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Avusuglo WS, Han Q, Woldegerima WA, Asgary A, Wu J, Orbinski J, Bragazzi N, Ahmadi A, Kong JD. Assessment of bidirectional impact of stigmatization induced self-medication on COVID-19 and malaria transmissions using mathematical modeling: Nigeria as a case study. Math Biosci 2024; 376:109249. [PMID: 39059710 DOI: 10.1016/j.mbs.2024.109249] [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: 09/08/2022] [Revised: 01/16/2024] [Accepted: 06/05/2024] [Indexed: 07/28/2024]
Abstract
The continual social and economic impact of infectious diseases on nations has maintained sustained attention on their control and treatment, of which self-medication has been one of the means employed by some individuals. Self-medication complicates the attempt of their control and treatment as it conflicts with some of the measures implemented by health authorities. Added to these complications is the stigmatization of individuals with some diseases in some jurisdictions. This study investigates the co-infection of COVID-19 and malaria and its related deaths and further highlights how self-medication and stigmatization add to the complexities of the fight against these two diseases using Nigeria as a study case. Using a mathematical model on COVID-19 and malaria co-infection, we address the question: to what degree does the impact of the interaction between COVID-19 and malaria amplify infections and deaths induced by both diseases via self-medication and stigmatization? We demonstrate that COVID-19 related self-medication due to misdiagnoses contributes substantially to the prevalence of disease. The control reproduction numbers for these diseases and quantification of model parameters uncertainties and sensitivities are presented.
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Affiliation(s)
- Wisdom S Avusuglo
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Canada; Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), Canada
| | - Qing Han
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Canada; Artificial Intelligence & Mathematical Modeling Lab (AIMM Lab), Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada; Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), Canada
| | - Woldegebriel Assefa Woldegerima
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Canada
| | - Ali Asgary
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Canada; Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), Canada
| | - Jianhong Wu
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Canada; Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), Canada
| | - James Orbinski
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; The Dahdaleh Institute for Global Health Research, York University, Canada
| | - Nicola Bragazzi
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Canada
| | - Ali Ahmadi
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; K. N. Toosi University of Technology, Faculty of Computer Engineering, Iran
| | - Jude Dzevela Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Canada; Artificial Intelligence & Mathematical Modeling Lab (AIMM Lab), Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada; Department of Mathematics, University of Toronto, Bahen Centre for Information Technology, Room 6291, 40 St. George Street, Toronto, Ontario, Canada; Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), Canada.
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Jifar WW, Oumer OM, Muhammed II, BaHammam AS. Assessment of factors associated with self-medication practices during the COVID-19 pandemic in southwestern Ethiopia: a community-based cross-sectional survey. BMC Infect Dis 2024; 24:925. [PMID: 39243065 PMCID: PMC11378505 DOI: 10.1186/s12879-024-09876-y] [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: 11/05/2022] [Accepted: 09/03/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Self-medication practices involve the use of medications without healthcare professional requests. The threat of coronavirus disease 2019 (COVID-19) caused the practice of a fittest to survive action, with the assumption that something is better than nothing. Moreover, owing to the lack of effective treatment for COVID-19, the general public has shifted toward self-medication and symptomatic treatment, with approximately 80% of people stockpiling medication for use during the pandemic. Thus, this study aimed to assess the factors associated with self-medication practices during the COVID-19 pandemic crisis in southwestern Ethiopia. METHODS A community-based cross-sectional study design was employed at selected drug retail outlets in southwestern Ethiopia for 415 community pharmacy clients from July 1, 2021, to September 1, 2021. Purposive sampling techniques were employed to select five drug retail outlets on the basis of high patient flows, and we took the study participants until the required quota allotted to each selected drug retail outlet had been filled. Bivariable and multivariable logistic regression analyses were employed to identify factors associated with self-medication. AORs with 95% CIs were used to report associations, and the level of significance was set at P < 0.05. RESULTS Self-medication was significantly associated with being female (AOR 3.51, 95% CI 1.04-12.41), having a college education or above (AOR 47, 95% CI 4.32-55.21), time wastage at public health facilities (AOR 2.71, 95% CI 3.47-5.21), being afraid of contracting COVID-19 (AOR 0.006, 95% CI 0.004-0.185), and having high fees at public health facility (AOR 0.006, 95% CI 0.004-0.185). The most frequently used medications to treat or prevent the COVID-19 pandemic were analgesics (42.4%) and cold medicines (29.5%). Headache (22.2%), fever (13.2%), respiratory infection (14.3%), and cold (21.4%) were the most frequently reported symptoms of the COVID-19 pandemic. CONCLUSION This study revealed high self-medication practices among study area residents during the COVID-19 pandemic. The primary reasons for self-medication in the context of COVID-19 are fear of the pandemic and time wastage at public health facilities. Therefore, special attention should be given to educating public and health care providers on the types of illnesses that can be self-diagnosed and self-treated and the types of drugs to be used for self-medication.
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Affiliation(s)
- Wakuma Wakene Jifar
- Department of Pharmacy, College of Health Sciences, Mattu University, Mattu, Ethiopia.
| | - Osman Mohammed Oumer
- Department of Pharmacy, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Ismael Indris Muhammed
- Department of Pharmacy, School of Applied Natural Science, Adama Science and Technology University, Adama, Ethiopia
| | - Ahmed S BaHammam
- University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
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Avusuglo WS, Han Q, Woldegerima WA, Bragazzi N, Asgary A, Ahmadi A, Orbinski J, Wu J, Mellado B, Kong JD. Impact assessment of self-medication on COVID-19 prevalence in Gauteng, South Africa, using an age-structured disease transmission modelling framework. BMC Public Health 2024; 24:1540. [PMID: 38849785 PMCID: PMC11157731 DOI: 10.1186/s12889-024-18984-y] [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: 04/19/2024] [Accepted: 05/28/2024] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVE To assess the impact of self-medication on the transmission dynamics of COVID-19 across different age groups, examine the interplay of vaccination and self-medication in disease spread, and identify the age group most prone to self-medication. METHODS We developed an age-structured compartmentalized epidemiological model to track the early dynamics of COVID-19. Age-structured data from the Government of Gauteng, encompassing the reported cumulative number of cases and daily confirmed cases, were used to calibrate the model through a Markov Chain Monte Carlo (MCMC) framework. Subsequently, uncertainty and sensitivity analyses were conducted on the model parameters. RESULTS We found that self-medication is predominant among the age group 15-64 (74.52%), followed by the age group 0-14 (34.02%), and then the age group 65+ (11.41%). The mean values of the basic reproduction number, the size of the first epidemic peak (the highest magnitude of the disease), and the time of the first epidemic peak (when the first highest magnitude occurs) are 4.16499, 241,715 cases, and 190.376 days, respectively. Moreover, we observed that self-medication among individuals aged 15-64 results in the highest spreading rate of COVID-19 at the onset of the outbreak and has the greatest impact on the first epidemic peak and its timing. CONCLUSION Studies aiming to understand the dynamics of diseases in areas prone to self-medication should account for this practice. There is a need for a campaign against COVID-19-related self-medication, specifically targeting the active population (ages 15-64).
