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Parajuli A, Mitchell J, King N, Arjyal A, Latham S, King R, Baral S. Drivers of antimicrobial resistance within the communities of Nepal from One Health perspective: a scoping review. Front Public Health 2024; 12:1384779. [PMID: 38706550 PMCID: PMC11066241 DOI: 10.3389/fpubh.2024.1384779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 04/01/2024] [Indexed: 05/07/2024] Open
Abstract
Background A major driver of antimicrobial resistance (AMR) is the inappropriate use of antimicrobials. At the community level, people are often engaged in behaviors that drive AMR within human, animal, and environmental (One Health) impacts. This scoping review consolidates research to determine (a) the community's knowledge, attitudes, and practices around AMR; (b) existing community-based interventions; and (c) barriers and enablers to addressing AMR in Nepal. Methods This scoping review follows the Joanna Briggs Institute scoping review methodology. Literature indexed in PubMed, Scopus, CINAHL, Global Index Medicus, HINARI-SUMMON, Embase (Ovid), Global Health (Ovid), CAB Abstracts (Ovid), Web of Science, and Google Scholar between January 2000 and January 2023 were reviewed for inclusion. Articles were included in the review if they considered the issues of AMR at the community level in Nepal; this excluded clinical and laboratory-based studies. A total of 47 studies met these criteria, were extracted, and analyzed to consolidate the key themes. Results A total of 31 (66%) articles exclusively included human health; five (11%) concentrated only on animal health; no studies solely focused on environmental aspects of AMR; and the remaining studies jointly presented human, animal, and environmental aspects. Findings revealed inadequate knowledge accompanied by inappropriate practice in both the human and animal health sectors. Four community interventions improved knowledge and practices on the appropriate use of antimicrobials among community people. However, various social and economic factors were found as barriers to the appropriate use of antimicrobials in the community. Conclusion Community engagement and One Health approaches could be key tools to improve awareness of AMR and promote behavioral change related to AM use in communities, as current studies have revealed inadequate knowledge alongside inappropriate practices shared in both human and animal health sectors. Systematic review registration DOI: 10.17605/OSF.IO/FV326.
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Affiliation(s)
| | - Jessica Mitchell
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Natalie King
- Academic Unit of Health Economics, University of Leeds, Leeds, United Kingdom
| | | | - Sophia Latham
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
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Acharya R, Panthi S, Khatiwada P, Bhattarai B, Singh S, Bhattarai K, Aryal R, Neupane D, Thapa A, Karki K, Basnet LB, Khanal VK, Ghimire A. Antibiotics use among residents in Eastern Nepal: a community-based mixed method study. Ann Med Surg (Lond) 2024; 86:748-755. [PMID: 38333289 PMCID: PMC10849382 DOI: 10.1097/ms9.0000000000001611] [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: 09/12/2023] [Accepted: 12/03/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction According to the WHO, more than two-thirds of all antibiotics are used in the community, of which about 30% are used inappropriately. The antimicrobial resistance (AMR) problem is a growing threat to Nepal because of indiscriminate and inappropriate use. However, exact data on the extent of inappropriate use of antibiotics in the community is scarce in Nepal. Objectives To know the extent of inappropriate use of antibiotics among the community and their knowledge and practice towards the usage of antibiotics. Methods A community-based cross-sectional study was conducted from 20 December 2017 to 20 March 2018 using a purposive sampling technique. A semi-structured questionnaire was used while conducting face-to-face interviews with 336 respondents to find out the knowledge and practice regarding antibiotic use. Investigators took different antibiotics (in all dosage forms) with them to show participants whether they knew and/or used the antibiotics in the last year. Results The mean age of respondents with standard deviation was 39.87±13.67 years ranging from 18 to 84 years. Around 35.42% of respondents were farmers and 34.52% were homemakers. 28.87% of respondents were illiterate, 32.44% had primary education and 33.33% had secondary education. Almost half of them (48.51%) think that antibiotics are safe and can be commonly used. So, 43.15% of them preferred taking antibiotics when they had a common cold. The majority of the participants (81.84%) did not have any idea about antibiotic resistance. 94.6% of the respondents used antibiotics inappropriately. Conclusion The results of the present study revealed that inappropriate use of antibiotics is high and associated with low earning wages in both males and females in the age group 18-39 years.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Anish Thapa
- Department of Medicine, Universal College of Medical Sciences, Bhairahawa, Lumbini Province
| | | | - Lila Bahadur Basnet
- School of Public Health and community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Province 1
| | - Vijay Kumar Khanal
- School of Public Health and community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Province 1
| | - Anup Ghimire
- School of Public Health and community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Province 1
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Marasini S, Sharma S, Joshi A, Kunwar S, Mahato RK, Shrestha A, Karmacharya B. Exploring knowledge, perceptions, and practices of antimicrobials, and their resistance among medicine dispensers and community members in Kavrepalanchok District of Nepal. PLoS One 2024; 19:e0297282. [PMID: 38241275 PMCID: PMC10798439 DOI: 10.1371/journal.pone.0297282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 01/02/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Inappropriate use of antimicrobials is a global public health issue, particularly in developing countries, including Nepal, where over-the-counter sales and self-medication of antimicrobials are common. OBJECTIVES To explore knowledge, perceptions, and practices of antimicrobials and their resistance among medicine dispensers and community members in Nepal. METHODS The study was conducted in three rural and five urban municipalities of the Kavrepalanchok district from May 2021 to August 2021. Data were collected using two qualitative approaches: In-Depth Interviews (IDIs) and Focus Group Discussions (FGDs). Data were analyzed using thematic analysis that combined deductive and inductive approaches to identify codes under pre-specified themes. RESULTS A total of 16 In-depth interviews with medicine dispensers and 3 focus group discussions with community members were conducted. Knowledge regarding antimicrobial resistance varied among dispensers. Those with a prior educational background in pharmacy often had good knowledge about the causes and consequences of antimicrobial resistance. Meanwhile, consumers were less aware of antimicrobial resistance. Community members perceived antimicrobials as effective medicines but not long-term solution for treating diseases. They reported that dispensing without a prescription was common and that both consumers and dispensers were responsible for the inappropriate use of antimicrobials. On the contrary, several dispensers said that self-medication was common among the consumers, especially among more educated groups. The medicine dispensers and consumers expressed concerns about the weak enforcement of policies regarding pharmacy drug use and dispensing practices. CONCLUSION Promoting and strengthening the appropriate use of antimicrobials among medicine dispensers and community members is crucial. Bold policies and collective implementation of regulations could help combat antimicrobial resistance.
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Affiliation(s)
- Sabina Marasini
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Sudim Sharma
- Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Anjali Joshi
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Surakshya Kunwar
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Roshan Kumar Mahato
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
- Institute for Implementation Science and Health, Kathmandu, Nepal
| | - Biraj Karmacharya
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
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Parajuli A, Garbovan L, Bhattarai B, Arjyal A, Baral S, Cooke P, Latham S, Barrington DJ, Mitchell J, King R. Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study. BMC Health Serv Res 2024; 24:57. [PMID: 38212733 PMCID: PMC10782613 DOI: 10.1186/s12913-023-10470-2] [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: 04/24/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is the process by which microbes evolve mechanisms to survive the medicines designed to destroy them i.e. antimicrobials (AMs). Despite being a natural process, AMR is being hastened by the abuse of AMs. In context of Nepal, there is limited information on drivers of AMR and barriers in addressing it from a community perspective. This study explores the local language and terminology used around AMs in the community, commonly used AMs and reasons for their usage, how these AMs are sourced, and the perceived barriers to addressing AMR via One Health approach. METHODS A phenomenological study design was utilized with applied qualitative research theoretically framed as pragmatism. Twelve in-depth interviews and informal discussions with a One Health focus, were purposively conducted with wide range of stakeholders and community resident of Kapilvastu municipality of Nepal during April 2022. The acquired data was analyzed manually via a thematic framework approach. The study obtained ethical approval from ethical review board of Nepal Health Research Council and University of Leeds. RESULTS Nepali and Awadhi languages does not have specific words for AMs or AMR, which is understandable by the community people. Rather, community use full explanatory sentences. People use AMs but have incomplete knowledge about them and they have their own local words for these medicines. The knowledge and usage of AMs across human and animal health is impacted by socio-structural factors, limited Government regulation, inadequate supply of AMs in local government health facilities and the presence of various unregulated health providers that co-exist within the health system. Novel ideas such as the use of visual and smart technology, for instance mobile phones and social media exposure, can enable access to information about AMs and AMR. CONCLUSION This study shows that terminology that is understandable by the community referring to AMs and AMR in Nepali and Awadhi languages does not exist, but full explanatory sentences and colloquial names are used. Despite regular utilisation, communities have incomplete knowledge regarding AMs. Since, knowledge alone cannot improve behaviour, behavioural interventions are required to address AMR via community engagement to co-produce their own solutions. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
| | - Lidis Garbovan
- Centre for World Cinema and Digital Cultures, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | | | | | | | - Paul Cooke
- Centre for World Cinema and Digital Cultures, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | - Sophia Latham
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Chester High Road, Neston, Liverpool, CH64 7TE, UK
| | - Dani J Barrington
- School of Population and Global Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western, 6009, Australia
| | - Jessica Mitchell
- Nuffield Centre for International Health and Development, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
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Nguyen CT, Nguyen HT, Boyer L, Auquier P, Fond G, Do KN, Dang AK, Do HP, Latkin CA, Ho RCM, Ho CSH. Prevalence and impacts of self-medication in a disadvantaged setting: the importance of multi-dimensional health interventions. Front Public Health 2023; 11:1176730. [PMID: 37575118 PMCID: PMC10412933 DOI: 10.3389/fpubh.2023.1176730] [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: 03/01/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background Self-medication is recognized as an effective form of treatment and is increasingly encouraged to treat minor illnesses. However, misuse of self-medication leaves devastating impacts on human health and causes antimicrobial resistance. Using medication without a prescription among farmers could cause more severe effects on their health than non-farm workers since they suffer from several occupational hazards such as excessive exposure to pesticides. Methods A cross-sectional study was conducted in 197 residents living in Moc Chau from August to September. A structured questionnaire and face-to-face were used to collecting data. The multivariate logistic model was applied to indicate associated factors with the self-medication. Results The prevalence of self-medication among farmers was 67%. Pain relievers (66.7%) and antibiotics (32.5%) were the types of medicines that were the most commonly purchased and used without a medical prescription. Ethnics and health status also significantly affected the self-medication practice as well as the purchase and use of antibiotics. The distance to travel to a medical center and the dangerous or difficult travel, participants with arthritis or inpatient treatment had significantly associated with buying and using the medicine and antibiotics without the medical prescription of farmers. Conclusion Our research highlights a considerably high prevalence of self-medication among farmers residing in the mountainous area of Vietnam. Individual factors such as ethnics, health status, distance to health centers, and dangerous or difficult travel were found to be related to the SM practice as well as the purchase and use of antibiotics. From that, the current study suggests interventions. For instance, official guidelines are needed to raise awareness and minimize the disadvantages of self-medication; and digital health technologies should be applied to reduce the gap in healthcare service between mountainous and other areas of Vietnam.
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Affiliation(s)
- Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Laurent Boyer
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Pascal Auquier
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Guillaume Fond
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Khanh Nam Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Kim Dang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huyen Phuc Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Thenmozhi B, Sharmil SH. Self-medication Practices of the Rural Community People: A Cross-Sectional Study. Indian J Community Med 2023; 48:619-622. [PMID: 37662137 PMCID: PMC10470567 DOI: 10.4103/ijcm.ijcm_842_22] [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: 10/10/2022] [Accepted: 05/03/2023] [Indexed: 09/05/2023] Open
Abstract
Background Self-medication is the practice of taking medicines without a physician's advice, and it has become more common in developing nations. The root cause could be anything from a shortage of physicians to financial factors. However, most people are not aware of the ill effects and drug reactions brought on by self-medication. This research aimed to find out the prevalence, frequency, common complaints, primary sources, and regular medicines utilized for self-medication, which are the goal of this study. Materials and Methods A cross-sectional study was conducted among the rural community people in Keezhur, Chengalpattu District, Tamil Nadu, India. A group of 253 participants were selected using a random sampling technique. A self-structured questionnaire was used to collect the data. The gathered information was coded and examined. Results Self-medication was common in 60.5% of people, and 46.6% of them frequently utilize analgesics. The most frequent condition for which people used self-medication was headache (30.4%). The practice was significantly correlated with the younger age group and the level of education. Conclusion Self-medication is harmful to one's health and is widespread in the research group's region. To reduce the practice of self-medication, general people should get sufficient health education.
