, Ashraf S, Ashraf M, Imran MA, Choudhary ZA, Hafsa HT, Awais AB, Kalsoom L, Farooq I, Habib Z, Ashraf S, Iqbal QUA, Ghufran M, Sherazi SSH, Akram MK, Akmal R, Rafique S, Nawaz K, Safdar Z, Siddique UN, Hassan M, Arshad S, Virk AR, Ashraf M, Saboor QA, Humayun A, Izhar M. Knowledge, attitude, and practice of clinicians about antimicrobial stewardship and resistance among hospitals of Pakistan: a multicenter cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:8382-8392. [PMID: 34490566 PMCID: PMC8421064 DOI: 10.1007/s11356-021-16178-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
Considering that antimicrobial resistance (AMR) is a global challenge, there is a dire need to assess the knowledge, attitude, and practice (KAP) of clinicians in AMR endemic countries. The current multicenter, cross-sectional study aimed at highlighting gaps in antimicrobial (AM) stewardship and AMR among practicing doctors working in public tertiary care teaching hospitals of Lahore, Pakistan. A KAP survey, based on a self-administered questionnaire containing 45 questions, was distributed among 336 clinicians in 6 randomly selected hospitals. Overall, 92% of the clinicians considered AMR as a worldwide problem but only 66% disagreed that cold and flu symptoms require antibiotics. Moreover, around 68% of the doctors felt confident about their practice in AM but still, 96% felt the need to get more knowledge about AM drugs. The need for refresher courses on rational antibiotic use was expressed by 84% of the participants. The main contributing factors considered for AMR by the doctors included excessive AM usage in the medical profession (87.1%) and multiple antibiotics per prescription (76.4%). Pharmacologically, AM spectrum was accurately chosen by 1.4% for Ampicillin, 0.003% for Erythromycin and 0% for Levofloxacin. Clinically, more than 50% of the clinicians used miscellaneous AM for empirical therapy of respiratory tract infection and cholecystitis. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 25. It is concluded that the knowledge of clinicians is relatively poor for AM spectrum and drugs of choice for certain infections. However, the clinicians are aware of their shortcomings and desire for improvement.
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Affiliation(s)
- Sohaib Ashraf
- Department of Cardiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan.
| | - Shoaib Ashraf
- Department of Pathobiology, Riphah International University, Lahore, Pakistan.
| | - Moneeb Ashraf
- Department of Pharmacology, King Edward Medical University, Mayo Hospital, Lahore, Pakistan.
| | - Muhammad Ahmad Imran
- Department of Microbiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan.
| | - Zawar Ahmad Choudhary
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Hadiqa Tul Hafsa
- Department of Microbiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Abeer Bin Awais
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Larab Kalsoom
- Department of Internal Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Iqra Farooq
- Department of Pediatrics Surgery, Children Hospital and Institute of Child Health, Lahore, Pakistan
| | - Zaighum Habib
- Department of Orthopedics, Tehsil Head Quarter, Ferozwala, Shaikhupura, Pakistan
| | - Sidra Ashraf
- Department of Biochemistry, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Qurrat Ul Ain Iqbal
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Muhammad Ghufran
- Medico Cirujano, ESACHS (Empresa de Servico Externo de la Asociacion Chilena de Seguridad), Punta Arenas, Chile
| | - Syed Sami Hussain Sherazi
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Kiwan Akram
- Department of Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Rutaba Akmal
- Department of Community Medicine, Sahara Medical College, Narowal, Pakistan
| | - Sundas Rafique
- Department of Internal Medicine, Mayo Hospital, Lahore, Pakistan
| | - Khawar Nawaz
- Department of Pediatrics, Sunny Downstate/Kings Country Medical Center, New York, NY, USA
| | - Zartasha Safdar
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Uzma Nasim Siddique
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Muhammad Hassan
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Shahroze Arshad
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Abdul Rehman Virk
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Muhammad Ashraf
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Qazi Abdul Saboor
- Department of Cardiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Ayesha Humayun
- Department of Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan
| | - Mateen Izhar
- Department of Microbiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
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Jali A, Hakami A, Dahas N, Mahnashi M, Siddiq A, Alsomaili H, Alhazmi AH. Antibiotic Use and Resistance Knowledge: Awareness Among the General Public in Jazan, Saudi Arabia. Cureus 2021; 13:e20369. [PMID: 35036203 PMCID: PMC8752910 DOI: 10.7759/cureus.20369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2021] [Indexed: 11/24/2022] Open
Abstract
Background and objective: Antibiotics (Abs) are a class of medication generally prescribed for bacterial infections. Abs misuse, caused by either medication non-compliance or self-medication, may lead to Abs resistance, a problem that is trending around the globe. In 2018, dispensing Abs without a prescription became prohibited in Saudi Arabia. This study aimed to evaluate knowledge and attitude toward Abs use and resistance in Jazan Province. Materials and methods: A cross-sectional study was conducted in the population of Jazan, using a self-administered electronic questionnaire to assess the knowledge and attitude toward Abs use and resistance and its related factors. Results: According to our findings, 543 participants responded and most of the participants use Abs with a prescription (n = 280; 75%). About 40% identified correctly that Abs can treat only bacteria, not viruses, and 44% denied that Abs can treat all coughs and common cases. Then, regarding the knowledge about resistance, we found that those who had heard about Abs resistance represented more than half of the participants (56%), and had better knowledge about Abs use. Further, more than half of those who have heard about Abs resistance correctly defined the antibiotic susceptibility test, and about two-thirds were able to answer the related questions about Abs resistance. Conclusion: To conclude, a positive correlation was found between knowledge about Abs resistance and Abs use. Thus, national Abs regulations and policies with continuous education and awareness must be continued to ensure a better understanding of Abs use.