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Affiliation(s)
- Wisdom S Avusuglo
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, Canada
| | - Qing Han
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, Canada
| | | | - Nicola Bragazzi
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, Canada
| | - Ali Asgary
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, Canada
- The Advanced Disaster, Emergency and Rapid Response Program, York University, Toronto, Canada
| | - Ali Ahmadi
- K. N.Toosi University of Technology, Faculty of Computer Engineering, Tehran, Iran
| | - James Orbinski
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), the Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
| | - Jianhong Wu
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, Canada
| | - Bruce Mellado
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), University of the Witwatersrand, Johannesburg, South Africa
| | - Jude Dzevela Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, Canada.
- Artificial Intelligence & Mathematical Modeling Lab (AIMM Lab), Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Canada.
- Department of Mathematics, University of Toronto, Toronto, Canada.
- Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), University of Toronto, Toronto, Canada.
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Beţiu AM, Lighezan R, Avram VF, Muntean DM, Elmér E, Petrescu L. Dose-dependent effects of acetaminophen and ibuprofen on mitochondrial respiration of human platelets. Mol Cell Biochem 2024; 479:1501-1512. [PMID: 37486451 DOI: 10.1007/s11010-023-04814-z] [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: 06/04/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
Acetaminophen and ibuprofen are widely used over-the-counter medications to reduce fever, pain, and inflammation. Although both drugs are safe in therapeutic concentrations, self-medication is practiced by millions of aged patients with comorbidities that decrease drug metabolism and/or excretion, thus raising the risk of overdosage. Mitochondrial dysfunction has emerged as an important pathomechanism underlying the organ toxicity of both drugs. Assessment of mitochondrial oxygen consumption in peripheral blood cells is a novel research field Cu several applications, including characterization of drug toxicity. The present study, conducted in human platelets isolated from blood donor-derived buffy coat, was aimed at assessing the acute, concentration-dependent effects of each drug on mitochondrial respiration. Using the high-resolution respirometry technique, a concentration-dependent decrease of oxygen consumption in both intact and permeabilized platelets was found for either drug, mainly by inhibiting complex I-supported active respiration. Moreover, ibuprofen significantly decreased the maximal capacity of the electron transport system already from the lowest concentration. In conclusion, platelets from healthy donors represents a population of cells easily available, which can be routinely used in studies assessing mitochondrial drug toxicity. Whether these results can be recapitulated in patients treated with these medications is worth further investigation as potential peripheral biomarker of drug overdose.
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Affiliation(s)
- Alina Maria Beţiu
- Doctoral School Medicine-Pharmacy, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, Romania, E. Murgu Sq. No. 2, 300041, Timisoara, Romania
- Center for Translational Research and Systems Medicine, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, Romania, E. Murgu Sq. No. 2, 300041, Timisoara, Romania
| | - Rodica Lighezan
- Department of Infectious Diseases-Parasitology, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, Romania, E. Murgu Sq. No. 2, 300041, Timisoara, Romania
- Regional Blood Transfusion Center, Timişoara, Str. Martir M. Ciopec No. 1, Timișoara, Romania
| | - Vlad Florian Avram
- Department of Internal Medicine-Diabetes, Nutrition, Metabolic Diseases and Rheumatology, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, Romania, E. Murgu Sq. No. 2, 300041, Timisoara, Romania
| | - Danina Mirela Muntean
- Center for Translational Research and Systems Medicine, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, Romania, E. Murgu Sq. No. 2, 300041, Timisoara, Romania.
- Department of Functional Sciences-Pathophysiology, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, Romania, E. Murgu Sq. No. 2, 300041, Timisoara, Romania.
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, E. Murgu Sq. No. 2, 300041, Timisoara, Romania.
| | - Eskil Elmér
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84, Lund, Sweden.
- Abliva AB, Medicon Village, 223 81, Lund, Sweden.
| | - Lucian Petrescu
- Doctoral School Medicine-Pharmacy, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, Romania, E. Murgu Sq. No. 2, 300041, Timisoara, Romania
- Center for Translational Research and Systems Medicine, "Victor Babeş" University of Medicine and Pharmacy of Timişoara, Romania, E. Murgu Sq. No. 2, 300041, Timisoara, Romania
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Miah MS, Mamun MR, Saif-Ur-Rahman KM, Rabby AA, Zakaria A. A qualitative exploration of purchasing, stockpiling, and use of drugs during the COVID-19 pandemic in an urban city of Bangladesh. PUBLIC HEALTH IN PRACTICE 2024; 7:100477. [PMID: 38379753 PMCID: PMC10878782 DOI: 10.1016/j.puhip.2024.100477] [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: 08/03/2023] [Revised: 02/03/2024] [Accepted: 02/09/2024] [Indexed: 02/22/2024] Open
Abstract
Objectives This research was conducted to explore the patterns and behavior of panic purchasing, stockpiling, and use of drugs during COVID-19 in the Sylhet city, Bangladesh. Study design The study adopted qualitative exploratory research design. Methods 25 in-depth interviews with drug sellers and clients and 7 key informant interviews were conducted with pharmacists and medical representatives of pharmaceutical companies in Sylhet city in Bangladesh from October 2020 to March 2021. Thematic analysis was used to evaluate the primary data. Results The findings revealed that individuals sought out, purchased, and stockpiled prescription-only drugs for self-medication purposes during the COVID-19 pandemic. News and rumor spread by social media, television, and everyday interactions concerning the severity of infections and the number of deaths caused an increase in self-medication as a preventive measure. The reason for this panic buying of drugs was identified as a fear of drug shortages, price hikes, the rise of infection, and the availability of medicines and home delivery services during the pandemic. Conclusion The purchasing, stockpiling and use of drugs by pharmacies varied based on the person dispensing the drugs, the customer, and the COVID-19 pandemic situation. Furthermore, the role of social media in spreading rumor and (dis) misinformation about drug use, a greater tendency to self-medicate, and poor regulation, influenced the individual's use of drugs. Therefore, the drug regulatory authorities and policymakers need to consider the real level of local drug use in order to encourage more rational use of drugs which will help to ensure that there is reliable access to safe, effective, and high-quality medicines and vaccines for all.
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Affiliation(s)
- Md. Shahgahan Miah
- Department of Anthropology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Md Razib Mamun
- Department of Anthropology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - KM Saif-Ur-Rahman
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Al Amin Rabby
- Department of Sociology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - A.F.M. Zakaria
- Department of Anthropology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
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Gacheri J, Hamilton KA, Munywoki P, Wakahiu S, Kiambi K, Fèvre EM, Oluka MN, Guantai EM, Moodley A, Muloi DM. Antibiotic prescribing practices in community and clinical settings during the COVID-19 pandemic in Nairobi, Kenya. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003046. [PMID: 38662675 PMCID: PMC11045065 DOI: 10.1371/journal.pgph.0003046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
The COVID-19 pandemic has significantly impacted healthcare systems, including antibiotic use practices. We present data on patterns of antibiotic dispensing and use in community and hospital settings respectively in Nairobi, Kenya during the pandemic. We conducted interviews with 243 pharmacies in Nairobi using a standardised questionnaire from November to December 2021. The data collected included demographic characteristics, antibiotic customers, types of antibiotics sold, and antibiotic prescribing practices. Additionally, we retrospectively reviewed health records for 992 and 738 patients admitted in COVID-19 and general wards at two large inpatient hospitals between April 2020 and May 2021, and January 2019 to October 2021, respectively. Demographic, utilisation of laboratory services, treatment, clinical, and outcome data were collected using a modified Global WHO Point Prevalence Surveys (Global-PPS) tool. Almost all pharmacies (91.4%) served customers suspected of having COVID-19 with a mean weekly number of 15.6 customers. All pharmacies dispensed antibiotics, mainly azithromycin and beta lactams to suspected COVID-19 infected customers. 83.4% of hospitalised COVID-19 patients received at least one antibiotic at some point during their hospitalisation, which was significantly higher than the 53.8% in general ward patients (p<0.001). Similarly, the average number of antibiotics administered to COVID-19 patients was higher than that of patients in the general ward (1.74 vs 0.9). Azithromycin and ceftriaxone were the most commonly used antibiotics in COVID-19 patients compared to ceftriaxone and metronidazole in the general wards. Only 2% of antibiotic prescriptions for COVID-19 patients were supported by microbiological investigations, which was consistent with the proportion of 6.8% among the general ward population. Antibiotics were commonly prescribed to customers and patients suspected of having COVID-19 either in community pharmacies or in hospital, without a prescription or laboratory diagnosis. These findings emphasize the crucial role of antibiotic stewardship, particularly in community pharmacies, in the context of COVID-19.