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Affiliation(s)
- B Thenmozhi
- Department of Medical-Surgical Nursing, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India
| | - S Hepsibah Sharmil
- Chettinad College of Nursing, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India
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Girmaw F, Sendekie AK, Mesfin B, Kassaw AT. Self-medication practices among pregnant women in Ethiopia. J Pharm Policy Pract 2023; 16:74. [PMID: 37337251 PMCID: PMC10278325 DOI: 10.1186/s40545-023-00584-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/09/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Self-medication is a worldwide issue that requires special attention due to the potentially harmful effects it can have not only on pregnant women but also on the fetus. OBJECTIVES This study assessed the magnitude of self-medication practice and associated factors among pregnant women following antenatal care (ANC) in primary healthcare settings in the North Wollo Zone of Ethiopia. METHODS An institutional-based cross-sectional study was conducted on 395 pregnant mothers who attended ANC follow-up in selected health centers in the North Wollo Zone of Ethiopia from April 20 to May 20, 2021. A multi-stage sampling method was employed to enroll participants. A face-to-face structured interview was conducted to collect the data. A logistic regression analysis was used to determine the factors associated with self-medication practice. A p value < 0.05 at the 95% confidence level was considered statistically significant. RESULTS Out of a total of 444 participants approached, 395 (89%) participated in the study. Of these, 44.6% reported practicing self-medication during the current pregnancy. Age < 35 (AOR = 2.18, 95% CI 1.02-9.15; p = 0.032), rural residence (AOR = 3.01, 95% CI 1.43-10.19; p = 0.017), and previous medication use (AOR = 5.02, 95% CI 1.24-12.93; p = 0.015) were found to have a significant association with self-medication practice. CONCLUSION Self-medication was highly prevalent among pregnant women in the study setting and result indicates need for critical action. Younger rural women with a history of self-medication use should be provided counselling to find a prescription medication, and measures are needed to minimize self-medication related harm in pregnant women.
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Affiliation(s)
- Fentaw Girmaw
- Department of Pharmacy, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, College of Medicines and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Betelhem Mesfin
- Department of Adult Health Nursing, School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Health Science, Woldia University, Woldia, Ethiopia
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Kumar M, Roy SS, Hameed S, Shakur AA, Mohan L, Dikshit H. Role of Sensitization and Awareness Program on Knowledge, Attitude, Views, and Practice of Self-Medication Among MBBS Students in a Medical College of Bihar. Cureus 2023; 15:e40774. [PMID: 37492819 PMCID: PMC10364848 DOI: 10.7759/cureus.40774] [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] [Accepted: 06/20/2023] [Indexed: 07/27/2023] Open
Abstract
Aims Self-medication is an essential component of self-care; however, its use has significantly increased. Its practice has many risks such as wrong diagnosis, adverse drug reactions, antimicrobial resistance, etc. Being future doctors, self-medication has a special impact on MBBS students. Henceforth, the present study was undertaken to sensitize MBBS students in a medical college in Bihar and to analyze its role in different aspects of self-medication. Methods and material This was a cross-sectional, questionnaire-based study. The questionnaire was circulated to MBBS students of all the phases. After collecting the responses, scoring and grading was done and then a sensitization and awareness program was conducted through different modes and medium. After three months the same questionnaire was distributed, and their response was again collected. Statistical analysis used With an expected 40% prevalence, the minimum sample size needed to attain a power of 95% and an alpha value of 0.05 was calculated to be 201. Statistical Package for Social Sciences version 16 was used for data analysis. The chi-square test was used to see the association in responses obtained, before and after sensitization. A P-value with ≤0.05 was considered statistically significant. Results The questionnaires were circulated among 439 students. On comparing the grades, we found that phase III students comparatively had better knowledge regarding different aspects of self-medication. On analyzing different aspects of self-medication, we found that there was a significant improvement in many aspects post-sensitization. Conclusions MBBS students are future doctors, hence they should be more educated about the pros and cons of self-medication. This study showed that the perception of participants improved after our educational activities. We hope that after becoming aware, these young budding doctors will spread awareness, which, in turn, will benefit society. Additionally, we hope that this study will have an impact on students from different medical colleges and even healthcare providers, promoting responsible self-medication practices when necessary.
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Affiliation(s)
- Manish Kumar
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Sukalyan S Roy
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Saajid Hameed
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Adil A Shakur
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Lalit Mohan
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Harihar Dikshit
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, IND
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Almaqhawi A, Alhamad M, Albaqshi B, Alquraini M, Altaha M, Alhussain H, Alfayez R, Ibrahim Ali S. Self-Medication Practices During the COVID-19 Pandemic Among the Adult Population in the Eastern Region of the Kingdom of Saudi Arabia. Cureus 2023; 15:e40505. [PMID: 37465789 PMCID: PMC10350656 DOI: 10.7759/cureus.40505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Self-medication is vital to public health because it has an impact on people's health and the current healthcare system, both positively and negatively. During public health catastrophes like the COVID-19 disease, this is particularly true. AIM This study aimed to examine the behavioral response of the community with regard to self-medication during the COVID-19 pandemic in the eastern region of the Kingdom of Saudi Arabia. METHODS During the COVID-19 outbreak from March to September 2020, a cross-sectional online survey of 398 participants using structured questionnaires was conducted to observe knowledge, prevalence, patterns, and sources of self-medication among the respondents in the eastern region of the Kingdom of Saudi Arabia. RESULTS The percentage of respondents who had heard about self-medication was 50.5%, and those who practiced self-medication during COVID-19 were 43.7% of the respondents. Regarding knowledge, 60.3% had a low overall knowledge level versus 39.7% who had a high knowledge level. Most of those who practiced self-medication took medication based on their own decision (34.4%). The most frequently used drugs during the outbreak were analgesics (43.5%) and vitamins (24.9%). Only 1% of participants reported using anti-malaria drugs (hydroxychloroquine). The most common reasons for self-medication practices were having a mild illness (30.4%), followed by fear of infection (26.6%). The symptoms for which the respondents took self-medication were headache (29.6%), cough (26.6%), and fever (24.6%). CONCLUSION Our investigation showed a low level of knowledge about self-medication and a considerable level of self-medication practices. Therefore, self-medication may be minimized with ongoing awareness-raising and sensitization.
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Affiliation(s)
- Abdullah Almaqhawi
- Family and Community Medicine, College of Medicine, King Faisal University, Hofuf, SAU
| | - Mahdi Alhamad
- Family and Community Medicine, College of Medicine, King Faisal University, Hofuf, SAU
| | - Baqer Albaqshi
- Family and Community Medicine, College of Medicine, King Faisal University, Hofuf, SAU
| | - Mohammed Alquraini
- Family and Community Medicine, College of Medicine, King Faisal University, Hofuf, SAU
| | - Musawi Altaha
- Family and Community Medicine, College of Medicine, King Faisal University, Hofuf, SAU
| | - Hassan Alhussain
- Family and Community Medicine, College of Medicine, King Faisal University, Hofuf, SAU
| | - Raed Alfayez
- Family and Community Medicine, College of Medicine, King Faisal University, Hofuf, SAU
| | - Sayed Ibrahim Ali
- Family and Community Medicine, College of Medicine, King Faisal University, Hofuf, SAU
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Mboni HM, Tshikongo AK, Chirubagula VB, Shakalenga CM, Kanyegere AM, Rugema BB, Mushobekwa SS, Akiba DB, Rusati NM. [Evaluation of self-medication practices and their characteristics among Uvira in Democratic Republic of Congo students]. Pan Afr Med J 2023; 45:53. [PMID: 37637404 PMCID: PMC10460111 DOI: 10.11604/pamj.2023.45.53.39690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/07/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction self-medication poses a threat to public health. The purpose of this study was to evaluate self-medication practices among Uvira students in the Democratic Republic of the Congo (DRC). Methods we conducted a cross-sectional descriptive study based on an indirect interview of 700 students, using a self-administered survey questionnaire. Data were processed using XLSTAT. Results according to the survey conducted on these 700 students, the prevalence of self-medication was 99.3% (n=695), of which 42.3% (n=294) started during adolescence. Of the total respondents, 57.4% (n=399) said they resorted to self-medication every time they fell ill and were short of money (n=471, 67.7%) for a consultation. The most commonly cited pathology encountered during this practice was malaria (n=212, 30.5%). Of all drugs used, paracetamol was in the first place (n=106, 15.3%) while the tablet was the form most used by these students (n=598, 86%). In terms of the drug combination, Fansidar-Coartem (n=106, 17.2%) was the most common; the dosage was age-dependent in 65.6% (n=456) of cases. This study also showed that 37.4% (n=695) of the students interviewed used phytotherapy, mainly to treat malaria (n=124, 47.3%). Conclusion among Uvira students, self-medication is extremely used, especially against malaria. Efforts must be made by healthcare personnel in collaboration with policymakers to raise awareness about the rational use of medications, in order to better control and potentially eradicate this practice that is harmful to health.
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Affiliation(s)
- Henry Manya Mboni
- Département de Pharmacologie, Faculté des Sciences Pharmaceutiques, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo
- Filière des Techniques Pharmaceutiques, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Arsène Kabamba Tshikongo
- Département de Biologie Clinique, Faculté des Sciences Pharmaceutiques, Université de Lubumbashi, Lubumbashi, République Démocratique Congo
| | - Valentin Bashige Chirubagula
- Département de Pharmacologie, Faculté des Sciences Pharmaceutiques, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo
| | - Cedrick Mutombo Shakalenga
- Département de Pharmacologie, Faculté des Sciences Pharmaceutiques, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo
| | - Arsène Mutula Kanyegere
- Filière des Techniques Pharmaceutiques, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Bontemps Byakujoga Rugema
- Filière des Sciences Infirmières, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Saili Stay Mushobekwa
- Filière des Sciences Infirmières, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Derrick Bushobole Akiba
- Filière de Santé Publique, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Nicolas Mihuhi Rusati
- Filière de Santé Publique, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
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Tadesse YB, Kassaw AT, Belachew EA. Evaluating self-medication practices in Ethiopia. J Pharm Policy Pract 2023; 16:47. [PMID: 36945071 PMCID: PMC10029313 DOI: 10.1186/s40545-023-00553-0] [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: 01/12/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Self-medication with antibiotics has become an important factor driving antibiotic resistance and it masks the signs and symptoms of the underlying disease and hence complicates the problem, increasing drug resistance and delaying diagnosis. This study aimed to assess the extent of self-medication practice with antibiotics and its associated factors among adult patients attending outpatient departments (OPD) at selected public Hospitals, in Addis Ababa, Ethiopia. METHODS Facility-based cross-sectional study was employed. A systematic random sampling technique was used to include the study participants. Self-administered with structured questionnaires were applied among patients who visited outpatient departments at selected public Hospitals, in Addis Ababa. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26. Descriptive statistics such as frequencies and percentages were used for the present categorical data. The data are presented in pie charts, tables, and bar graphs. Furthermore, bivariable and multivariable binary logistic regression analyses were used to identify significant associations. Statistical significance was declared at p value < 0.05. RESULTS Out of 421 respondents interviewed, 403 (95.7%) participants completed questionnaires. Among the respondents, 71% had generally practiced self-medication. Among these, 48.3% had self-medication with antibiotics, while 51.7% had used other drugs. The most commonly cited indication for self-medication practice was abdominal pain 44.9%, followed by Sore throat 21% commonly used antibiotics are amoxicillin (57%), ciprofloxacin (13%), amoxicillin/clavulanic (10%), erythromycin (8%), cotrimoxazole (7%), and doxycycline (5%). CONCLUSIONS Self-medication with antibiotics was common among the study participants. The prevalence of general self-medication was 71%, whereas that of self-medication with antibiotics was 48.3%. In general, the potentially dangerous effects of SMP seem to be underestimated by patients with OPD patients.
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Affiliation(s)
- Yabibal Berie Tadesse
- Pharmaceutical Chemistry Department, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia.
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Shrestha AB, Pokharel P, Sapkota UH, Shrestha S, Mohamed SA, Khanal S, Jha SK, Mohanty A, Padhi BK, Asija A, Sedhai YR, Rijal R, Singh K, Chattu VK, Rodriguez-Morales AJ, Barboza JJ, Sah R. Drug Resistance Patterns of Commonly Used Antibiotics for the Treatment of Helicobacter pylori Infection among South Asian Countries: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2023; 8:tropicalmed8030172. [PMID: 36977173 PMCID: PMC10051479 DOI: 10.3390/tropicalmed8030172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
Background: In South Asia, resistance to commonly used antibiotics for the treatment of Helicobacter pylori infection is increasing. Despite this, accurate estimates of overall antibiotic resistance are missing. Thus, this review aims to analyze the resistance rates of commonly used antibiotics for the treatment of H. pylori in South Asia. Methods: The systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We searched five medical databases for relevant studies from inception to September 2022. A random effect model with a 95% confidence interval (CI) was used to calculate the pooled prevalence of antibiotic resistance. Results: This systematic review and meta-analysis included 23 articles, 6357 patients, 3294 Helicobacter pylori isolates, and 2192 samples for antibiotic resistance. The prevalences of antibiotic resistance to common antibiotics were clarithromycin: 27% (95%CI: 0.17–0.38), metronidazole: 69% (95%CI: 0.62–0.76), tetracycline: 16% (95%CI: 0.06–0.25), amoxicillin: 23% (95%CI: 0.15–0.30), ciprofloxacin: 12% (95%CI: 0.04–0.23), levofloxacin: 34% (95%CI: 0.22–0.47), and furazolidone: 14% (95%CI: 0.06–0.22). Subgroup analysis showed antibiotic resistances were more prevalent in Pakistan, India, and Bangladesh. Furthermore, a ten-year trend analysis showed the increasing resistance prevalence for clarithromycin (21% to 30%), ciprofloxacin (3% to 16%), and tetracycline (5% to 20%) from 2003 to 2022. Conclusion: This meta-analysis showed a high prevalence of resistance among the commonly used antibiotics for H. pylori in South Asian countries. Furthermore, antibiotic resistance has been increasing over the time of 20 years. In order to tackle this situation, a robust surveillance system, and strict adherence to antibiotic stewardship are required.