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Altorkmani A, Alzabibi MA, Shibani M, Ismail H, Sawaf B, Daher N, Al-Moujahed A. Assessing the Syrian Population's Knowledge, Attitudes, and Practices Regarding Antibiotic Usage. Avicenna J Med 2021; 11:132-138. [PMID: 34646789 PMCID: PMC8500066 DOI: 10.1055/s-0041-1732815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Antibiotic resistance is a serious public health threat that results mainly secondary to antibiotics misuse. The present study aimed to determine the knowledge, attitude, and practice toward antibiotic use among the Syrian population. Methods This cross-sectional study was conducted at the outpatient clinics of two major hospitals in Damascus, Syria. Applying a random convenience sampling, data were collected in a 1-week period by interviewing participants using a structured questionnaire, which targeted demographics, practice, knowledge, and attitude. Data were used to assess the relationship between the knowledge level and attitudes and demographics. Results Most respondents had a moderate level of knowledge (187, 74.8%) and a moderate attitude score (148, 59.2%). In addition, most respondents (149, 59.6%) stated that they take antibiotics based on pharmacist advice only and do not complete the full antibiotic course (200, 80%). A significant association was found between the knowledge level and financial status ( p -value = 0.003), education level ( p -value = 0.001), and having relatives working in the health care sector ( p -value = 0.021). In addition, a significant association was found between the attitude and having health insurance. Conclusion This study provides baseline evidence about the knowledge, attitudes, and practices regarding antibiotics among the Syrian population, that will help in designing targeted interventions to solve the inappropriate use of antibiotics.
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Affiliation(s)
- Abdallah Altorkmani
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Mhd Amin Alzabibi
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Mosa Shibani
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Hlma Ismail
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Bisher Sawaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Nizar Daher
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Ahmad Al-Moujahed
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Stanford, California, United States
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Guo S, Sun Q, Zhao X, Shen L, Zhen X. Prevalence and risk factors for antibiotic utilization in Chinese children. BMC Pediatr 2021; 21:255. [PMID: 34074254 PMCID: PMC8168021 DOI: 10.1186/s12887-021-02706-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/06/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China. METHODS English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis. RESULTS Of 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver's self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue. CONCLUSION The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.