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Affiliation(s)
- June Gacheri
- International Livestock Research Institute, Nairobi, Kenya
- Department of Pharmacology, Clinical Pharmacy and Pharmacy Practice, University of Nairobi, Nairobi, Kenya
| | - Katie A. Hamilton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | | | | | - Karen Kiambi
- International Livestock Research Institute, Nairobi, Kenya
| | - Eric M. Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Margaret N. Oluka
- Department of Pharmacology, Clinical Pharmacy and Pharmacy Practice, University of Nairobi, Nairobi, Kenya
| | - Eric M. Guantai
- Department of Pharmacology, Clinical Pharmacy and Pharmacy Practice, University of Nairobi, Nairobi, Kenya
| | - Arshnee Moodley
- International Livestock Research Institute, Nairobi, Kenya
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Dishon M. Muloi
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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Marques FRDM, Laranjeira C, Carreira L, Gallo AM, Baccon WC, Goes HDF, Salci MA. Managing long COVID symptoms and accessing health services in Brazil: A grounded theory analysis. Heliyon 2024; 10:e28369. [PMID: 38571660 PMCID: PMC10988007 DOI: 10.1016/j.heliyon.2024.e28369] [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: 10/30/2023] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
Background The worldwide community has shown significant interest in researching the management of Long COVID. However, there is scarce evidence about the daily experiences of people living with Long COVID and their insights into the healthcare services provided to them. Aims This study aims to understand the experience of Long COVID sufferers with their symptoms and in accessing health services. Method We employed Charmaz's grounded theory methodology, informed by constructivism, and applied the COREQ guidelines for qualitative research. Sixty-six Brazilians living with Long COVID participated in the study. The data was collected using semi-structured telephone interviews and analyzed using a constant comparative process. Findings The findings refer firstly to the consequences of persistent Long COVID symptoms. Secondly, they describe how the disease trajectory required Long COVID sufferers to reorganize their routines and develop adaptive strategies. Lastly, they reflect a diverse array of both positive and negative interactions inside the healthcare system conveyed by individuals suffering from Long COVID. These elements converge towards the core category of the study: "The limbo of Long COVID sufferers: between the persistence of symptoms and access to health services". Conclusions Long COVID is characterized by its varied nature, including a range of physical and emotional repercussions experienced by individuals. There is a need for enhanced comprehension and discourse about Long COVID across several domains, including the general public, policy-making entities, and healthcare professionals. In this sense, the development of specialized services or the reinforcement of existing services to support long COVID sufferers is imperative.
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Affiliation(s)
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801, Évora, Portugal
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Herbert de Freitas Goes
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
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Haykal T, Mina J, Fleifel M, Dimassi H, Nasr J, Mahdi A, Harb R, El Hout G, Franjieh E, Mokhbat J, Farra A, Helou M, Husni R. Evolution of COVID-19 infection characteristics in a Lebanese cohort of inpatients during different pandemic periods. Pathog Glob Health 2024; 118:160-169. [PMID: 37482700 PMCID: PMC11141305 DOI: 10.1080/20477724.2023.2239492] [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] [Indexed: 07/25/2023] Open
Abstract
This study aims to describe COVID-19 patients characteristics, laboratory and imaging results, and the different outcomes of patients admitted to the Lebanese American University Medical Center-Rizk Hospital over a period of 9 months. In this observational retrospective study, data were obtained from electronic medical records of 491 male and female patients from the ages of 17 to 97. Analysis of the patients was performed in 3 periods: August 2020 to October 20 November 202020 to January 2021 and February 2021 to April 2021 corresponding with 3 waves of newly diagnosed cases during this period. The sample showed a male predominance with an average age of 63. The average hospitalization length was 10.1 days. The majority of patients were discharged to quarantine. The distribution of hospitalized cases was significantly correlated to the monthly distribution of newly COVID-19 cases in Lebanon. There was no significant difference in patient's characteristics between the 3 periods of the study (gender, age, body mass index, smoking, and medical conditions). Clinical presentations of the patients varied between the 3 periods. Similarly, the course and outcome of infection varied. Patients received less oxygen during period 1, while more patients were cured during period 3. This study presents the first Lebanese cohort of COVID-19 patients with their medical background, clinical presentation, laboratory results, radiological findings and course of infection with its outcome. It also shows how the relations between the medical manifestation of the COVID-19 pandemic and the socio-political measures of infection control are deeply intertwined.
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Affiliation(s)
- Tony Haykal
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Jonathan Mina
- Department of Internal Medicine, Staten Island University Hospital, New York, USA
| | - Mohamad Fleifel
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Hani Dimassi
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Janane Nasr
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Ahmad Mahdi
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Ranime Harb
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Ghida El Hout
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Elissar Franjieh
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Jacques Mokhbat
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Anna Farra
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Mariana Helou
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Rola Husni
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
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Rojop N, Moreno P, Grajeda L, Romero J, Reynoso L, Muñoz E, Palmer GH, Cordón-Rosales C, Call DR, Ramay BM. Informal sale of antibiotics in Guatemalan convenience stores before and after implementation of federal antibiotic dispensing legislation. BMC Pharmacol Toxicol 2024; 25:11. [PMID: 38273410 PMCID: PMC10809560 DOI: 10.1186/s40360-023-00720-8] [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: 10/03/2022] [Accepted: 12/05/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Convenience stores in Guatemala provide essential consumer goods in communities, but many dispense antibiotics illegally. Federal legislation, passed in August of 2019, requires prescriptions for antibiotic purchase at pharmacies but it is unclear if this legislation is enforced or if it has any impact on unlawful sales of antibiotics. METHODS To determine if antibiotic availability changed in convenience stores, we carried out a repeated measures study collecting antibiotic availability data before and after implementation of the dispensing regulation. RESULTS There was no statistical difference in the proportion of convenience stores that sold antibiotics before and after antibiotic regulations [66.6% (295/443) and 66.7% (323/484), respectively, P>0.96], nor in the number of stores selling amoxicillin [55.5% (246/443) and 52.3% (253/484), respectively, P>0.96], but fewer stores (20%) sold tetracycline capsules after regulation was passed (P<0.05). For stores visited both before and after passage of legislation (n=157), 15% stopped selling antibiotics while 25% started selling antibiotics. Antibiotics from convenience stores were reportedly sold for use in people and animals. CONCLUSIONS Antibiotics remain widely available in convenience stores consistent with no significant change in the informal sector after implementation of prescription requirements for pharmacies. Importantly, effects from regulatory change could have been masked by potential changes in antibiotic use during the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic.