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Affiliation(s)
| | - Pashupati Pokharel
- Department of Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu 1524, Nepal
| | | | - Sajina Shrestha
- Department of Internal Medicine, KIST Medical College, Imadol, Patan 284128, Nepal
| | - Shueb A. Mohamed
- School of Medicine, Alexandria University, Alexandria 21568, Egypt
| | - Surakshya Khanal
- Department of Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu 1524, Nepal
| | - Saroj Kumar Jha
- Department of Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu 1524, Nepal
| | - Aroop Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur 273008, India
| | - Bijaya Kumar Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ankush Asija
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Yub Raj Sedhai
- Division of Pulmonary Disease and Critical Care Medicine, University of Kentucky College of Medicine, Bowling Green, KY 42101, USA
| | - Rishikesh Rijal
- Division of infectious Diseases, University of Louisville, Louisville, KY 40208, USA
| | - Karan Singh
- Division of Pulmonary Disease and Critical Care Medicine, University of Kentucky College of Medicine, Bowling Green, KY 42101, USA
| | - Vijay Kumar Chattu
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5R 0A3, Canada
- Center for Transdisciplinary Research, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha 442107, India
| | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
- Master’s Program in Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima 15846, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 1101, Lebanon
| | - Joshuan J. Barboza
- Escuela de Medicina, Universidad Cesar Vallejo, Trujillo 13007, Peru
- Correspondence: (J.J.B.); (R.S.)
| | - Ranjit Sah
- Department of Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu 1524, Nepal
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune 411018, India
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, India
- Correspondence: (J.J.B.); (R.S.)
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Saha A, Zam D, Khan AA, Dutta P, Mannan A, Alam N. Prevalence and determinants of self-medication practices among general population: A cross-sectional study in Thimphu, Bhutan and Chattogram, Bangladesh. J Public Health Res 2023; 12:22799036231152327. [PMID: 36726455 PMCID: PMC9885035 DOI: 10.1177/22799036231152327] [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: 06/20/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Background Self-medication is a global phenomenon and a potential contributor to negative health consequences on human health including emergence of antibiotic drug resistance globally. Objective The primary objective of this study was to estimate the prevalence and determinants of self-medication in Thimphu, Bhutan and Chattogram, Bangladesh, two neighbouring South Asian country. Methodology A community-based cross-sectional study was conducted in the city of Thimphu, Bhutan and Chattogram, Bangladesh. A pre-tested and semi-structured questionnaire was used to collect information on socio-demographic characteristics, health status and self-medication practices in the previous year. Results Out of the 998 recruited participants, 61.8% (170/275) from Thimphu and 41.5% (300/723) from Chattogram reported self-medication practices in last year of interview. In Thimphu, eye/ear infection (90.9%), fever (84.9%), headache (80.5%) and cough and cold (78.2%) were the major illnesses reported for self-medication, whereas in Chattogram people mostly self-medicated for skin disorder (74.4%), diarrhoeal illness (59.1%) and eye/ear infection (48.1%). Knowledge on side-effects of the drugs taken for self-medication was comparatively higher in Thimphu than in Chattogram. Both in Thimphu and Chattogram, higher odds of self-medication were found for common illnesses with adjusted OR 7.8; 95% CI 3.3-18.4 and adjusted OR 2.0; 95% CI 1.4-2.8, respectively in Thimphu and Chattogram. Conclusion Self-medication was found to be substantially high in both the cities, however, rate of self-medication was higher in Thimphu compared to Chattogram. Knowledge and awareness raising about harmful effect of self-medication and effective regulation over selling of prescription medication in pharmacies should be strengthened in both countries.
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Affiliation(s)
- Ayan Saha
- Department of Bioinformatics and
Biotechnology, Asian University for Women, Chattogram, Bangladesh
- Disease Biology and Molecular
Epidemiology Research Group, Chattogram, Bangladesh
| | - Dawa Zam
- Department of Public Health, Asian
University for Women, Chattogram, Bangladesh
| | - Ayesha Ahmed Khan
- Department of Microbiology, Chittagong
Medical College, Chattogram, Bangladesh
| | - Preya Dutta
- Disease Biology and Molecular
Epidemiology Research Group, Chattogram, Bangladesh
- Department of Pharmacy, BGC Trust
University Bangladesh, Chattogram, Bangladesh
| | - Adnan Mannan
- Disease Biology and Molecular
Epidemiology Research Group, Chattogram, Bangladesh
- Department of Genetic Engineering &
Biotechnology, University of Chittagong, Chattogram, Bangladesh
| | - Nazmul Alam
- Department of Public Health, Asian
University for Women, Chattogram, Bangladesh
- Nazmul Alam, Department of Public Health,
Asian University for Women, Badsha Miah Road, Chattogram-4000, Bangladesh.
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Ghimire P, Pant P, Khatiwada S, Ranjit S, Malla S, Pandey S. Self-medication practice in Kathmandu Metropolitan City: A cross-sectional study. SAGE Open Med 2023; 11:20503121231158966. [PMID: 36896193 PMCID: PMC9989370 DOI: 10.1177/20503121231158966] [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: 09/14/2022] [Accepted: 02/03/2023] [Indexed: 03/06/2023] Open
Abstract
Objectives Self-medication is increasingly popular among people in developing nations like Nepal where the expense of healthcare is relatively high and over-the-counter) medications are widely and easily accessible. Although this method has certain advantages, it is also clear that it has some drawbacks, including the potential for adverse drug reactions, drug resistance, medication interactions, and increased morbidity and mortality. This study aimed to evaluate the use of self-medication in nine wards of Kathmandu Metropolitan City (ward no. 4, 5, 13, 15, 16, 17, 23, 31, and 32). Methods This cross-sectional descriptive survey was conducted in the chosen wards of Kathmandu Metropolitan city for 3 months from August to October 2021. A semi-structured questionnaire was used to collect data from 372 patients who were seeking self-medication. The participants were chosen randomly. Results Self-medication was common among people (78%). The most frequent ailments for which participants self-medicated were the common cold (17.1%), headache (14.7%), fever (14.5%), and cough (7.6%). Anticold medications (18.2%), non-steroidal anti-inflammatory drugs (17.4%), antipyretics (15.2%), and analgesics (9.1%) were the most popular drug classes used in self-medication. The two most frequent justifications for self-medication were the absence of any major ailment (35%) and self-experience (22.7%). When symptoms started, the majority of patients started taking medication for themselves, and 47.7% of them got their prescriptions directly from the pharmacist by explaining their symptoms. When the symptoms were not relieved by the medication used for self-medication, it was found that the majority of participants (79.7%) stopped using the medication and visit the doctor. Conclusion The prevalence of self-medication in Kathmandu city was ascertained by assessing the practice among residents of the Kathmandu Metropolitan city. The study showed self-medication is common among people and therefore, proper education about drug use and self-medication is needed.
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Affiliation(s)
| | - Poonam Pant
- Pharmacy Program, CiST College, Kathmandu, Nepal
| | | | | | - Sharad Malla
- Pharmacy Program, CiST College, Kathmandu, Nepal
| | - Sudip Pandey
- Madan Bhandari University of Science and Technology, Lalitpur, Nepal
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Ghimire K, Banjara MR, Marasini BP, Gyanwali P, Poudel S, Khatri E, Dhimal M. Antibiotics Prescription, Dispensing Practices and Antibiotic Resistance Pattern in Common Pathogens in Nepal: A Narrative Review. Microbiol Insights 2023; 16:11786361231167239. [PMID: 37066121 PMCID: PMC10102948 DOI: 10.1177/11786361231167239] [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: 03/30/2022] [Accepted: 03/16/2023] [Indexed: 04/18/2023] Open
Abstract
Antimicrobial resistance (AMR) is increasing and it is a serious public health problem worldwide. Nepal is considered as one of the contributors for rising AMR due to the most prevalent irrational use of antibiotics. In this review, we have assessed the practices of antibiotic prescription and dispensing, and antibiotic resistance of commonly encountered bacteria in Nepal. There is exponential increase of therapeutic consumption of antibiotics either without clinician's prescription or irrational prescription. Almost half of the population in Nepal was found to purchase antibiotics easily from the nearby pharmacies without clinician's prescription. Irrational prescription is exceeded in remote areas which could be due to lack of access with health posts and hospitals. The third generation cephalosporins, which are considered as the last resort antibiotics were found to be relatively prescribed and dispensed higher as compared to other classes of antibiotics. Despite the existing limited functional surveillance system, antibiotic resistance among bacteria is increasing in Nepal because of irrational prescription, dispensing and consumption of antibiotics without prescription.
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Affiliation(s)
- Kalpana Ghimire
- Central Department of Microbiology,
Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Megha Raj Banjara
- Central Department of Microbiology,
Tribhuvan University, Kirtipur, Kathmandu, Nepal
- Megha Raj Banjara, Central Department of
Microbiology, Tribhuvan University, Kirtipur, Kathmandu 44618, Nepal.
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Shrestha S. Experiencing Dengue as a Medical Student. JNMA J Nepal Med Assoc 2022; 60:1073-1075. [PMID: 36705100 PMCID: PMC9795126 DOI: 10.31729/jnma.7915] [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: 10/28/2022] [Indexed: 12/02/2022] Open
Abstract
Dengue is a disease which spreads by the bite of an infected Aedes mosquito. Reading about a disease in a textbook and experiencing it as a patient is a completely different thing. This article highlights the feeling of a medical student as a patient. It provides the reader with an idea of how Basic Science knowledge can be used for rational decision-making. Self- prescription of medication without consulting a doctor can be more harmful in many circumstances. We also need to be aware of the warning signs of Dengue virus infection. Keywords clopidogrel; dengue; medical student.
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Affiliation(s)
- Shubham Shrestha
- Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal,Correspondence: Mr Shubham Shrestha, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal. , Phone: +977-9749843530
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17
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Saha A, Marma KKS, Rashid A, Tarannum N, Das S, Chowdhury T, Afrin N, Chakraborty P, Emran M, Mehedi HMH, Hussain MI, Barua A, Mistry SK. Risk factors associated with self-medication among the indigenous communities of Chittagong Hill Tracts, Bangladesh. PLoS One 2022; 17:e0269622. [PMID: 35696405 PMCID: PMC9191716 DOI: 10.1371/journal.pone.0269622] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background In developing countries like Bangladesh, self-medication has become a predicament associated with health risks and clinical complications. To date, no studies have been conducted on the practice of self-medication among the indigenous population living in Chittagong Hill Tract (CHT). Objectives This study was aimed to determine the prevalence of self-medication and analyzing the factors associated with it among the indigenous population in CHT. Methods This cross-sectional study was conducted from late October to early December 2020; among different indigenous group populations residing in the three districts of CHT aged 18 or more. A pre-tested and semi-structured questionnaire was developed to collect data on socio-demographic characteristics, health status, frequency of self-medication, reasons for self-medication in last one year, as well as other variables. Multivariate logistic regression was performed to assess associated factors with self-medication. Results A total of 1350 people from different indigenous populations were interviewed, among whom 49.9% practiced self-medication. The rate of self-prescribed antibiotics usage (80.9%) was significantly higher compared to other drugs. Self-prescribed medications were mostly used for diarrhea and food poisoning (60.6%), cough, cold and fever (51.4%), and headache (51.4%). A common source of self-prescribed medicines was community or retail pharmacy and the most reported reason for self-prescribed medication was the long-distance of healthcare facilities from home. Conclusion The prevalence of self-medication is substantially high among indigenous people and the effect is alarming. Particular concern is the misuse of antibiotics and analgesic drugs. Increasing awareness among the population of the negative effect of self-medication and implementation of proper policies and actions are urgently needed to prevent self-medication among indigenous population in Bangladesh.