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Affiliation(s)
- Shasha Guo
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Qiang Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Xinyang Zhao
- School of Nursing, China Medical University, Shenyang, 110100, China
| | - Liyan Shen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Xuemei Zhen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
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11
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Yeika EV, Ingelbeen B, Kemah BL, Wirsiy FS, Fomengia JN, van der Sande MAB. Comparative assessment of the prevalence, practices and factors associated with self-medication with antibiotics in Africa. Trop Med Int Health 2021; 26:862-881. [PMID: 33942448 DOI: 10.1111/tmi.13600] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate and compare the prevalence, reasons, sources and factors associated with self-medication with antibiotics (SMA) within Africa. METHODS Systematic review and meta-analysis. An electronic search of PubMed and Google Scholar databases was performed for observational studies conducted between January 2005 and February 2020. Two reviewers independently screened abstracts and full texts using the PRISMA flowchart and performed quality assessment of eligible studies. Both qualitative and quantitative syntheses were carried out. RESULTS Forty studies from 19 countries were eligible for qualitative synthesis. The prevalence of SMA in Africa ranged from 12.1% to 93.9% with a median prevalence of 55.7% (IQR 41-75%). Western Africa was the sub-region with the highest reported prevalence of 70.1% (IQR 48.3-82.1%), followed by Northern Africa with 48.1% (IQR 41.1-64.3%). We identified 27 antibiotics used for self-medication from 13 different antibiotic classes. Most frequently used antibiotics were penicillins (31 studies), tetracyclines (25 studies) and fluoroquinolones (23 studies). 41% of these antibiotics belong to the WHO Watch Group. The most frequent indications for SMA were upper respiratory tract infections (27 studies), gastrointestinal tract symptoms (25 studies) and febrile illnesses (18 studies). Common sources of antibiotics used for self-medication were community pharmacies (31 studies), family/friends (20 studies), leftover antibiotics (19 studies) and patent medicine stores (18 studies). The most frequently reported factor associated with SMA was no education/low educational status (nine studies). CONCLUSIONS The prevalence of SMA is high in Africa and varies across sub-regions with the highest prevalence reported in Western Africa. Drivers of SMA are complex, comprising of socio-economic factors and insufficient access to health care coupled with poorly implemented policies regulating antibiotic sales.
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Affiliation(s)
| | - Brecht Ingelbeen
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ben-Lawrence Kemah
- University Hospitals North Midlands, Stoke-on-Trent, UK.,Health Education & Research Organization, Buea, Cameroon
| | | | - Joseph Nkeangu Fomengia
- École de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium.,Sintieh Research Academy, Yaoundé, Cameroon
| | - Marianne A B van der Sande
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Global Health, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
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12
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Marusinec R, Kurowski KM, Amato HK, Saraiva-Garcia C, Loayza F, Salinas L, Trueba G, Graham JP. Caretaker knowledge, attitudes, and practices (KAP) and carriage of extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) in children in Quito, Ecuador. Antimicrob Resist Infect Control 2021; 10:2. [PMID: 33407927 PMCID: PMC7789729 DOI: 10.1186/s13756-020-00867-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/04/2020] [Indexed: 12/11/2022] Open
Abstract
Background The rapid spread of extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) is an urgent global health threat. We examined child caretaker knowledge, attitudes, and practices (KAP) towards proper antimicrobial agent use and whether certain KAP were associated with ESBL-EC colonization of their children. Methods Child caretakers living in semi-rural neighborhoods in peri-urban Quito, Ecuador were visited and surveyed about their KAP towards antibiotics. Fecal samples from one child (less than 5 years of age) per household were collected at two time points between July 2018 and May 2019 and screened for ESBL-EC. A repeated measures analysis with logistic regression was used to assess the relationship between KAP levels and child colonization with ESBL-EC. Results We analyzed 740 stool samples from 444 children living in households representing a range of environmental conditions. Of 374 children who provided fecal samples at the first household visit, 44 children were colonized with ESBL-EC (11.8%) and 161 were colonized with multidrug-resistant E. coli (43%). The prevalences of ESBL-EC and multidrug-resistant E. coli were similar at the second visit (11.2% and 41.3%, respectively; N = 366). Only 8% of caretakers knew that antibiotics killed bacteria but not viruses, and over a third reported that they “always” give their children antibiotics when the child’s throat hurts (35%). Few associations were observed between KAP variables and ESBL-EC carriage among children. The odds of ESBL-EC carriage were 2.17 times greater (95% CI: 1.18–3.99) among children whose caregivers incorrectly stated that antibiotics do not kill bacteria compared to children whose caregivers correctly stated that antibiotics kill bacteria. Children from households where the caretaker answered the question “When your child’s throat hurts, do you give them antibiotics?” with “sometimes” had lower odds of ESBL-EC carriage than those with a caretaker response of “never” (OR 0.48, 95% CI 0.27–0.87). Conclusion Caregivers in our study population generally demonstrated low knowledge regarding appropriate use of antibiotics. Our findings suggest that misinformation about the types of infections (i.e. bacterial or viral) antibiotics should be used for may be associated with elevated odds of carriage of ESBL-EC. Understanding that using antibiotics is appropriate to treat infections some of the time may reduce the odds of ESBL-EC carriage. Overall, however, KAP measures of appropriate use of antibiotics were not strongly associated with ESBL-EC carriage. Other individual- and community-level environmental factors may overshadow the effect of KAP on ESBL-EC colonization. Intervention studies are needed to assess the true effect of improving KAP on laboratory-confirmed carriage of antimicrobial resistant bacteria, and should consider community-level studies for more effective management.