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Affiliation(s)
- N Rojop
- Department of Epidemiology, School of Sciences and Humanities, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - P Moreno
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Department of Pharmaceutical Chemistry, School of Sciences and Humanities, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - L Grajeda
- Department of Epidemiology, School of Sciences and Humanities, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - J Romero
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - L Reynoso
- Department of Pharmaceutical Chemistry, School of Sciences and Humanities, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - E Muñoz
- Department of Pharmaceutical Chemistry, School of Sciences and Humanities, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - G H Palmer
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States of America
| | - C Cordón-Rosales
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States of America
| | - D R Call
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States of America
| | - B M Ramay
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
- Department of Pharmaceutical Chemistry, School of Sciences and Humanities, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States of America.
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Salvador-Carrillo J, Campos-Loza L, Guillen-Carbajal D, Osada J, Zevallos A, Torres-Roman JS. Use of ivermectin and factors associated with the prevention and/or treatment of COVID-19: a cross-sectional online survey in the province of Chincha, Peru. F1000Res 2024; 12:149. [PMID: 38178941 PMCID: PMC10765097 DOI: 10.12688/f1000research.128675.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 01/06/2024] Open
Abstract
Background Peru has reported one of the highest mortality rates from COVID-19 worldwide. The Chincha province has been one of the most affected regions in Peru and the leading promoter of the use of ivermectin for the treatment of COVID-19. Therefore, our study aimed to evaluate the frequency of use and factors associated with the use of ivermectin for COVID-19 in Chincha. Methods A cross-sectional study was conducted during the second wave of COVID-19 in Peru. For statistical analyses, frequencies and percentages were reported. Prevalence ratios (PR) with a 95% confidence interval (CI), and a p-value of 0.05 were used to determine statistical significance. SPSS version 22 (IBM Corp) program was used for the analyses. Results A total of 432 participants were included in the study. A total of 67.6% (n = 292) of the participants used ivermectin during the COVID-19 pandemic. Of these, 20.20% (n=59) of the people used ivermectin for prophylactic purposes only, while 41.79% (n=122) used it as treatment for COVID-19 only, and 38.01% (n=111) used it for both reasons. The consumption of ivermectin was associated with being 50 years or older (PR:1.27, 95% CI:1.04-1.54), having a technical education level (PR:1.16, 95% CI:1.01-1.34), having had symptoms of COVID-19 with negative/no diagnosis (PR: 1.28, 95% CI: 1.07-1.53) or positive diagnosis (PR:1.38, 95% CI:1.18-1.61), or having had contact with infected people (PR:1.45, 95% CI:1.06-1.98). Conclusions Most people in Chincha used ivermectin during the second wave of the COVID-19 pandemic. The main factors associated with the use of ivermectin for the prevention/treatment of COVID-19 were age ≥50 years, having a technical education level, having had symptoms with negative/no diagnosis or positive diagnosis, and contact with people infected with SARS-CoV-2.
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Affiliation(s)
- Jose Salvador-Carrillo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Ica, Peru
| | - Luz Campos-Loza
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Ica, Peru
| | - David Guillen-Carbajal
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Ica, Peru
| | - Jorge Osada
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Ica, Peru
| | - Alejandra Zevallos
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Ica, Peru
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11
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Karbwang J, Torres CE, Navarro AM, Wongwai P, Jimenez EB, Shetty Y, Ramalingam S, Koli P, Amir L, Rachmawati SD, Waworundeng M, Rizki H, Noor ASM, Ghimire P, Gyanwali P, Sharma S, Ghimire N, Wanigatunge C, Yimtae K. The readiness of the Asian research ethics committees in responding to the COVID-19 pandemic: A multi-country survey. F1000Res 2024; 13:19. [PMID: 39165349 PMCID: PMC11333877 DOI: 10.12688/f1000research.143138.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 08/22/2024] Open
Abstract
Background COVID-19 is a highly challenging infectious disease. Research ethics committees (RECs) have challenges reviewing research on this new pandemic disease under a tight timeline and public pressure. This study aimed to assess RECs' responses and review during the outbreak in seven Asian countries where the Strategic Initiative for Developing Capacity in Ethical Review (SIDCER) networks are active. Methods The online survey was conducted in seven Asian countries from April to August 2021. Two sets of online questionnaires were developed, one set for the chairs/secretaries and another set for the REC members.The REC profiles obtained from the REC members are descriptive in nature. Data from the chairs/secretaries were compared between the RECs with external quality assessment (SIDCER-Recognized RECs, SR-RECs) and non-external quality assessment (Non-SIDCER-Recognized RECs, NSR-RECs) and analyzed using a Chi-squared test. Results A total of 688 REC members and 197 REC chairs/secretaries participated in the survey. Most RECs have standard operating procedures (SOPs), and have experience in reviewing all types of protocols, but 18.1% had no experience reviewing COVID-19 protocols. Most REC members need specific training on reviewing COVID-19 protocols (93%). In response to the outbreak, RECs used online reviews, increased meeting frequency and single/central REC. All SR-RECs had a member composition as required by the World Health Organisation ethics guidelines, while some NSR-RECs lacked non-affiliated and/or layperson members. SR-RECs reviewed more COVID-related product development protocols and indicated challenges in reviewing risk/benefit and vulnerability (0.010), informed consent form (0.002), and privacy and confidentiality (P = 0.020) than NSR-RECs. Conclusions Surveyed RECs had a general knowledge of REC operation and played a significant role in reviewing COVID-19-related product development protocols. Having active networks of RECs across regions to share updated information and resources could be one of the strategies to promote readiness for future public health emergencies.