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Affiliation(s)
- Ayan Saha
- Department of Genetic Engineering and Biotechnology, East West University, Dhaka, Bangladesh
- * E-mail: ,
| | | | - Afrah Rashid
- Department of Public Health and Bioinformatics, Asian University for Women, Chattogram, Bangladesh
| | - Nowshin Tarannum
- Department of Microbiology, University of Chittagong, Chattogram, Bangladesh
| | - Srabanty Das
- Department of Biochemistry and Molecular Biology, University of Chittagong, Chattogram, Bangladesh
| | | | - Nusrat Afrin
- Department of Pharmacy, University of Chittagong, Chattogram, Bangladesh
| | - Prashanta Chakraborty
- Department of Genetic Engineering and Biotechnology, University of Chittagong, Chattogram, Bangladesh
| | - Md. Emran
- Department of Biochemistry & Biotechnology, University of Science & Technology Chittagong, Chattogram, Bangladesh
| | | | | | - Ashim Barua
- Upazila Health Complex, Alikadam, Bandarban, Bangladesh
| | - Sabuj Kanti Mistry
- ARCED Foundation, Mirpur, Dhaka, Bangladesh
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
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Thapa P, KC B, Lee SWH, Dujaili JA, Gyawali S, Mohamed Ibrahim MI, Alrasheedy AA. Managing Pain in Low Resource Settings: Healthcare Professionals’ Knowledge, Attitude and Practice Regarding Pain Management in Western Nepal. J Pain Res 2022; 15:1587-1599. [PMID: 35677698 PMCID: PMC9169832 DOI: 10.2147/jpr.s360243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/14/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Parbati Thapa
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Bhuvan KC
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Correspondence: Bhuvan KC, School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, 47500, Malaysia, Email
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | | | - Sudesh Gyawali
- Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal
| | | | - Alian A Alrasheedy
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, Saudi Arabia
- Alian A Alrasheedy, Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, Saudi Arabia, Email
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Demissie F, Ereso K, Paulos G. Self-Medication Practice with Antibiotics and Its Associated Factors Among Community of Bule-Hora Town, South West Ethiopia. Drug Healthc Patient Saf 2022; 14:9-18. [PMID: 35115843 PMCID: PMC8801374 DOI: 10.2147/dhps.s325150] [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: 10/04/2021] [Accepted: 01/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background Self-medication with antibiotics is being practiced worldwide with high prevalence, mostly in developing countries. Several factors induce the practice of self-medication, such as irrational and uncontrolled dispensing of medicinal substances, difficulty accessing health-care systems, and cost of diagnosis. Thus, this study assessed the prevalence of self-medication with antibiotics, and its associated factors among the community of Bule-Hora town, South West Ethiopia. Methods A community-based cross-sectional study design was used. All households residing in Bule Hora town were used as source population and households in the selected kebeles were included by using a systematic random sampling method. Eight hundred twenty-six study participants were selected for the study. Pre-tested structured questionnaires had been used to collect the required data. Then the collected data were checked for completeness and analyzed by using SPSS version 20. Odds ratios with 95% C.I. were used to measure the association between independent variables and outcome and variables with p-value <0.05 had been considered statistically significant. Results Prevalence of self-medication with antibiotics in the past 12 months prior to the data collection was found to be 38.9% [95% CI (1.56, 1.64)]. Being male (AOR = 1.53; 95% CI: 0.489, 0.869) with p value of 0.004, no health insurance scheme (AOR = 2.16; 95% CI: 0.274, 0.779) and availability of some drugs in shop (AOR = 12.98; 95% CI: 0.017, 0.353) with p value of 0.001 were found to be significantly associated with self-medication of antibiotics. Conclusion The study revealed that more than one-third of the respondents practiced self-medication. Availability and irrational dispensing of some drugs in the shops were significantly associated with self-medication practice. Therefore, it is important to educate society on the appropriate use of drugs and discourage the use of prescription drugs without medication order.
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Affiliation(s)
- Fitsum Demissie
- Department of Pharmacy, Institute of Health, Bule-Hora University, Bule-Hora, Oromia, Ethiopia
| | - Kelil Ereso
- Department of Pharmacy, Institute of Health, Bule-Hora University, Bule-Hora, Oromia, Ethiopia
| | - Getahun Paulos
- Department of Pharmaceutics, School of Pharmacy, Institute of Health Sciences, Jimma University, Jimma, Oromia, Ethiopia
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Akhtar SS, Heydon S, Norris P. Bringing Medicine from Pakistan and Self-Medication Among Pakistani Mothers in New Zealand. J Immigr Minor Health 2022; 24:682-688. [PMID: 34091799 PMCID: PMC8179088 DOI: 10.1007/s10903-021-01228-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 02/05/2023]
Abstract
Worldwide migration leads to people bringing beliefs and practices from one country into another, including those related to self-medication. This study explores the self-medication practices of Pakistani mothers for their children and their reasons for self-medication. We interviewed 23 immigrants. Each interview lasted 60-80 min and was conducted in Urdu. Participants had been living in New Zealand on average 3.25 years. They talked about their prior knowledge and experiences regarding self-medication behaviour for their children. The majority of the mothers treat their children at home before visiting a general practitioner (GP) due to previous unsatisfactory experiences. There was a significant relationship between participants who had family members in healthcare professions, their experiences of healthcare services and self-medication. Bringing medicines from Pakistan is a key source for self-medication practices. Self-medication awareness programs could help mothers to practice safe and responsible use of medicines for the benefit of their children.
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Affiliation(s)
| | - Susan Heydon
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Pauline Norris
- Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Alsayed A, Darwish El Hajji F, Al-Najjar MA, Abazid H, Al-Dulaimi A. Patterns of antibiotic use, knowledge, and perceptions among different population categories: A comprehensive study based in Arabic countries. Saudi Pharm J 2022; 30:317-328. [PMID: 35498229 PMCID: PMC9051960 DOI: 10.1016/j.jsps.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/17/2022] [Indexed: 10/26/2022] Open
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Kassa T, Gedif T, Andualem T, Aferu T. Antibiotics self-medication practices among health care professionals in selected public hospitals of Addis Ababa, Ethiopia. Heliyon 2022; 8:e08825. [PMID: 35128109 PMCID: PMC8803584 DOI: 10.1016/j.heliyon.2022.e08825] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/08/2021] [Accepted: 01/20/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Self-medication is the first option and response to most illness episodes. Use of antimicrobials without health care professionals' guidance may result in greater probability of inappropriate use, missed diagnosis, delays in appropriate treatment, pathogen resistance and increased morbidity. There is no sector in the health care community which is immune to drug abuse or misuse of which the worst offenders include physicians, nurses and pharmacy professionals. Self-medication among health care professionals may be an indicator that the health professional is neglecting his or her own health. This represents serious issues for both patients and the professionals. OBJECTIVE To assess self-medication practices with antibiotics among health care professionals in selected hospitals of Addis Ababa, Ethiopia. METHOD Facility based cross-sectional study was conducted from April to May, 2017 among 317 health care professionals. Convenient sampling technique was used to select study participants. Data were collected through self-administered questionnaire and analyzed using Statistical Package for Social Sciences software version 20. Binary logistic regression analysis was done to check the relationship between the dependent variable (antibiotic self-medication) and selected independent variables (sex, age, marital status, income, professional qualification and work experience). RESULTS The prevalence of self-medication with antibiotics among health care professionals in one month recall period was found to be 72 (22.7%). The main reasons given for this practice were being familiar with the treatment options, 31 (43.1%) and need for rapid relief, 25 (34.7%). Respiratory problems, 29 (40.3%) and gastro intestinal problems, 28 (38.9%) were the most common illnesses for which self-medication with antibiotics was practiced while penicillins, 30 (41.6%) and fluoroquinolones, 29 (40.3%) constituted the two most commonly used antibiotics for the same. None of the variables had significant association with the practice of self-medication with antibiotics. CONCLUSION Self-medication with antibiotics was common among the study participants. Efforts should be made by health authorities including Drug and Therapeutics Committee, Drugs Regulatory Authority, Hospitals' management and other stakeholders to ensure safe usage of antibiotics.
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Affiliation(s)
- Tsehay Kassa
- Teklehaimanot Health Center, Addis Ababa, Ethiopia
| | - Teferi Gedif
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Temesgen Aferu
- School of Pharmacy, College of Medicine and Health Sciences, Mizan Tepi University, Mizan- Aman, Ethiopia
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Al-Hazmi AM, Arafa A, Sheerah H, Alshehri KS, Alekrish KA, Aleisa KA, Jammah AA, Alamri NA. Prevalence of and Risk Factors for Nonprescription Antibiotic Use among Individuals Presenting to One Hospital in Saudi Arabia after the 2018 Executive Regulations of Health Practice Law: A Cross-Sectional Study. Antibiotics (Basel) 2021; 10:antibiotics10080923. [PMID: 34438973 PMCID: PMC8388660 DOI: 10.3390/antibiotics10080923] [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: 05/28/2021] [Revised: 06/22/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
Antibiotic resistance is a worldwide public health emergency. Nonprescription antibiotic use is a chief cause of antibiotic resistance. The Saudi Government, as a consequence, imposed in 2018 executive regulations to prevent the distribution of antibiotics without a prescription. Herein, we aimed to investigate the prevalence of and risk factors for nonprescription antibiotic use among individuals presenting to one hospital in Saudi Arabia after enacting these regulations. This cross-sectional study was conducted on people, aged ≥18 years, who presented to the primary healthcare clinics of King Khalid University Hospital in Riyadh during the period between 1/1/2019 and 28/2/2019. Participants were asked to fill out a self-administrated questionnaire assessing their nonprescription antibiotic use during the past year in addition to sociodemographic information. Then, logistic regression analyses were performed to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for age, sex, education, and nationality of any nonprescription antibiotic use compared with no use within the past year. Out of 463 participants, 62.9% were females, 67.4% were <40 years, and 93.7% were Saudi citizens. Overall, 30.5% of participants reported nonprescription antibiotic use during the past year (19.7% one to two times and 10.8% more than two times). Male and non-Saudi participants were more likely to report any nonprescription antibiotic use, with HRs (95% CIs) of 1.99 (1.30, 3.04) and 3.81 (1.73, 8.35), respectively. The main reasons behind nonprescription antibiotic use were having previous experience with a health condition (69.2%), inaccessibility of healthcare (26.6%), and recommendation from a relative or a friend (16.1%). A major limitation of this study was that it included individuals attending one hospital. Individuals who seek medical consultation could be dissimilar to those who do not see doctors regarding nonprescription antibiotic use.
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Affiliation(s)
- Ali Mohsen Al-Hazmi
- Health Promotion and Health Education Research, Research Chairs Program, King Saud University, Riyadh 11451, Saudi Arabia;
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
- Correspondence:
| | - Ahmed Arafa
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan;
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef 62514, Egypt
| | - Haytham Sheerah
- Health Promotion and Health Education Research, Research Chairs Program, King Saud University, Riyadh 11451, Saudi Arabia;
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan;
| | - Khalid Saeed Alshehri
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (K.S.A.); (K.A.A.); (K.A.A.); (A.A.J.); (N.A.A.)
| | - Khalid Alwalid Alekrish
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (K.S.A.); (K.A.A.); (K.A.A.); (A.A.J.); (N.A.A.)
| | - Khalid Abdullah Aleisa
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (K.S.A.); (K.A.A.); (K.A.A.); (A.A.J.); (N.A.A.)
| | - Abdullah Ali Jammah
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (K.S.A.); (K.A.A.); (K.A.A.); (A.A.J.); (N.A.A.)
| | - Nawaf Abdullah Alamri
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (K.S.A.); (K.A.A.); (K.A.A.); (A.A.J.); (N.A.A.)
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Adhikari B, Pokharel S, Raut S, Adhikari J, Thapa S, Paudel K, G C N, Neupane S, Neupane SR, Yadav R, Shrestha S, Rijal KR, Marahatta SB, Cheah PY, Pell C. Why do people purchase antibiotics over-the-counter? A qualitative study with patients, clinicians and dispensers in central, eastern and western Nepal. BMJ Glob Health 2021; 6:bmjgh-2021-005829. [PMID: 33975888 PMCID: PMC8118002 DOI: 10.1136/bmjgh-2021-005829] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Over-the-counter (OTC) use of antibiotics contributes to the burgeoning rise in antimicrobial resistance (AMR). Drawing on qualitative research methods, this article explores the characteristics of OTC sales of antibiotic in Nepal, its drivers and implications for policy. Methods Data were collected in and around three tertiary hospitals in eastern, western and central Nepal. Using pre-defined guides, a mix of semi-structured interviews and focus group discussions were conducted with dispensers at drug stores, patients attending a hospital and clinicians. Interviews were audio-recorded, translated and transcribed into English and coded using a combination of an inductive and deductive approach. Results Drug shops were the primary location where patients engaged with health services. Interactions were brief and transactional: symptoms were described or explicit requests for specific medicine made, and money was exchanged. There were economic incentives for clients and drug stores: patients were able to save money by bypassing the formal healthcare services. Clinicians described antibiotics as easily available OTC at drug shops. Dispensing included the empirical use of broad-spectrum antibiotics, often combining multiple antibiotics, without laboratory diagnostic and drug susceptibility testing. Inappropriately short regimens (2–3 days) were also offered without follow-up. Respondents viewed OTC antibiotic as a convenient alternative to formal healthcare, the access to which was influenced by distance, time and money. Respondents also described the complexities of navigating various departments in hospitals and little confidence in the quality of formal healthcare. Clinicians and a few dispensers expressed concerns about AMR and referred to evadable policies around antibiotics use and poor enforcement of regulation. Conclusions The findings point to the need for clear policy guidance and rigorous implementation of prescription-only antibiotics.