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Affiliation(s)
- Rachel Marusinec
- Berkeley School of Public Health, University of California, Berkeley, CA, USA
| | - Kathleen M Kurowski
- Berkeley School of Public Health, University of California, Berkeley, CA, USA
| | - Heather K Amato
- Berkeley School of Public Health, University of California, Berkeley, CA, USA
| | - Carlos Saraiva-Garcia
- Microbiology Institute, Colegio de Ciencias Biologicas Y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - Fernanda Loayza
- Microbiology Institute, Colegio de Ciencias Biologicas Y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - Liseth Salinas
- Microbiology Institute, Colegio de Ciencias Biologicas Y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - Gabriel Trueba
- Microbiology Institute, Colegio de Ciencias Biologicas Y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - Jay P Graham
- Berkeley School of Public Health, University of California, Berkeley, CA, USA.
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13
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Mallah N, Rodríguez-Cano R, Figueiras A, Takkouche B. Design, reliability and construct validity of a Knowledge, Attitude and Practice questionnaire on personal use of antibiotics in Spain. Sci Rep 2020; 10:20668. [PMID: 33244041 PMCID: PMC7693171 DOI: 10.1038/s41598-020-77769-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/11/2020] [Indexed: 11/23/2022] Open
Abstract
Numerous questionnaires are available on Knowledge, Attitudes, and Practices (KAP) towards antibiotics' use by adults, but none of these questionnaires is fully validated. We undertook an exhaustive literature review to design a comprehensive KAP questionnaire concerning the personal use of antibiotics in Galicia, North Spain. The Item Content Validity Index (I-CVI) and modified Kappa statistic (K*), confirmed the content validity of the questions (0.78 ≤ I-CVI ≤ 1.00 and 0.78 ≤ K* ≤ 1.00). The S-CVI statistic showed the content validity of the scale (S-CVI/Ave: 0.95). Following face validity and pilot testing, the Test-Retest Reliability in a sample of 145 adults confirmed the reliability of the questions. We carried out Confirmatory Factor Analysis using cross loadings and modification indices to choose the most adequate model in data collected from 844 adults. We estimated the indicators of model fit and demonstrated that the selected model has a good to excellent fit, thus establishing the construct validity. The final version of the questionnaire was highly accepted by the general adult population as reflected by the response rate (95.85%) and the low percentage of unanswered questions (0.4-2.7%). Our fully validated questionnaire could prove useful for research as it permits generating high quality data and reducing measurement error.
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Affiliation(s)
- Narmeen Mallah
- Department of Preventive Medicine, University of Santiago de Compostela, R/ San Francisco, s/n, 15782, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Rubén Rodríguez-Cano
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adolfo Figueiras
- Department of Preventive Medicine, University of Santiago de Compostela, R/ San Francisco, s/n, 15782, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, R/ San Francisco, s/n, 15782, Santiago de Compostela, Spain.
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain.
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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14
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El-Kholy A, Badawy M, Gad M, Soliman M. Serotypes and Antimicrobial Susceptibility of Nasopharyngeal Isolates of Streptococcus pneumoniae from Children Less Than 5 Years Old in Egypt. Infect Drug Resist 2020; 13:3669-3677. [PMID: 33116686 PMCID: PMC7586055 DOI: 10.2147/idr.s250315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022] Open
Abstract
Purpose Streptococcus pneumoniae (S. pneumoniae) is the etiology of severe and life-threatening infections in children less than 5 years old. Though pneumococcal conjugate vaccines (PCVs) are effective in the prevention of pneumococcal infections, yet they are not included in the National Immunization Program in Egypt pending the identification of pathogenic serotypes. As S. pneumoniae colonization of the pharynx predisposes to pneumonia and invasive pneumococcal disease (IPD) caused by the colonizing serotypes, identification of the nasopharyngeal (NP) serotypes can be a surrogate to the invasive serotypes. In this study, we aimed to 1. Identify the serotypes and antimicrobial susceptibility testing (AST) of Streptococcus pneumoniae colonizing the nasopharynx of Egyptian children younger than 5 years in two successive winter seasons. 2. Correlate the identified serotypes with vaccine coverage of the 13-valent conjugate pneumococcal vaccines (PCV13). 