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Affiliation(s)
- Juntra Karbwang
- Drug Discovery and Development Center, Thammasat University, Pathum Thani, Bangkok, 12120, Thailand
- Clinical Coordination and Training Center, Strategic Initiative in Developing Capacity in Ethical Review (SIDCER), Thammasat University, Pathum Thani, 12120, Thailand
| | - Cristina E. Torres
- National Institutes of Health, University of the Philippines Manila, Manila, Metro Manila, 1000, Philippines
- Clinical Coordination and Training Center, Forum for Ethical Review Committees in Asia and the Pacific (FERCAP), Thammasat University, Pathum Thani, 12120, Thailand
| | - Arthur M. Navarro
- Clinical Coordination and Training Center, Forum for Ethical Review Committees in Asia and the Pacific (FERCAP), Thammasat University, Pathum Thani, 12120, Thailand
- Department of Social Sciences, University of the Philippines Manila, Manila, Metro Manila, 1000, Philippines
| | - Phanthipha Wongwai
- Clinical Coordination and Training Center, Forum for Ethical Review Committees in Asia and the Pacific (FERCAP), Thammasat University, Pathum Thani, 12120, Thailand
- Faculty of Medicine, Khon Kaen University, Nai Mueang, Khon Kaen, 40002, Thailand
| | - Edlyn B. Jimenez
- National Institutes of Health, University of the Philippines Manila, Manila, Metro Manila, 1000, Philippines
| | - Yashashri Shetty
- Department of Pharmacology & Therapeutics, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, 400012, India
| | - Sudha Ramalingam
- Department of Community Medicine, PSG Institute of Medical Sciences and Reseach, Coimbatore, 641004, India
| | - Paresh Koli
- Department of Pharmacology & Therapeutics, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, 400012, India
| | - Lisa Amir
- Forum of Indonesian Recognized Ethics Committees (FIRREC), Jakarta, 10430, Indonesia
- Dental Research Ethics Committee Faculty of Dentistry, Universitas Indonesia, Jakarta, Jakarta, 10430, Indonesia
| | - Septi Dewi Rachmawati
- Forum of Indonesian Recognized Ethics Committees (FIRREC), Jakarta, 10430, Indonesia
- Health Research Ethics Committee, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Monalisa Waworundeng
- Forum of Indonesian Recognized Ethics Committees (FIRREC), Jakarta, 10430, Indonesia
- Ethics Committee, Mochtar Riady Institute for Nanotechnology (MRIN), Tangerang, 15810, Indonesia
| | - Harnawan Rizki
- Forum of Indonesian Recognized Ethics Committees (FIRREC), Jakarta, 10430, Indonesia
| | - Asyraf Syahmi Mohd Noor
- National Institutes of Health, Ministry of Health, Federal Government of Malaysia, Kuala Lumpur, 40170, Malaysia
| | - Prakash Ghimire
- National Ethical Review Board, Nepal Health Research Council, Ministry of Health & Population, Kathmandu, 7626, Nepal
| | - Pradip Gyanwali
- National Ethical Review Board, Nepal Health Research Council, Ministry of Health & Population, Kathmandu, 7626, Nepal
| | - Subhanshi Sharma
- National Ethical Review Board, Nepal Health Research Council, Ministry of Health & Population, Kathmandu, 7626, Nepal
| | - Namita Ghimire
- National Ethical Review Board, Nepal Health Research Council, Ministry of Health & Population, Kathmandu, 7626, Nepal
| | - Chandanie Wanigatunge
- Faculty of Medical Science, University of Sri Jayewardenepura, Gangodawila, Nugegoda, 10250, Sri Lanka
| | - Kwanchanok Yimtae
- Faculty of Medicine, Khon Kaen University, Nai Mueang, Khon Kaen, 40002, Thailand
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Chimukuche RS, Kawuma R, Nkosi B, Seeley J. Scoping review on lessons learnt on the promotion and use of drugs and traditional medicine in Africa during COVID-19. Glob Public Health 2024; 19:2323028. [PMID: 38471036 DOI: 10.1080/17441692.2024.2323028] [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: 08/29/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024]
Abstract
ABSTRACTScientific evidence on the safety and efficacy of pharmaceutical drugs, substances and herbal medicines is important in medical advertising and promotion. Following guidelines for conducting a scoping review, we systematically searched PubMed, SCOPUS and Web of Science to identify in peer reviewed articles medications that were promoted and used widely in Africa during the COVID-19 pandemic. We also searched for information about how safety concerns about untested/or not properly tested drugs were communicated to the public during the pandemic. Of the 2043 articles identified, 41 papers were eligible for inclusion. Most studies were clinical trials (n = 11), systematic reviews (n = 9), quantitative studies (n = 9) the rest were qualitative studies, reviews and reports. We found that following global trends, several drugs, traditional and herbal treatments were used and repurposed for the treatment of respiratory symptoms of COVID-19 in Africa. The results highlighted the value of some herbal medicines for treatment during the COVID-19 pandemic, as well as the risks posed by the unregulated sharing of advice and recommendations on treatments in Africa, and globally.
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Affiliation(s)
- Rujeko Samanthia Chimukuche
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infection & Immunity, University College London, London, UK
| | - Rachel Kawuma
- Social Science, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Busisiwe Nkosi
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Law, University of KwaZulu-Natal, Durban, South Africa
| | - Janet Seeley
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Social Science, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- School of Public Health and Nursing, University of KwaZulu-Natal, Durban, South Africa
- Department of Global Health and Development, London School of Tropical Hygiene and Medicine, London, UK
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13
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Shao XT, Wang YS, Gong ZF, Li YY, Tan DQ, Lin JG, Pei W, Wang DG. Surveillance of COVID-19 and influenza A(H1N1) prevalence in China via medicine-based wastewater biomarkers. WATER RESEARCH 2023; 247:120783. [PMID: 37924682 DOI: 10.1016/j.watres.2023.120783] [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: 06/21/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023]
Abstract
The simultaneous monitoring of individual or multiple diseases can be achieved by selecting therapeutic medicines used to treat the primary symptoms of the condition as biomarkers in wastewater. This study proposes a novel approach to monitor the prevalence of COVID-19 and influenza A (H1N1) by selecting nine medicines to serve as biomarkers, including three antipyretics, three antivirals, and three cough suppressants. To verify our approach, wastewater samples were collected from seventeen urban and five rural wastewater treatment plants (WWTPs) in a Chinese city over a period of one year. The use of antipyretics increased notably during the COVID-19 pandemic, while the consumption of antivirals for influenza A (H1N1) rose in the post-COVID-19 pandemic period, indicating a minor spike in the occurrence of influenza A (H1N1) after the COVID-19 pandemic. Fever is a significant symptom of COVID-19 and can serve as a reliable indicator of disease prevalence. Our research found that the prevalence of COVID-19 in urban areas was significantly higher (at 78.5 %, 95 % CI: 73.4 % - 83.9 %) than in rural areas (with a prevalence of 48.1 %, 95 % CI: 42.4 % - 53.8 %). The prevalence of COVID-19 in urban areas in this study was consistent with the data reported by the Chinese center for Disease Control and Prevention (82.4 %). Continuous monitoring of WWTPs in urban areas with fluctuating populations and complex demographics can provide early disease warning. Our results demonstrate the feasibility of evaluating community disease prevalence by selecting major therapeutic medicines as biomarkers in wastewater.
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Affiliation(s)
- Xue-Ting Shao
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, China, 116026
| | - Yan-Song Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, China, 116026
| | - Zhen-Fang Gong
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, China, 116026
| | - Yan-Ying Li
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, China, 116026
| | - Dong-Qin Tan
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, China, 116026
| | - Jian-Guo Lin
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, China, 116026
| | - Wei Pei
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, China, 116026
| | - De-Gao Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, China, 116026.