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Affiliation(s)
- Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sunil Pokharel
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Shristi Raut
- Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal
| | | | - Suman Thapa
- Patan Academy of Health Sciences, Patan, Nepal
| | - Kumar Paudel
- Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal
| | - Narayan G C
- Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal
| | - Sandesh Neupane
- Country Coordinating Mechanism, The Global Fund, Ministry of Health and Population, Kathmandu, Nepal
| | | | - Rakesh Yadav
- Nepal Public Health Research & Development Centre, Kathmandu, Nepal
| | - Sirapa Shrestha
- Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Nepal
| | | | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Christopher Pell
- Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
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Shrestha JTM, Kushwaha DK, Tiwari S, Bhattarai P. Study of Self-medication among First and Seventh Semester Medical and Dental Undergraduate Students of Tertiary Care Teaching Hospital in Nepal: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2021; 59:55-60. [PMID: 34508459 PMCID: PMC7893408 DOI: 10.31729/jnma.5385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction: Although appropriate self-medication can ease minor illness and is time and cost-effective, it can lead to irrational drug use and increased resistance, leading to prolonged morbidity. Inclined towards medical information and drug indices, medical students have an open arena for self-medication practice. This study was conducted to find the prevalence of self-medication among first and seventh semester medical and dental students in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among medical and dental undergraduates from July 2020 to August 2020 after receiving ethical clearance from the Institutional Review Committee of Kathmandu University School of Medical Sciences (IRC Approval Number: 35/20). A questionnaire was responded to by participants through a google form. Participants were enrolled through the convenience sampling method. Data were collected and entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences version 25. Results: Out of 199 respondents, the prevalence of self-medication was 100 (50.3%) (46.76-53.84 at 95% Confidence Interval). First semester medical 36 (73.5%) and dental undergraduates 24 (80%) had higher practice. Seventh-semester medical students 14 (51.9%) usually self-medicated within one day of onset of symptoms. Headache 47 (47%) was the most common indication. Analgesics 62 (62%) were most commonly used drugs procured most commonly from pharmacies 114 (57.3%). Dosage form was drug selection criteria for 120 (60.3%) students. Conclusions: Since self-medication is crammed with serious health hazards, proper exposure to the topic should be given to medical, dental students, and pharmacists. The implication of self-medication into the pharmacology syllabus is a must.
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Affiliation(s)
| | | | - Saurabh Tiwari
- Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Pratigya Bhattarai
- Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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26
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Abebe K, Beressa TB, Yimer BT. In-vitro Evaluations of Quality Control Parameters of Paracetamol Tablets Marketed in Gondar City, Northwest Ethiopia. DRUG HEALTHCARE AND PATIENT SAFETY 2020; 12:273-279. [PMID: 33376411 PMCID: PMC7762764 DOI: 10.2147/dhps.s282420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/09/2020] [Indexed: 11/23/2022]
Abstract
Background The aim of this research was to evaluate quality control parameters of available brands of paracetamol tablets in Gondar city since standard quality parameters are essential for a better quality of the product. The different brands of paracetamol tablets were obtained from local pharmacies in Gondar town and the University of Gondar (UOG) hospital pharmacies. Methods Five brands of paracetamol, from each, 102 tablets were collected from private pharmacies, government health centers, and UOG pharmacies. The popular brands in the city, Panadol, Para-denk, Paramol, Paracetamol (EPHARM), and Cadimol, conventional tablets of 500 mg strength were chosen and the tablets were assessed for different quality parameters: weight variation, hardness, friability, disintegration, dissolution, and drug content (assay) using compendial methods. The tablets were evaluated to check if they comply with the specifications of USP (United States Pharmacopeia). Results From the results, it was observed that all the brands of paracetamol have passed the tests and met the specifications of USP. Results of weight variation, hardness, friability, and disintegration time ranged from 0.46 to 1.11%, 117.0 to 174.70 N, 0.07 to 0.63%, and 01 to 08 minutes for all the tablets, respectively. The dissolution profiles of all the brands are within the acceptable label claim. The assay results showed that the drug content of the paracetamol brands ranged from 95.04% to 106.81%. The dissolution rate was significantly different (p < 0.05) as compared to code 1 with all brands tested at 30 minutes. The disintegration time of different brands was also significantly different from the comparator (code 1) except code 2. Conclusion Based on the finding from this study, there were no significant deviations from pharmacopeia standards and specifications. The brands studied were safe enough and could be used to achieve the desired therapeutic effect.
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Affiliation(s)
- Konjit Abebe
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tamirat Bekele Beressa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Bilal Tessema Yimer
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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27
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Onchonga D, Omwoyo J, Nyamamba D. Assessing the prevalence of self-medication among healthcare workers before and during the 2019 SARS-CoV-2 (COVID-19) pandemic in Kenya. Saudi Pharm J 2020; 28:1149-1154. [PMID: 32837218 PMCID: PMC7426227 DOI: 10.1016/j.jsps.2020.08.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Self-medication plays a key role in public health as it influences both negatively and positively on the health of individuals and the existing healthcare systems. This is especially the case during public health emergencies like the 2019 SARS-CoV-2 disease. OBJECTIVES The study aimed at assessing the prevalence of self-medication before and during the outbreak of COVID-19 pandemic among healthcare workers and its associated factors. METHODS Stratified sampling was used to select 379 study respondents. The authors developed an online questionnaire, pretested and submitted to various online professional groups of different cadres of healthcare workers. Collected data was analysed using descriptive and inferential statistics. The data was presented in tables, graphs, percentages, and cross-tabulation with different variables. Multivariable logistic regression was used to ascertain factors that influence an individual's desire to self-medicate and associations were considered significant at p < 0.05. RESULTS The overall prevalence of self-medication increased from 36.2% (n = 137) before the pandemic to 60.4% (n = 229) during the pandemic. The respondents' gender, level of education, age, marital status, participation in physical activity, and drug reaction events, were significantly associated with self-medication before and during the outbreak (P < 0.05). Multivariable logistic regression analyses showed that participants engaging in physical activities, working during the day and being healthy were less likely to self-medicate (p < 0.01). CONCLUSION Self-medication is an important health issue, especially during the COVID-19 pandemic. Continuous awareness creation and sensitization could help in reducing self-medication practices among healthcare workers.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
- Ministry of Health- Samburu County, Kenya
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Rangari GM, Bhaisare RG, Korukonda V, Chaitanya YL, N H. Prevalence of self-medication in rural area of Andhra Pradesh. J Family Med Prim Care 2020; 9:2891-2898. [PMID: 32984145 PMCID: PMC7491850 DOI: 10.4103/jfmpc.jfmpc_204_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 11/22/2022] Open
Abstract
Background: The consumption of medicine without consulting a doctor is called self-medication. In the recent decade, the prevalence of self-medication was increased mainly in the developing countries. The reason varies from the nonavailability of doctors to economical reason. But people are not aware of the side effects and interactions of drugs. This is risky behavior and may lead to death. The objective of this study is to find out the prevalence and various reasons, sources, and common drugs used for self-medication. Materials and Methods: A cross-sectional community-based study conducted in Visakhapatnam district, Andhra Pradesh. 166 houses were selected by using a simple random sampling method. One respondent from one household was interviewed by using a semi-structured questionnaire. The data obtained were analyzed by using SPSS V22. Chi-square and Fisher exact tests were applied to find associations. Phi, Cramer Rao V, and contingency coefficient were applied to find the strength of association. A value of P < 0.05 was considered significant. Results: Among 166 subjects, the majority (58.4%) of participants were in the age group between 18-30 and most of them were female 142 (85.5%). The prevalence of self-medication was 68.1%. The main source of self-medication was directly from the pharmacy, that is, pharmacists (72.6%). Analgesics were commonly (85%) self-medicated drug. The main indication for self-medication was headache (78.8%) and fever (66.4%). Conclusion: The prevalence of self-medication was high and which is hazardous to health. This needs prompt legislative action.
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Affiliation(s)
- Gaurav M Rangari
- Department of Pharmacology, All India Institute of Medical Science, Mangalagiri, Andhra Pradesh, India
| | - Roza G Bhaisare
- Department of Community Medicine, Nimra Institute of Medical Science, Vijayawada, Andhra Pradesh, India
| | - Venkatasandhya Korukonda
- Department of Community Medicine, Medical Student, GVP IHC and MT, Visakhapatnam, Andhra Pradesh, India
| | - Y Lakshmi Chaitanya
- Department of Community Medicine, Medical Student, GVP IHC and MT, Visakhapatnam, Andhra Pradesh, India
| | - Hanumanth N
- Department of Community Medicine, GVP IHC and MT, Visakhapatnam, Andhra Pradesh, India
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Chapagain K, Rauniyar GP. Self-medication Practices among the Peri-urban Households of Two Communities of Dharan Sub-metropolitan city of Eastern Nepal: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2020; 58:569-573. [PMID: 32968290 PMCID: PMC7580369 DOI: 10.31729/jnma.5185] [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: 11/12/2022] Open
Abstract
Introduction: Self-medication practice is the use of medication without prescription of health care professionals. Drug resistance, drug side effects, wastage of resources, and serious health hazards including death are associated with self-medication. We conducted this study to find out the prevalence of self-medication among the peri-urban population of two randomly selected communities of Dharan, Nepal. Methods: A descriptive cross-sectional study was conducted among people residing in two randomly selected wards of peri-urban areas of Dharan from November 2017 and April 2018 after obtaining ethical clearance (IRC/1030/017). A pretested, structured self-administered questionnaire was used for data collection. Data were collected and entered in Statistical Package for the Social Sciences version 11.5; point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 426 respondents, the overall prevalence of self-medication was 312 (73.23%) at 95% Confidence Interval (67.83-78.63%). It was more common among female 158 (78.60%). Common symptoms were headache 201 (64.42%), fever 135 (43.26%), gastrointestinal 93 (29.8%) and respiratory illness 87 (27.88%). Analgesics and antipyretics 275 (88.14%) were the most common drugs selfmedicated with. Seeking opinion from pharmacist 112 (35.89%) was the commonest method adopted to procure drugs and comfort 127 (40.7%) and time constraints 122 (39.1%) were the commonest reasons. Conclusions: Prevalence of self-medication among the peri-urban population was similar to other studies. Headache and fever was the common symptoms for which self-medication were adopted. Awareness regarding potential dangers of self-medication and different drug side effects are recommended at the community level.
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Affiliation(s)
- Kumud Chapagain
- Departmentof Clinical Pharmacology and Therapeutics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Gajendra Prasad Rauniyar
- Departmentof Clinical Pharmacology and Therapeutics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Alidu L, Grunfeld EA. 'What a dog will see and kill, a cat will see and ignore it': An exploration of health-related help-seeking among older Ghanaian men residing in Ghana and the United Kingdom. Br J Health Psychol 2020; 25:1102-1117. [PMID: 32656938 DOI: 10.1111/bjhp.12454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 06/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health care utilization rates are lower among men; however, little is known about how men's health care utilization is affected by migration. The aim of this study was to explore health-related help-seeking decisions among older Ghanaian men residing in the United Kingdom and in Ghana. METHODS Twenty-six men aged 50 years or over were recruited from community locations within two large cities in the UK and Ghana. Face-to-face semi-structured interviews were undertaken to explore the illness and help-seeking experiences of older men. RESULTS Help-seeking experiences differed among the Ghanaian men living in the UK and in Ghana. Three themes were identified that impacted on help-seeking decisions: (1) pluralistic approaches to managing health and illness and (2) perceptions of formal health services in Ghana and UK and (3) financial constraints and masculinity norms as barriers to help-seeking. CONCLUSION This is the first study to look at help-seeking decisions among older men residing in the UK and Ghana. Findings highlight how older migrant men's explanatory models of their health encompass enduring faith-based beliefs around causation of illness and approaches to management, as well as the use of pluralistic approaches to managing health. This study supports the call for culturally sensitive community-based interventions to increase engagement and facilitate improved health outcomes for migrant populations, particularly older men.
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Affiliation(s)
- Lailah Alidu
- Population Evidence and Technology, University of Warwick Medical School, Coventry, UK
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Paudel S, Aryal B. Exploration of self-medication practice in Pokhara valley of Nepal. BMC Public Health 2020; 20:714. [PMID: 32429936 PMCID: PMC7236217 DOI: 10.1186/s12889-020-08860-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-medication (SM) is the practice of consuming medication without the consultation of physician. The drugs most commonly self-medicated are paracetamol, analgesics, ranitidine, oral rehydration solution and antibiotics. The objective of the study was to assess the SM status and its causes in Pokhara valley of Nepal. METHOD The study was conducted among the people residing in Pokhara metropolitan city. The study duration was of 4 months from April to July, 2018. The study population were patients attending health general and oral health screening programs at Baidam, Birauta, Hemja and Pame areas of Pokhara. Structured questionnaire was used to collect demographics of the patients and the details of the usage of self-medication. RESULT Out of 201 patients, 38.2% patients were found to be self-medicating. The most common illness sought for SM was ache (headache, body ache) in 50% subjects followed by cough and cold in 31% and gastritis in 23%. Paracetamol was the drug consumed by 16 subjects followed by nimesulide by 11. Lack of knowledge about the disadvantages of SM led to self-medication in 65% of respondents. The personnel most commonly consulted for medication were pharmacists (60%). CONCLUSION The trend of SM is high in Pokhara valley. The comedics were consulted most often for SM due to lack of knowledge of consultation to physicians. The public should be made aware about SM.