3. Compare the serotypes and AST of S. pneumoniae from NP to those of IPD that were routinely identified in our clinical laboratory during the study period. Materials and Methods The study was conducted in two successive winter seasons (December 2015–March 2016; December 2016–March 2017). We enrolled 334 children, aged 6 months to 5 years, attending the outpatient general clinics of Cairo University Children Hospital, excluding those with fever, signs of infection, history of antibiotic intake or hospitalization in the preceding month. We tested NP swabs for S. pneumoniae by culture and real-time PCR. Serotyping was performed by sequential multiplex PCR for all positive samples. AST was done to S. pneumoniae isolates by Vitek-2™ (BioMérieux, Marcy-L’Etoile, France). We included routinely detected S. pneumoniae from sterile body sites during the study period, and identified their serotypes and AST. Results PCR was positive for pneumococci in 217 out of 334 pharyngeal swabs (65%), including 186 typable samples. The most common serotypes were serotypes 1, 6ABC, 19 F, 5 and 18ABC. By culture, we isolated only 110 out of 334 pharyngeal swabs (32.9%). The theoretical coverage of the PCV13 vaccine for the detected serotypes was 77.4%. The AST of NP isolates revealed low susceptibility rates to all antimicrobials except for vancomycin, linezolid, levofloxacin and clindamycin. During the study period, we identified 40 IPD; 21 identified by PCR and 19 by culture. The commonest pneumococcal serotypes were 1, 18ABC, 6ABC and 5. The PCV13 coverage was 75%. By Vitek-2, the isolates showed 100%, 100%, 94.7%, 89.5%, 84.2%, 84.2% and 78.9% susceptibility to vancomycin, linezolid, clindamycin, levofloxacin, penicillin, cefotaxim and erythromycin, respectively. Conclusion Based on the serotype vaccine coverage and the emerging antimicrobial resistance of S. pneumoniae, PCVs will be valuable to Egyptian children.
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Affiliation(s)
- Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Magda Badawy
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha Gad
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - May Soliman
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
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15
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Simon B, Kazaura M. Prevalence and Factors Associated with Parents Self-Medicating Under-Fives with Antibiotics in Bagamoyo District Council, Tanzania: a Cross-Sectional Study. Patient Prefer Adherence 2020; 14:1445-1453. [PMID: 32884246 PMCID: PMC7443408 DOI: 10.2147/ppa.s263517] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/25/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Self-medication with antibiotics (SMA) is a global problem. This extends to medication of under-fives by their parents. In particular, there is currently insufficient information for this problem. PURPOSE To determine the proportion and factors associated with medication of under-fives with antibiotics by their parents. MATERIALS AND METHODS A cross-sectional study among parents/caregivers of under-fives in 30 hamlets/streets of Bagamoyo District Council, in Tanzania was conducted between July and August, 2019. Respondents were the under-fives' parents/caregivers aged at least 18 years selected from households using probability proportional to a size cluster-sampling method. Respondents were required to report whether or not the under-fives had been unwell within the past 12 months and to describe the type or specific name of any medicine administered to their child. We used descriptive and analytical procedures to analyze the data. RESULTS The study included 730 parents/caregivers of under-fives. Their mean age was 32.2 (SD=7.4) years. The majority 668 (91.5%) were biological mothers and 574 (78.6%) having completed primary education. The proportion of parental SMA to under-fives was 47.7% (95% CI=43.7, 51.8). Knowledge on the appropriate use of antibiotics among parents was low. The most commonly used antibiotic was amoxicillin, 181 (62.0%). Independent factors associated with parental SMA to under-fives were average household income, distance to the nearest health facility, knowledge about use of antibiotics and the parent/caregiver's awareness of prescription-only medicines (POMs). CONCLUSION Since the prevalence of SMA by parents to under-fives in Bagamoyo District is high, there is a need for health systems to enhance those measures that would control the sale of antibiotics without prescriptions. In addition, more than half of all study participants have a minimal understanding of the use of antibiotics and are unaware of POMs. Findings indicate a need to have routine continuous health education at the community level about the use of antibiotics.
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Affiliation(s)
| | - Method Kazaura
- Department of Epidemiology/Biostatistics, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- Correspondence: Method Kazaura Department of Epidemiology/Biostatistics, Muhimbili University of Health and Allied Sciences, PO Box 65015, Dar Es Salaam, TanzaniaTel +255-784-767717 Email
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Sale of Antibiotics without Prescriptions in Alexandria, Egypt. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.1.34] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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