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Oumer A, Ale A, Hamza A, Dagne I. Extent and Correlates of Self-Medication Practice among Community-Dwelling Adults in Eastern Ethiopia. BIOMED RESEARCH INTERNATIONAL 2023; 2023:4726010. [PMID: 38075321 PMCID: PMC10703530 DOI: 10.1155/2023/4726010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023]
Abstract
Background The use of medications without proper medical consultations poses significant health risks, drug resistance, and undiagnosed disease conditions, becoming a major pharmaceutical challenge in the 21st century. This study assessed the magnitude and associated factors of self-medication practice among adults in parts of Ethiopia. Methods A community-based cross-sectional study was conducted among 647 randomly selected adults residing in randomly selected households in eastern Ethiopia via a stratified sampling approach. A pretested interviewer-administered questionnaire was used to collect the data on self-medication practice. Data were presented using tables, frequencies, percentages, and graphs. A multivariable binary logistic regression was done to identify factors associated with self-medication practice and presented as an adjusted odds ratio along with its 95% CI. Associations with a p value below 5% were used to declare statistical significance. Results A total of 647 adults with a mean age of 41.7 (11.4) years were included. Overall, 15.8% (95% CI: 12.5-18.2) of them reported to have practiced self-medication in the past month, while 67.9% (95% CI: 64.1-74.7) have practiced self-medication, mainly due to the mild nature of the symptom (11%), intention to get a rapid cure (12.2%), physical accessibility (9.1%), and less confidence in the quality of health facility services (3.7%). The majority of the drugs were in the form of oral tablets in the antibiotic, antipain, and gastrointestinal categories. Female (AOR = 1.66 and 95% CI: 0.76-3.61), larger family size (AOR = 1.34 and 95% CI: 0.73-2.46), illiteracy (AOR = 4.47 and 95% CI: 1.17-17.1), poor socioeconomic class (AOR = 4.6795 and CI: 1.71-12.7), perceived health facility visit stay as long (AOR = 1.55 and 95% CI: 0.80-3.00), khat use (AOR = 2.86 and 95% CI: 1.27-6.47), cigarette smoking (AOR = 2.86 95% CI: 1.27-6.47), and poor knowledge on proper medication use (AOR = 7.98 and 95% CI: 4.61-13.8) were associated with increased odds of self-medication. Conclusion The practice of self-medication is a health concern and is associated with lower socioeconomic class, illiteracy, substance abuse, a perceived long stay at a health facility, and poor knowledge of medication use. Behavioral interventions targeting this segment of the population via various approaches would help.
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Affiliation(s)
- Abdu Oumer
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Ahmed Ale
- School of Medicine, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Aragaw Hamza
- Department of Anesthesia, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Imam Dagne
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
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Ealla KKR, Kumari N, Sahu V, Veeraraghavan V, Peddapalegani P, Ramani P, Ramachandra SS. Antibiotics Knowledge, Usage, and Prescription Patterns Among Dental Practitioners in Hyderabad, South India. Cureus 2023; 15:e49554. [PMID: 38156157 PMCID: PMC10753869 DOI: 10.7759/cureus.49554] [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: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Antimicrobial resistance is a pertinent issue in the healthcare sector, accounting for 1.27 million patient deaths worldwide. Dental practitioners account for 3% to 11% of total antibiotic prescriptions. Therefore, this study aimed to specifically assess their knowledge of antibiotic prescriptions, guidelines, and clinical practices. METHOD Before conducting this knowledge, attitude, and practice (KAP) survey, study approval was obtained from the Scientific Review Board of Saveetha Dental College and Hospitals, Chennai, India. A total of 200 participants were randomly selected from the list of Indian Dental Association (Hyderabad chapter), and dental colleges, dental conferences, and peer suggestions. We received a total of 130 responses by the end of the survey. RESULTS The survey revealed gaps in practitioners' KAP. Of those surveyed, 83 (63.85%) of the practitioners kept themselves updated about antibiotic guidelines and news, but many (94, 72.31%) were unaware of the WHO's access, watch, reserve (AWaRe) and antimicrobial stewardship concepts (103, 79.23%). A total of 111 (85.38%) practitioners considered cross-reactions with other medications, yet only 28 (21.5%) practitioners tested patients for antibiotic sensitivity. While 64 (49.23%) practitioners encountered patients who did not respond to antibiotics, 84 (64.62%) practitioners encountered patients who demanded antibiotics. CONCLUSION This study highlights the lack of awareness about the WHO's AWaRe classification and antimicrobial stewardship among the majority of dental practitioners across Hyderabad. Misuse or overuse of antibiotics was indicated in this survey by both patients and dental practitioners. Prioritizing updates on antibiotic knowledge and guidelines and awareness of their use is important. It is essential to educate patients about the ill effects of self-prescribing antibiotics. Dental practitioners need to consider cross-reactions and antibiotic-sensitivity testing before prescribing antibiotics. Labeling the sensitivity of a particular antibiotic for specific microbes on packaging can help reduce misuse and the use of antibiotics for the wrong indications.
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Affiliation(s)
- Kranti Kiran Reddy Ealla
- Oral and Maxillofacial Pathology, Saveetha Institute of Medical And Technical Sciences, Chennai, IND
- Oral and Maxillofacial Pathology, Malla Reddy Institute of Dental sciences, Hyderabad, IND
| | - Neema Kumari
- Microbiology, Malla Reddy Institute of Medical Sciences, Hyderabad, IND
| | - Vikas Sahu
- Oral and Maxillofacial Pathology, Malla Reddy Institute of Dental Sciences, Hyderabad, IND
| | | | | | - Pratibha Ramani
- Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Saveetha University, Chennai, IND
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Al Meslamani AZ, Abdel-Qader DH. The Abuse and Misuse of Over-the-Counter Medicines During COVID-19. Hosp Pharm 2023; 58:437-440. [PMID: 37711408 PMCID: PMC9988622 DOI: 10.1177/00185787231158777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The abuse and misuse of OTC medicines is a common problem in community pharmacies and is expected to escalate during the COVID-19 pandemic. However, there is limited research on the patterns, causes, and consequences of these incidents during the pandemic. This article aims to provide evidence-based insights into the potential impact of COVID-19 on the abuse and misuse of OTC medicines, and suggest strategies for reducing these occurrences for pharmacy practitioners and healthcare managers.
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17
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Law SK, Au DCT, Chow WYL, Poon CH, Chow KKC, Zhao Z, Chan SW, Wang Y, Li S. Behavioral Prevention, Treatment, and Rehabilitation of Using Western and Chinese Medicines or Herbal Products among the Public in Response to COVID-19 in Hong Kong: A Cross-Sectional Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:5637720. [PMID: 37680699 PMCID: PMC10482558 DOI: 10.1155/2023/5637720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/26/2023] [Accepted: 07/19/2023] [Indexed: 09/09/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic occurred in Hong Kong for more than two years. This article conducted a cross-sectional study for participants to investigate the behavioral prevention, treatment, and rehabilitation of using Western medicines or herbal products for COVID-19 in Hong Kong. A questionnaire was designed and performed over 2 weeks from 1 May to 15 May 2022. It consisted of five parts with around 20 questions conducted including sociodemographic information, prevention, treatment, rehabilitation of COVID-19, and also the sources of information. The pattern usage of Chinese or Western medicines for COVID-19 was studied after data collection. 318 people participated in this survey, and only 311 were qualified. The sociodemographic information, e.g., personal educational level, and behavior for the prevention of COVID-19, which included wearing masks (98.7%), using alcohol hand sanitizer (83.0%), washing hands frequently (82.4%), avoiding crowds (53.1%), and staying home more often (50.6%). Western medicines, such as antipyretic drugs, antitussive drugs, and pain reliever drugs, whilst Chinese medicines, such as Lianhua Qingwen Jiaonang, Huoxiang Zhengqi San or Wan, and Nin Jiom Pei Pa Koa, were most commonly used in the treatment and rehabilitation periods of COVID-19. Herbal products, including lemon, honey, ginger, and herbal tea, were used as a daily diet to fight against COVID-19. Based on the result findings, Chinese medicines or herbal products were used during the COVID-19 pandemic, but most of the participants used an unknown Chinese medicine practitioner's prescription and self-administered Chinese medicine. The pattern of Chinese medicines and Western medicines' usage in the prevention, treatment, and rehabilitation of COVID-19 was also investigated; this showed a statistically significant association between the variables according to gender, age, and Chinese or Western medicines for further investigation.