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Affiliation(s)
- Sabita Paudel
- Department of Pharmacology, Gandaki Medical College - Teaching Hospital, Rithepani, Pokhara, Nepal.
| | - Bijay Aryal
- Karnali Academy of Health Sciences, Jumla, Karnali province, Nepal
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32
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Bhattarai R, Khanal S, Shrestha S. Prevalence of Self-medication Practices for Oral Health Problems among Dental Patients in a dental college: A Descriptive Cross-sectional Study. ACTA ACUST UNITED AC 2020; 58:209-213. [PMID: 32417855 PMCID: PMC7580453 DOI: 10.31729/jnma.4866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction: Self-medication means the use of medications for the treatment of any disease on their own, without consulting any healthcare professional. At times self-medication can be useful if practiced correctly by saving time and money, whereas disadvantages often occur due to lack of evaluation by trained medical professionals and delay ineffective treatment and can result in unnecessary expenses and drug dependence. This study was conducted to find out the self-medication behavior and its associated factors among patients visiting a dental hospital in Kathmandu. Methods: A hospital-based, cross-sectional study was conducted on 265 patients in Kantipur Dental College from December 2019 to January 2020 among the patients attending the dental Out Patient Department. Ethical clearance was obtained from the Institutional Review Committee of Kantipur Dental College. A convenience sampling technique was used. Proformas were prepared in English, translated to Nepali and re-translated to English by the back-translation method. Data entry was done in Microsoft Excel and analysis in SPSS 20. Descriptive statistics was done. Results: The prevalence of self-medication practice was found to be 166 (62.6%). Out of total participants, 99 (59.6%) consumed medicines for few days only and the most common triggering factor was found to be toothache in 101 (60.8%) participants. The most common reason for self-medication was found to be a previous experience of treating similar illnesses. Conclusions: The prevalence of self-medication was found to be low as compared to the study done in similar settings. Self-medication practice is a sensitive issue that hasn't been given the required consideration. It is of concern to find every other dental patient being indulged in self-medication whether in the present or the past.
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Affiliation(s)
- Rosina Bhattarai
- Department of Community Dentistry, College of Medical Sciences, Bharatpur, Chitwan, Nepal
| | - Sunita Khanal
- Department of Community Dentistry, Kantipur Dental College, Dhapasi, Kathmandu, Nepal
| | - Sujita Shrestha
- Department of Community Dentistry, Kantipur Dental College, Dhapasi, Kathmandu, Nepal
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Ansari M, Alanazi A, Moin A. Consumers' awareness, attitude and associated factors towards self-medication in Hail, Saudi Arabia. PLoS One 2020; 15:e0232322. [PMID: 32343748 PMCID: PMC7188286 DOI: 10.1371/journal.pone.0232322] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 04/12/2020] [Indexed: 12/29/2022] Open
Abstract
Objectives To determine the factors motivating the consumers towards self-medication, the intended indications and the consumers’ perceptions about complications that may arise due to its use. Design Cross-sectional community based prospective study Place and duration of study Community pharmacies located at various locations of Hail, Saudi Arabia from January 2019 to March 2019. Methods The subjects of this cross-sectional study were people visiting community pharmacies for self-medication. Data on 663 participants was collected through a validated questionnaire prepared on the basis of WHO guidelines for the regulatory assessment of medicinal products for use in self-medication. Two trained data collectors visited the randomly selected community pharmacies, approached and interviewed the consumers purchasing medicines without prescriptions. Data was entered in SPSS and analyzed using descriptive and inferential analyses (alpha level = 0.05). Results Out of 663 respondents, 68.6% were university graduates; and 33.9% were healthcare professionals. Consumers preferred self-medication mainly for headache (85.8%), cold and sore throat (80.8%), cough (75.7%) and fever (71.8%) with the justification that these illnesses were minor (90.2%), time saving (82.2%), convenient (74.7%), quicker relief (66.1%), and economical (61.2%). Occupation was significantly associated with the reasons for preferring self-medication (p<0.001). Similarly, age, gender and education were also significantly associated with most of the reasons for opting self-medication. People were quite aware about harmful consequences of self-medication. Multivariate logistic regression analysis showed that the respondents with lower education (AOR = 2.404 [95% CI: 1.579–3.661]), non-healthcare professionals (AOR = 1.712 [95% CI: 1.143–2.565]) and higher monthly income (AOR = 0.376 [95% CI: 0.236–0.599]) preferred self-medication (p <0.001, p = 0.009, p <0.001) respectively. Conclusion Self-medication was prevalent among young university graduate males for minor ailments mainly due to convenience and time saving. Despite people beliefs about the harmful consequences of self-medication, its use was omnipresent particularly among the respondents with lower education, non-healthcare professionals and people with higher monthly income.
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Affiliation(s)
- Mukhtar Ansari
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
- * E-mail:
| | - Abdulrahman Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Afrasim Moin
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail, Saudi Arabia
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De Sanctis V, Soliman AT, Daar S, Di Maio S, Elalaily R, Fiscina B, Kattamis C. Prevalence, attitude and practice of self-medication among adolescents and the paradigm of dysmenorrhea self-care management in different countries. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:182-192. [PMID: 32191679 PMCID: PMC7569583 DOI: 10.23750/abm.v91i1.9242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 11/23/2022]
Abstract
Self-medication (SM) is an important worldwide public health issue affecting children and adolescents. The pattern of SM varies in different communities, affected by factors such as age, sex, income, expense, self-care orientation, educational level and medical knowledge. It is a fairly common practice: for minor health problems, it often provides cheap, rapid, and convenient solutions, outside of the health care system of many countries. Painkillers, antipyretics, cough medicines, cold preparations, dermatological products, nutritional supplements and antibiotics are the drugs most frequently used. Potential risks include incorrect self-diagnosis, improper dosage, inappropriate choice of therapy, masking of severe disease and drug interactions. Lack of awareness of warnings and precautions, storage conditions, the recommended shelf-life and adverse reactions increase the risk of side effects. Little is known about the SM of dysmenorrhea by adolescent girls. Attitudes towards treatment are influenced by cultural, ethnic, and religious factors. Some girls discuss dysmenorrhea with family and friends, and the majority may not seek medical advice. As dysmenorrhea is a common problem for adolescents, it is essential that these girls be aware of the normal and abnormal symptoms of menstruation. In the light of these findings, the roles of family, school, health professionals and health authorities are of utmost importance for the implementation of measures to approach this health problem in a more efficient way. (www.actabiomedica.it)
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Affiliation(s)
- Vincenzo De Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy.
| | - Ashraf T Soliman
- Department of Pediatrics, University of Alexandria, Alexandria, Egypt.
| | - Shahina Daar
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman.
| | - Salvatore Di Maio
- Emeritus Director in Pediatrics, Children's Hospital "Santobono-Pausilipon," Naples, Italy.
| | - Rania Elalaily
- Department of Primary Health Care, Abu Nakhla Hospital, Doha, Qatar.
| | | | - Christos Kattamis
- First Department of Paediatrics, National Kapodistrian University of Athens, Athens, Greece.
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Yadav UN, Lloyd J, Hosseinzadeh H, Baral KP, Dahal S, Bhatta N, Harris MF. Facilitators and barriers to the self-management of COPD: a qualitative study from rural Nepal. BMJ Open 2020; 10:e035700. [PMID: 32156769 PMCID: PMC7064074 DOI: 10.1136/bmjopen-2019-035700] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To understand the facilitators and barriers to the self-management of chronic obstructive pulmonary disease (COPD) in rural Nepal. SETTINGS Community and primary care centres in rural Nepal. PARTICIPANTS A total of 14 participants (10 people with COPD and 4 health care providers) were interviewed. PRIMARY AND SECONDARY OUTCOME MEASURES People with COPD and healthcare provider's experience of COPD self-management in rural Nepal. RESULTS Facilitators and barriers affecting COPD self-management in Nepal operated at the patient-family, community and service provider levels. People with COPD were found to have a limited understanding of COPD and medications. Some participants reported receiving inadequate family support and described poor emotional health. At the community level, widespread use of complementary and alternative treatment was found to be driven by social networks and was used instead of western medicine. There were limited quality controls in place to monitor the safe use of alternative treatment. While a number of service level factors were identified by all participants, the pertinent concerns were the levels of trust and respect between doctors and their patients. Service level factors included patients' demands for doctor time and attention, limited confidence of people with COPD in communicating confidently and openly with their doctor, limited skills and expertise of the doctors in promoting behavioural change, frustration with doctors prescribing too many medicines and the length of time to diagnose the disease. These service level factors were underpinned by resource constraints operating in rural areas. These included inadequate infrastructure and resources, limited skills of primary level providers and lack of educational materials for COPD. CONCLUSIONS The study findings suggest the need for a more integrated model of care with multiple strategies targeting all three levels in order to improve the self-management practices among people with COPD.
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Affiliation(s)
- Uday Narayan Yadav
- Reserach and Evaluation, Forum for Health Reserach and Development, Dharan, Nepal
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Hassan Hosseinzadeh
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kedar Prasad Baral
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Sagar Dahal
- Ministry of Health and Population, Government of Nepal, Kathmandu, Province III, Nepal
| | - Narendra Bhatta
- Department of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Mark Fort Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
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Abstract
Traditional herbal medicine is widely used globally. Despite its extensive use, there are no proper regulations on standardization and use of herbal medicinal products. Nepal has a rich biodiversity and demography comprising of different socio-ethnic groups. Herbal medicines are utilized prominently in Nepalese communities. These herbal products may cause side effects and adverse effects, such as nephrotoxicity, neurotoxicity with the heavy metal toxicity associated with their powdered dosage forms. The side effects of using herbal products have been documented, such as bleeding with use of Ginkgo biloba and increase in blood pressure with use of Ephedra. Regulation of herbal products is essential to promote their optimal and rational use. Standard tools are available for assessing adverse effects of herbal products from health authorities, like the World Health Organization. In Nepal, self-medication practice using traditional herbal medicines is common and includes the concomitant use of allopathic. There is no focal point to address the regulatory issues on herbal products currently in Nepal. The Department of Drug Administration in Nepal is nominated as a national pharmacovigilance center and there are no reports on adverse events from the use of herbal medicines so far. However, not having any reports does not ensure the absolute safety and effectiveness of herbal products, so vigilance is warranted. Herbal pharmacovigilance is needed for Nepal to ensure safe and effective use of herbal medicines as the current pharmacovigilance ecosystem does not capture those cases. In the Nepalese context, the absence of reporting mechanisms may have underreported adverse cases of herbal products. The present opinion article aims to discuss the use of herbal products in Nepal, the challenges associated with the adverse reaction due to herbal medicines, and recommendations to overcome these challenges
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Tackling antimicrobial resistance in Bangladesh: A scoping review of policy and practice in human, animal and environment sectors. PLoS One 2020; 15:e0227947. [PMID: 31986167 PMCID: PMC6984725 DOI: 10.1371/journal.pone.0227947] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 01/04/2020] [Indexed: 11/29/2022] Open
Abstract
Background Antimicrobial resistance (AMR) has become an emerging issue in the developing countries as well as in Bangladesh. AMR is aggravated by irrational use of antimicrobials in a largely unregulated pluralistic health system. This review presents a ‘snap shot’ of the current situation including existing policies and practices to address AMR, and the challenges and barriers associated with their implementation. Methods A systematic approach was adopted for identifying, screening, and selecting relevant literature on AMR situation in Bangladesh. We used Google Scholar, Pubmed, and Biomed Central databases for searching peer-reviewed literature in human, animal and environment sectors during January 2010-August 2019, and Google for grey materials from the institutional and journal websites. Two members of the study team independently reviewed these documents for inclusion in the analysis. We used a ‘mixed studies review’ method for synthesizing evidences from different studies. Result Of the final 47 articles, 35 were primary research, nine laboratory-based research, two review papers and one situation analysis report. Nineteen articles on human health dealt with prescribing and/or use of antimicrobials, five on self-medication, two on non-compliance of dosage, and 10 on the sensitivity and resistance patterns of antibiotics. Four papers focused on the use of antimicrobials in food animals and seven on environmental contamination. Findings reveal widespread availability of antimicrobials without prescription in the country including rise in its irrational use across sectors and consequent contamination of environment and spread of resistance. The development and transmission of AMR is deep-rooted in various supply and demand side factors. Implementation of existing policies and strategies remains a challenge due to poor awareness, inadequate resources and absence of national surveillance. Conclusion AMR is a multi-dimensional problem involving different sectors, disciplines and stakeholders requiring a One Health comprehensive approach for containment.
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Marathe PA, Kamat SK, Tripathi RK, Raut SB, Khatri NP. Over-the-counter medicines: Global perspective and Indian scenario. J Postgrad Med 2020; 66:28-34. [PMID: 31898596 PMCID: PMC6970327 DOI: 10.4103/jpgm.jpgm_381_19] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Patients often approach a pharmacist instead of visiting a doctor for minor ailments such as cough, cold, allergies, pain, fever, acidity, diarrhea, and skin-related conditions. Purchase of specific medicines over the counter is legally recognized in most countries. 'Over-the-Counter (OTC) Medicines' means drugs which are legally allowed to be sold by pharmacists without need for a prescription. The term does not have a legal definition in India. Technically, drugs are OTC unless they are specifically stated as prescription only drugs. OTC drugs allow faster and cheaper access to healthcare; however, their misuse and adverse health effects cause concerns. This article describes concept of OTC medicines and practices in India against the background of globally prevalent regulations and practices. A recognized category of OTC medicines by law, patient awareness programs, and support of pharmacists and pharmaceutical companies are required to optimize the use of OTC medicines in India.
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Affiliation(s)
- P A Marathe
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - S K Kamat
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - R K Tripathi
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - S B Raut
- Behavioral Neuroscience Group, Department of Psychology, University of Tasmania, Australia
| | - N P Khatri
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, India
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Emad S, Abedi S, Dehghani Z, Ghahramani Y. Prevalence of Self-Medication with Antibiotics amongst Clients Referred to Outpatient University Dental Clinics in Iranian Population: A Questionnaire-Based Study. IRANIAN ENDODONTIC JOURNAL 2020; 15:1-5. [PMID: 36704324 PMCID: PMC9723210 DOI: 10.22037/iej.v15i1.24334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/02/2019] [Accepted: 10/19/2019] [Indexed: 01/28/2023]
Abstract
Self-medication with antibiotics may increase the risk of inappropriate use and development of antibiotic-resistant bacteria. The aim of this study was to determine the prevalence of self-medication with antibiotics amongst dental outpatients in Iranian population. Methods and Materials One thousand and two hundred of dentistry patients, who were referred to dental school clinics in ten major provinces of Iran, participated in this study. A valid self-administered questionnaire regarding self-medication with antibiotics in case of dental pain was used to collect data. Data were analysed using descriptive statistics and Logistic regression analysis. Results In our study population, the prevalence of self-medication was 42.6%. Amongst the Iranian cities, the highest prevalence of self-medication with antibiotics belonged to the city of Bandar Abbas (64%) and the lowest was seen in the city of Kerman (27.3%). Men were more likely to take antibiotics. Amoxicillin was the mostly used antibiotic. Severe pain, previous self-medications and high costs of dental visits were the most common reasons for self-medication with antibiotics in the investigated population. In addition, the present study showed that marriage, acceptable financial status and high level of education could decrease self-medication with antibiotics. Conclusions In the current investigation, an alarming fact was that self-medication for dental problems seemed very common amongst the studied population. One of its most important consequences was bacterial resistance. Therefore, there should be plans to promote and prioritize public health awareness and encourage general public's motivation to reduce the practice of self-medication.
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Affiliation(s)
- Sara Emad
- Dentist, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shadi Abedi
- Dentist, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Dehghani
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yasamin Ghahramani
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding author: Yasamin Ghahramani, Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Tel: +98-713 6263193,E-mail:
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Fekadu G, Dugassa D, Negera GZ, Woyessa TB, Turi E, Tolossa T, Fetensa G, Assefa L, Getachew M, Shibiru T. Self-Medication Practices and Associated Factors Among Health-Care Professionals in Selected Hospitals of Western Ethiopia. Patient Prefer Adherence 2020; 14:353-361. [PMID: 32110001 PMCID: PMC7040189 DOI: 10.2147/ppa.s244163] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/07/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Even though the type, extent and reasons for self-medication practice (SMP) vary, globally self-medication (SM) is rising to relieve burdens on health services. However, inappropriate SMP results in economic wastes, damage of vital organs, incorrect therapy selection, risk of adverse drug reactions and development of antimicrobial-resistant pathogens. These consequences have severe implications including legal, ethical and quality of health-care delivery. Temporal increment and high prevalence of SM among health professionals is also a major bottleneck for Ethiopia. Hence, the study aimed to assess the SM among health-care professionals (HCPs) in selected governmental hospitals of Western Ethiopia. METHODS An instiution-based cross-sectional study was conducted among 338 HCPs using a pre-tested and self-adminstered questionnaries from March 1 to 25, 2018. Simple random sampling was used to select study participants and SMP (yes or no) was the outcome of the study variable. Data were entered and analyzed using SPSS version 20. Crude and adjusted odds ratios (95% CI) were calculated and all results were deemed to be statistically significant when p < 0.05. RESULTS Among the 338 participants, 184 (54.4%) were females and the mean age of the study participants was 25±3.23 years. About 154 (45.6%) of them had work experience of less than 5 years and 49.7% were nurses by profession. The prevalence of SM was 73.4% with 3 months of recall for SM. Familiarity with medicines and ailments (46.8%) and mildness of illness (40.7%) were the most common reasons to self-medicate. The most frequently reported ailments were headache (37.1%) and gastric pain (29.8%). Analgesics (44.4%) and antibiotics (42.7%) were the most commonly used self-medicated categories of drugs. Female sex (Adjusted odds ratio [AOR] =2.13, 95% CI: 1.43-8.66), age 20-29 years (AOR=4.53, 95% CI: 1.01-14.45) and work experience of <5 years (AOR= 3.01, 95% CI: 1.32-11.71) were significantly associated with SMPs. CONCLUSION The study revealed a high prevalence of SMP among HCPs. Sex, age, and work experience were significantly associated with SMPs. Hence, the use of prescription drugs without prescription should be discouraged and appropriate health education should be provided by all concerned bodies on the proper use of drugs.
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Affiliation(s)
- Ginenus Fekadu
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
- Correspondence: Ginenus Fekadu Clinical Pharmacy Unit Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Oromia, EthiopiaTel +251-917137145Fax +251576617980 Email
| | - Dinka Dugassa
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | | | - Tilahun Bakala Woyessa
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tadesse Tolossa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Lemessa Assefa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Motuma Getachew
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- Department of Pediatrics and Child Health, Wollega University Referral Hospital, Nekemte, Ethiopia
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Evaluation of Nasal Decongestants by Literature Review. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Over-the-counter drugs are medicines that are available to consumers without a prescription. The most common оver - the-counter preparations in self - medication are nasal decongestants that can be used systemically or locally in the form of drops or nasal sprays. The most common indications for nasal decongest-ants are viral infections and allergic conditions in order to alleviate the symptoms so it is necessary to inform the users about the type of drug, the active substance it contains and the correct dosage regimen. Given their availability and the prevailing safety precaution, these preparations can lead to numerous prolonged conditions and complications. The mechanism of action of nasal decongestants is based on the reduction of blood vessels’ swelling in the nose, which helps the opening of the airway. As a result, most nasal decongestants cause vasoconstriction (narrowing of blood vessels). There are nasal decongestants that block histamine and have a good effect on people who suffer from seasonal allergies.
Availability (free sale) and prolonged use of the decongestant lead to a decrease in the sensitivity of the alpha receptor, which leads to the need to increase the dose at shorter time intervals to achieve the same effect. As a consequence, patients use excessive, uncontrolled doses of nasal decongestants, which is a public problem and warns of the necessity of identification and the taking of measures to prevent their uncontrolled procurement and use.
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Mortazavi SMJ, Moharrami A, Shafiei H, Ebrahimzadeh MH, Karimi M. Unapproved Weight Gain Supplement as a Cause of Avascular Necrosis: A Cautionary Report. THE ARCHIVES OF BONE AND JOINT SURGERY 2019; 7:561-565. [PMID: 31970262 PMCID: PMC6935523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
Avascular necrosis of the femoral head (AVNFH) is a leading cause of end-stage joint disease in the young population that can lead to total hip replacement in early life. There are various risk factors, including trauma, corticosteroids, thrombosis, hypertension, and alcohol. There is a growing number of patients with AVNFH and history of self-medication with herbal supplement used for weight gain in Iran. The present study aimed to demonstrate the prevalence rate of using unapproved weight gain supplements (UWGS) in patients with AVNFH. An observational and cross-sectional study was conducted to estimate the prevalence rate of using UWGSs in patients with osteonecrosis at Imam Khomeini Hospital, Tehran, Iran, from January 2012 to 2018. The data were analyzed in SPSS software (version 24) through descriptive statistics and tests of means. Out of 207 patients with AVNFH, 115 cases were male. In total, 44 patients (20.95%) had a history of using UWGSs, and there had no other risk factors of osteonecrosis of FH. In conclusion, UWGSs can be a risk factor for AVNFH, and it is necessary to develop educational programs to alert young population about the side effects of these supplements.
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Affiliation(s)
- S M Javad Mortazavi
- Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
- Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Research performed at Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Moharrami
- Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
- Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Research performed at Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Shafiei
- Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
- Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Research performed at Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad H Ebrahimzadeh
- Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
- Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Research performed at Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Karimi
- Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
- Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Research performed at Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Mwita S, Meja O, Katabalo D, Richard C. Magnitude and factors associated with anti-malarial self-medication practice among residents of Kasulu Town Council, Kigoma-Tanzania. Afr Health Sci 2019; 19:2457-2461. [PMID: 32127817 PMCID: PMC7040277 DOI: 10.4314/ahs.v19i3.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Anti- malarial self-medication practice in Africa is very common. It is considered as an alternative way for people who cannot afford the cost of health care services. This study was conducted to assess the magnitude and factors associated with anti-malarial self-medication practice among residents of Kasulu Town Council. Materials and methods The study was a descriptive cross sectional study. Two hundred and eighty consenting respondents were selected by systematic random sampling and interviewed with the aid of a semi structured questionnaire to assess anti-malarial self- medication practice. A p value of less than 0.05 was considered statistically significant, at 95% confidence interval. Results Prevalence of anti-malarial self-medication was (69.6%). Majority of the respondents (83.1%) reported that, they did not get better after self- medication. About 36% of the respondents metioned time taken in health facilities as the main factor for self-medication. Conclusion This study revealed that, self-medication practice is very common among community members in Kasulu district. The main reasons identified for self-medication was long time taken to get treatment in health facilities.
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Affiliation(s)
- Stanley Mwita
- School of Pharmacy, Catholic university of Health and Allied Sciences, Mwanza, Tanzania
| | - Omary Meja
- School of Pharmacy, Catholic university of Health and Allied Sciences, Mwanza, Tanzania
| | - Deogratias Katabalo
- School of Pharmacy, Catholic university of Health and Allied Sciences, Mwanza, Tanzania
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Shaamekhi HR, Asghari Jafarabadi M, Alizadeh M. Demographic determinants of self-medication in the population covered by health centers in Tabriz. Health Promot Perspect 2019; 9:181-190. [PMID: 31508338 PMCID: PMC6717925 DOI: 10.15171/hpp.2019.26] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 05/20/2019] [Indexed: 11/09/2022] Open
Abstract
Background: Self-medication is the choice and use of medications by people to treat a self-diagnosed illness or symptom. The aim of this study was to search the relationship between a number of socio-demographic conditions and self-medication in the population covered by health complexes in Tabriz, Iran. Methods: This study was a cross-sectional descriptive-analytic study and was carried out on the population covered by health complexes in Tabriz. Participants were recruited by a multi-stage sampling method. A total of 1000 participants were included in the study. Data collection was done using a researcher-created questionnaire. Data were analyzed using chi-square test and logistic regression. Results: The incidence of self-medication was 70.9% for participants who reported illness in the last month. The chance of self-medication was higher in young (P=0.007) and middle-aged (P=0.012) groups, and housewives (P=0.048); and was lower among participants who were not literate (P=0.047). There was no significant relationship between gender and self medication (P=0.553). The high cost of visits was mentioned as a reason for self-medication. The most frequently mentioned drugs used in self-medication were analgesics, cold medicines, and antibiotics, respectively. More frequent reasons for self-medication were the previous experience of the disease, the assumption that the ailment was not important, and the high cost of visits, respectively. Conclusion: The prevalence of self-medication in this study was high. Considering the results, education in the community, financial support, and monitoring the delivery of drugs can play an important role in improving the pattern of drug use.
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Affiliation(s)
- Hamid Reza Shaamekhi
- Department of Community and Family Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biostatistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahasti Alizadeh
- Social Determinants of Health Research Centre, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Nkrumah J, Gbagbo FY. Self-Medication among Pregnant Women in Effutu and Agona West Municipalities of the Central Region of Ghana. ACTA ACUST UNITED AC 2019. [DOI: 10.14302/issn.2641-4538.jphi-19-2965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Self-medication in pregnancy is a health concern in Ghana. We assessed the practice among 136 pregnant women in Effutu and Agona West Municipalities using facility-based, cross-sectional design and mixed method approach of data collection. Data analysis used SPSS and manual content analysis. Results show that pregnant women of all backgrounds self-medicate, with prevalence of 69%, motivated by cheaper treatment cost (17%), minor ailments (29%) and positive outcomes (33%). Commonly used medications include antibiotics (23%), pain killers (20%) and herbal preparations (19%). Preventing self-medication in pregnancy therefore requires awareness creation and evidence based Social Behavioral Change Communication on associated dangers.