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Affiliation(s)
- Siu Kan Law
- Faculty of Science and Technology, The Technological and Higher Education Institute of Hong Kong, Tsing Yi, New Territories, Hong Kong
| | - Dawn Ching Tung Au
- Faculty of Science and Technology, The Technological and Higher Education Institute of Hong Kong, Tsing Yi, New Territories, Hong Kong
- Hong Kong Chinese Medicine Pharmacists Association, San Po Kong, Hong Kong
| | - Wesley Yeuk Lung Chow
- Faculty of Science and Technology, The Technological and Higher Education Institute of Hong Kong, Tsing Yi, New Territories, Hong Kong
- Hong Kong Chinese Medicine Pharmacists Association, San Po Kong, Hong Kong
| | - Chung Hang Poon
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Kylie Ka Ching Chow
- Faculty of Science and Technology, The Technological and Higher Education Institute of Hong Kong, Tsing Yi, New Territories, Hong Kong
| | - Zhongzhen Zhao
- School of Chinese Medicine, Hong Kong Baptist Univesity, Kowloon Tong, Hong Kong
| | - Shun Wan Chan
- Faculty of Science and Technology, The Technological and Higher Education Institute of Hong Kong, Tsing Yi, New Territories, Hong Kong
| | - Yanping Wang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Kowloon, Hong Kong
| | - Saimei Li
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Moussa AA, Omar FD, Fiidow OA, Ali FH, Babatunde SM. Self-medication practices against COVID-19 infection and awareness among residents of Mogadishu, Somalia: A cross-sectional analysis. PLoS One 2023; 18:e0284854. [PMID: 37379300 DOI: 10.1371/journal.pone.0284854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 04/06/2023] [Indexed: 06/30/2023] Open
Abstract
The novel coronavirus disease (COVID-19) pandemic has affected several countries worldwide, resulting in a considerable strain on healthcare systems and increased trend of self-medication practices. This study aims to evaluate the awareness of COVID-19 and the prevalence of self-medication during the pandemic among residents in Mogadishu, Somalia. A cross-sectional study was conducted using a structured and pretested questionnaire between May 2020 and January 2021. Participants from various disciplines were randomly recruited within the study location and interviewed about their self-medication practices during the pandemic. Descriptive statistics were used to summarise the respondents' information and responses to the questionnaire items. Associations between participants' demographic characteristics and specific items relating to self-medication practices were analysed using the Chi-square test. A total of 350 residents participated in the study. Approximately 63% of the participants reported having practised COVID-19 related self-medication with the main reasons being pharmacists' advice (21.4%) and having an old prescription (13.1%), whereas 37.1% did not report their reasons for self-medication. Most participants (60.4%) engaged in self-medication despite not having any symptoms and 62.9% had taken antibiotics in the last three months. Most participants were aware that no medication has been approved for COVID-19 (81.1%), the negative effects of self-medication (66.6%), and the transmission routes of the virus. Meanwhile, more than 40% of the participants have not worn a mask while outside their homes, and do not follow the international COVID-19 guidelines. The most prevalent drug used by participants for self-medication against COVID-19 was paracetamol (81.1%) and antibiotics (78%). The factors associated with awareness of COVID-19 and self-medication practices included age, gender, educational qualification, and occupation. This study revealed considerable high self-medication practices among Mogadishu residents, thus highlighting the need to promote awareness regarding the adverse effects of self-medication and sanitisation guidelines in addressing COVID-19 at the community level.
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Affiliation(s)
- Ayan Aden Moussa
- Institute for Medical Research, SIMAD University, Mogadishu, Somalia
- Faculty of Medicine and Health Science, SIMAD University, Mogadishu, Somalia
| | - Fardosa Dahir Omar
- Faculty of Medicine and Health Science, SIMAD University, Mogadishu, Somalia
| | - Osman Abubakar Fiidow
- Institute for Medical Research, SIMAD University, Mogadishu, Somalia
- Faculty of Medicine and Health Science, SIMAD University, Mogadishu, Somalia
| | - Fadumo Hassan Ali
- Institute for Medical Research, SIMAD University, Mogadishu, Somalia
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Zheng Y, Liu J, Tang PK, Hu H, Ung COL. A systematic review of self-medication practice during the COVID-19 pandemic: implications for pharmacy practice in supporting public health measures. Front Public Health 2023; 11:1184882. [PMID: 37397709 PMCID: PMC10310324 DOI: 10.3389/fpubh.2023.1184882] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Since the COVID-19 pandemic, self-medication had become highly popular due to the risk of virus infection and overwhelming medical resources. Pharmacists are well-positioned to provide public health education and disease prevention. This study aims to provide an overview of the research about self-medication during COVID-19 and the role of pharmacists in ensuring the drug safety related to self-medication. Methods Databases (PubMed, Google Scholar, Scopus, EBSCO host, and Web of Science) were searched for published studies on the practice of self-medication in COVID-19 pandemic without restriction in population and location. Primary search terms were "self-medication," "self-care," "self-management," "non-prescription drugs," "2019nCoV," and "COVID-19." Studies conducted during the pandemic but not exclusively for COVID-19 disease were eligible for inclusion. Results The database search yielded a total of 4,752 papers. After appropriate screening, 62 articles met the inclusion criteria. Most of the studies were cross-sectional in nature. The review highlighted a very high prevalence of self-medication during COVID-19, ranging from 7.14 to 88.3%. The purpose of self-medication was mainly to treat and prevent COVID-19; fever, body aches, cough, headache, and sore throat were the most frequently mentioned indications. Categories of drugs commonly used in self-medication included antibiotics, herbs, vitamins, and analgesics, most of which came from pharmacies. Information about self-medication usually obtained from relatives and friends, social networks and health care professionals. Common reasons for self-medication included saving money and time, prior experience and mild illness; reasons associated with COVID-19 were mainly fear of contracting the virus and poor access to doctors. Gender, age, education, marital status, and concern about COVID-19 were the most usual associated factors. The role of pharmacists in self-medication included sources of information, advice on medication use, and management of adverse reactions. Conclusion During the COVID-19 pandemic, self-medication practices were widespread and varied across countries and populations. Self-medication has emerged as an important component of health care, but also as a huge global challenge. The engagement of healthcare administrators and policy makers are essential to regulate self-medication practices. The expertise and favorable conditions of pharmacists make them positioned as key roles in public health interventions for self-medication. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=395423, identifier CRD42023395423.