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Affiliation(s)
- Jacqueline Nkrumah
- University of Education, Winneba, Faculty of Science Education, Department of Health Administration and Education, P.O Box 25, Winneba, Central Region, Ghana, West African
| | - Fred Yao Gbagbo
- University of Education, Winneba, Faculty of Science Education, Department of Health Administration and Education, P.O Box 25, Winneba, Central Region, Ghana, West African
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Sunpuwan M, Punpuing S, Jaruruengpaisan W, Kinsman J, Wertheim H. What is in the drug packet?: access and use of non-prescribed poly-pharmaceutical packs (Yaa Chud) in the community in Thailand. BMC Public Health 2019; 19:971. [PMID: 31331304 PMCID: PMC6647088 DOI: 10.1186/s12889-019-7300-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 'Yaa Chud' is a non-prescribed poly-pharmaceutical pack containing several types of drugs, including antibiotics and steroids, which can be purchased over the counter in Thailand for self-medication. Although it is illegal, it is still available at some community outlets. This study aimed to understand access to and use of Yaa Chud at the community level in order to raise awareness on its usage and to provide policy recommendations to address the problem. METHODS This study employed qualitative methods, including in-depth interviews with 18 drug suppliers and 16 community members, and six focus group discussions. It included inventories from 17 drug suppliers. Data were collected in selected communities of the Kanchanaburi Demographic Surveillance System, located in the western region of Thailand.Thematic analysis was based upon the Health Services Utilization Model and conducted using the Open Code qualitative software program. RESULTS Overcrowding, long waiting times, and a perceived unwelcoming environment at public health-care service outlets were identified as factors that drive people into the private sector, where loose regulation of drug laws facilitates access and use of Yaa Chud. Migrants and older people were most likely to seek and use Yaa Chud, especially for mild illness. Availability, easy access through a user's network, low cost, and perceived effectiveness were identified as factors that enable access and use of Yaa Chud. CONCLUSIONS Though illegal in Thailand, Yaa Chud is likely to remain available for self-medication by community members, due to the persisting demand by the elderly and migrant workers. There is an urgent need to replace these mixed medications with better choices. Safer Yaa Chud may be a preferred, first-line health-care option, which could help reduce congestion in the formal health-care setting. At the same time, enforcement of regulatory compliance needs to be continued in order to stop the supply of unsafe Yaa Chud.
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Affiliation(s)
- Malee Sunpuwan
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Sureeporn Punpuing
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand.
| | - Wipaporn Jaruruengpaisan
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - John Kinsman
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Heiman Wertheim
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- The Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Clinical Microbiology and the Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, Netherlands
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Malik B, Bhattacharyya S. Antibiotic drug-resistance as a complex system driven by socio-economic growth and antibiotic misuse. Sci Rep 2019; 9:9788. [PMID: 31278344 PMCID: PMC6611849 DOI: 10.1038/s41598-019-46078-y] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/17/2019] [Indexed: 01/21/2023] Open
Abstract
Overwhelming antibiotic use poses a serious challenge today to the public-health policymakers worldwide. Many empirical studies pointed out this ever-increasing antibiotic consumption as primary driver of the community-acquired antibiotic drug-resistance, especially in the middle- and lower-income countries. The association is well documented across spatio-temporal gradients in many parts of the world, but there is rarely any study that emphasizes the mechanism of the association, which is important for combating drug-resistance. Formulating a mathematical model of emergence and transmission of drug-resistance, we in this paper, present how amalgamating three components: socio-economic growth, population ecology of infectious disease, and antibiotic misuse can instinctively incite proliferation of resistance in the society. We show that combined impact of economy, infections, and self-medication yield synergistic interactions through feedbacks on each other, presenting the emergence of drug-resistance as a self-reinforcing cycle in the population. Analysis of our model not only determines the threshold of antibiotic use beyond which the emergence of resistance may occur, but also characterizes how fast it develops depending on economic growth, and lack of education and awareness of the population. Our model illustrates that proper and timely government aid in population health can break the self-reinforcing process and reduce the burden of drug-resistance in the community.
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Affiliation(s)
- Bhawna Malik
- Disease Modelling Lab, Department of Mathematics, School of Natural Sciences, Shiv Nadar University, Gautan Buddha Nagar, India.
| | - Samit Bhattacharyya
- Disease Modelling Lab, Department of Mathematics, School of Natural Sciences, Shiv Nadar University, Gautan Buddha Nagar, India.
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Ha TV, Nguyen AMT, Nguyen HST. Self-medication practices among Vietnamese residents in highland provinces. J Multidiscip Healthc 2019; 12:493-502. [PMID: 31456640 PMCID: PMC6620316 DOI: 10.2147/jmdh.s211420] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 05/16/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Monitoring self-medication practice, which refers to individuals using medicine without instructions of physicians, is critical to control its harmful effects. However, in Vietnam, evidence about self-medication among individuals in highland areas is constrained. This study examined self-medication practice among residents living in highland areas in Vietnam and determined associated factors. Materials and methods: A cross-sectional study was performed in five highland provinces with 1000 individuals. Information about individual and household's socioeconomic status and self-medication practice in the last 12 months was surveyed. Multivariate logistic and Poisson regressions were used to identify associated factors with self-medication. Results: 83.3% reported self-medication in the last 12 months, with the mean times of self-medication being 4.5 times (SD=4.1). Female (OR=0.62, p<0.01), ethnic minorities, higher number of members having health insurance in family (OR=0.82, p<0.01) and higher annual household income (OR=0.78, p<0.05) were associated with the lower likelihood of "Only buy medicines at pharmacy stores when having illness in the last 12 month". Moreover, people who were females (OR=0.59, p<0.05), white-collar worker (OR=0.25, p<0.01) and had higher number of children in the family (OR=0.68, p<0.05) were less likely to practice self-medication. People who were ethnic minorities, white-collar worker (Coef.=-0.32, p<0.01) and higher number of members having health insurance in family had lower times of self-medication in the last 12 months compared to other groups. Meanwhile, individuals having higher number of members in the family (Coef.=0.07, p<0.01) and higher annual household income (Coef.=0.08, p<0.01) had highertimes of self-medication in the last 12 months. Conclusion: Residents in highland areas in Vietnam had a considerably high 12-month prevalence of self-medication. Medical products quality management and self-medication guideline are potential to maximize the effects of self-medication. Moreover, promoting the use of health insurance should also be concerned as a solution to address this issue.
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Affiliation(s)
- Thuy Van Ha
- Department of Health Insurance, Ministry of Health of Vietnam, Hanoi 100000, Vietnam
| | - An Mai Thi Nguyen
- Department of Planning and Financing, Ministry of Health of Vietnam, Hanoi 100000, Vietnam
| | - Ha Song Thi Nguyen
- Department of Pharmacoeconomics and Management, Hanoi University of Pharmacy, Hanoi 100000, Vietnam
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Haque M, Rahman NAA, McKimm J, Kibria GM, Azim Majumder MA, Haque SZ, Islam MZ, Binti Abdullah SL, Daher AM, Zulkifli Z, Rahman S, Kabir R, Lutfi SNNB, Aishah Binti Othman NS. Self-medication of antibiotics: investigating practice among university students at the Malaysian National Defence University. Infect Drug Resist 2019; 12:1333-1351. [PMID: 31190922 PMCID: PMC6529675 DOI: 10.2147/idr.s203364] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/25/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Self-medication of drugs to alleviate symptoms is a common global behavior, helping relieve burdens on health services, but many drugs eg, antibiotics are prescription-only. Self-medication of antibiotics (SMA) is an irrational use of drugs, contributing to microbial resistance increasing health care costs and higher mortality and morbidity. This study aimed to assess SMA among university students. Methods: This was a cross-sectional study conducted among medical and non-medical students of the National Defence University of Malaysia. A validated instrument was used to gather data. Ethics approval was obtained. Random and universal sampling was adopted, and SPSS 21 was used for data analysis. Results: A total of 649 students participated in the study: 48.5% male and 51.5% female, 39.3% reported self-medicating with antibiotics. Penicillin, doxycycline, clarithromycin were the antibiotics most used with the majority reporting no adverse drug reactions. Cost savings and convenience were the principal reasons for SMA which were mainly obtained from local retail pharmacies. Despite medical students (particularly the more senior) having better knowledge of antibiotic use than non-medical students, 89% of all research participants responded that practicing SMA was a good/acceptable practice. Conclusion: SMA is common amongst Malaysian students and, despite understanding why SMA is unwise, even medical students self-medicate.
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Affiliation(s)
- Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| | - Nor Azlina A Rahman
- Department of Physical Rehabilitation Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Kuantan, 25200, Malaysia
| | - Judy McKimm
- Swansea University School of Medicine, Grove Building, Swansea University, Swansea, Wales, SA2 8PP, UK
| | - Golam Mohammad Kibria
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| | - Md Anwarul Azim Majumder
- Department of Medical Education, Faculty of Medical Sciences, The University of the West Indies, Bridgetown, Barbados, West Indies
| | - Seraj Zohurul Haque
- Department of Orthopedic Surgery, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, UK
| | - Md Zakirul Islam
- Department of Pharmacology, Eastern Medical College, Burichang3520, Bangladesh
| | - Shahidah Leong Binti Abdullah
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| | - Aqil Mohammad Daher
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| | - Zainal Zulkifli
- Department of Surgery, Sultan Haji Ahmad Shah Hospital, Temerloh, Pahang, 28000, Malaysia
| | - Sayeeda Rahman
- Department of Pharmacology and Public Health, School of Medicine, American University of Integrative Sciences, Bridgetown, Barbados
| | - Russell Kabir
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, Essex, UK
| | - Siti Nur Najihah Binti Lutfi
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| | - Nur Syamirah Aishah Binti Othman
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
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50
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Bellver-Domingo Á, Maldonado-Devis M, Hernández-Sancho F, Carmona E, Picó Y. Identification of effective parameters for anti-inflammatory concentration in València City's wastewater using fuzzy-set qualitative comparative analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 663:110-124. [PMID: 30711579 DOI: 10.1016/j.scitotenv.2019.01.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/14/2019] [Accepted: 01/26/2019] [Indexed: 06/09/2023]
Abstract
The current literature about pharmaceutical and personal care compounds (PPCPs) focuses on identifying their concentration and toxicological risk both in surface water and in wastewater. However, the influence of urban areas (population ageing, income level, hospitals and others) has not yet been analysed. Knowing how a population (and its facilities) affects PPCPs' presence in wastewater is important to identify the conditions that are responsible for their presence. In this work, the influence of water consumption, population ageing, income level, hospitals and nursing homes on the anti-inflammatory concentration have been analysed. To fill the gap between the quantitative data on PPCPs' concentration and the qualitative reasoning of the influence of urban areas on the anti-inflammatory concentration, the use of fuzzy-set qualitative comparative analysis (fsQCA) is proposed. The fsQCA results are presented as recipes that show the different causal combinations of conditions that explain the presence of anti-inflammatories in wastewater. Using fsQCA for urban wastewater management with the aim of explaining the presence of anti-inflammatories in wastewater treatment plants (WWTPs) is a novelty in the literature. The results obtained here show the influence of water consumption (WATCON), hospitals (HOSP) and population ageing (POPAG) as the main conditions for the anti-inflammatory concentration in Valèncian wastewater. Specifically, these conditions are present in all the recipes obtained with consistency of 99%. Through the results obtained, it would be possible to identify that HOSP are the main facilities that discharge anti-inflammatories into urban wastewater. Hence, the necessity of preventive measures to avoid the anti-inflammatory discharge into water bodies has been showed. Furthermore, under a methodological point of view, this work highlights the eligibility of fsQCA as a wastewater cycle management tool.
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Affiliation(s)
- Águeda Bellver-Domingo
- Water Economic Group, Faculty of Economics, University of Valencia, Avda. dels Tarongers, s/n, 46022 València, Spain.
| | - Mónica Maldonado-Devis
- Water Economic Group, Faculty of Economics, University of Valencia, Avda. dels Tarongers, s/n, 46022 València, Spain
| | - Francesc Hernández-Sancho
- Water Economic Group, Faculty of Economics, University of Valencia, Avda. dels Tarongers, s/n, 46022 València, Spain
| | - Eric Carmona
- Environmental and Food Safety Research Group (SAMA-UV), Desertification Research Centre (CIDE-GV-UV), Faculty of Pharmacy, University of Valencia, Spain
| | - Yolanda Picó
- Environmental and Food Safety Research Group (SAMA-UV), Desertification Research Centre (CIDE-GV-UV), Faculty of Pharmacy, University of Valencia, Spain
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