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Affiliation(s)
- Yu Zheng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Jiayu Liu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Pou Kuan Tang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
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Orellana-Manzano A, Cordeiro FB, Garcia-Angulo A, Centeno E, Vizcaíno-Tumbaco MJ, Poveda S, Murillo R, Andrade-Molina D, Mirabá M, Mehta S, Cárdenas W. A report on SARS-CoV-2 first wave in Ecuador: drug consumption dynamics. Front Pharmacol 2023; 14:1197973. [PMID: 37388452 PMCID: PMC10300276 DOI: 10.3389/fphar.2023.1197973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction: The first COVID-19 wave in Ecuador started in March 2020 and extended until November. Several types of drugs have been proposed as a potential treatment during this period, and some affected people have self-medicated. Method: A retrospective study was conducted with 10,175 individuals who underwent RT-PCR tests for SARS-CoV-2 from July to November 2020. We compared the number of positive and negative cases in Ecuador with symptoms and drug consumption. The Chi-square test of independence compared clinical and demographic data and PCR test results. Odds ratios analyzed drug consumption dynamics. Results: Of 10,175 cases, 570 were positive for COVID-19, while 9,605 were negative. In positive cases, there was no association between the RT-PCR result and sex, age, or comorbidities. When considering demographic data, Cotopaxi and Napo had the highest rates of positive cases (25.7% and 18.8%, respectively). Manabí, Santa Elena, and Guayas regions had fewer than 10% positive cases. The Drug consumption dynamic analysis showed that negative COVID-19 cases presented higher drug consumption than positive cases. In both groups, the most consumed medication was acetaminophen. Acetaminophen and Antihistamines had higher odds of consumption in positive PCR cases than in negative. Symptoms like fever and cough were more related to positive RT-PCR results. Conclusion: The first COVID-19 wave in Ecuador has affected the provinces differently. At a national level, the consumption of drugs has been highly associated with self-medication.
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Affiliation(s)
- Andrea Orellana-Manzano
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Fernanda B. Cordeiro
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Andrea Garcia-Angulo
- Facultad de Ciencias Naturales y Matemáticas, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Elizabeth Centeno
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - María José Vizcaíno-Tumbaco
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Sebastián Poveda
- Facultad de Ciencias Naturales y Matemáticas, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Ricardo Murillo
- Facultad de Ciencias Naturales y Matemáticas, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Derly Andrade-Molina
- Laboratorio de Ciencias Omicas, Facultad de Ciencias de la Salud, Universidad Espíritu Santo, Samborondon, Ecuador
| | - Mariuxi Mirabá
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Washington Cárdenas
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
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Alwhaibi M, Bin Malik S, Alswailem L, Alruthia Y. Self-medication among adults with chronic health conditions: a population-based cross-sectional survey in Saudi Arabia. BMJ Open 2023; 13:e069206. [PMID: 37068891 PMCID: PMC10111896 DOI: 10.1136/bmjopen-2022-069206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
OBJECTIVES This study aimed to assess the prevalence of self-medication (SM), the reasons for SM and the relationship between chronic health conditions and SM among adult individuals. SETTING This was an online questionnaire-based cross-sectional study disseminated on different social media platforms in Saudi Arabia. PARTICIPANTS Saudi Arabia sample of adult individuals aged 18 and above. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was SM, measured using the following question: 'During the past 6 months, have you used any medicines or dietary supplements, or herbal medicines or vitamins not prescribed or recommended by a doctor?' A positive answer indicates a self-medicated participant. RESULTS Out of 1645 individuals who viewed the study link, 1295 participants completed the survey with a response rate of 95.1%. Overall, 989 (76.4%) participants reported practicing SM in the past 6 months. SM was higher among younger participants, women, those with higher education levels and high income, and working in the health field. About 198 (73.3%) who have chronic conditions practised SM for chronic health conditions, such as (hypertension and hypercholesterolemia). Previous experience with the same illness (n=530, 25.7%) and attempting to save time (n=466, 22.6%) were the main reasons behind SM, according to the participants. Adverse drug events were reported by 204 (20.6%) of self-medicating individuals and 274 (64.9%) of them reported discontinuing SM. CONCLUSIONS The findings of this study indicate a high prevalence rate of SM among the adult population in Saudi Arabia. Individuals with chronic health conditions reported a high rate of SM. Launching public education campaigns to improve public awareness of the harms of SM if misused, especially among those with chronic health conditions, is essential.
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Affiliation(s)
- Monira Alwhaibi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Shatha Bin Malik
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Leena Alswailem
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Yazed Alruthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Vengidesh R, Kadandale S, Ramachandran A, Srinivasan S, Parthasarathy R, Thanikachalam Y, Kumar P. Antibiotic Prescription Patterns for Endodontic Procedures in India: A Knowledge, Attitude, and Practices (KAP) Survey. Cureus 2023; 15:e37804. [PMID: 37223150 PMCID: PMC10202345 DOI: 10.7759/cureus.37804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/25/2023] Open
Abstract
Objective The purpose of this study is to evaluate the antibiotic prescription patterns of endodontists, general dentists, and other dental specialists for endodontic procedures in India by using the knowledge, attitude, and practices (KAP) survey method. Methods This cross-sectional study was carried out from February 2022 to May 2022 and involved dentists across India. A self-made questionnaire survey was created to judge the knowledge of various dental practitioners, which includes general dentists, endodontists, other dental specialists, and post-graduates with regard to antibiotic usage guidelines for endodontic purposes. A total of about 310 dental practitioners were surveyed across India. The questionnaire was circulated via social platforms such as WhatsApp, Instagram, and Facebook Messenger. Statistical analysis Data for KAP regarding antibiotic prescription patterns among general dentists, endodontists, other dental specialists, and postgraduates were entered into Microsoft Excel and analyzed using IBM SPSS Statistics for Windows, Version 20 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.). Descriptive statistics of the study population were examined. The level of statistical significance was determined at p<0.05. Results For the percentage of patients who were prescribed systemic antibiotics every day for endodontic reasons, about 38.6% (119) responded 0-10% and 27.3% (84) responded 10-30%. For the order of antibiotics that they prefer from most to least, about 85.4% (263) responded amoxicillin > metronidazole > doxycycline > azithromycin > clindamycin > ciprofloxacin. For the question of whether they use local antibiotics, about 35% answered yes of which 25% were endodontists, 2% were general dentists, 5% were other dental specialists, and 3% were post-graduates. About 77.3% of the total participants were unaware of the antimicrobial stewardship concept and AwaRe classification from WHO. About 53.2% (164) attended CDE programs with regard to antibiotic usage. Conclusion It is evident from the results of the present study that there is over-prescription of antibiotics by practitioners especially by general dentists without following proper guidelines for endodontic treatments. More emphasis should be made on the proper prescription pattern of antibiotics, proper understanding of endodontic diagnosis, and the need for antibiotics at the undergraduate level. In addition, proper awareness, as well as proper prescription of antibiotics, should be made for existing dental professionals.
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Affiliation(s)
- Ramya Vengidesh
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Sadasiva Kadandale
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Anupama Ramachandran
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Srividhya Srinivasan
- Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai, IND
| | | | - Yashini Thanikachalam
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Praveen Kumar
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
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Vâţă A, Roşu FM, Dorneanu OS, Lehaci AE, Luca Ş, Loghin II, Miftode ID, Luca CM, Miftode EG. Antibiotic Usage in the COVID-19 Intensive Care Unit of an Infectious Diseases Hospital from Nord-Eastern Romania. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040645. [PMID: 37109601 PMCID: PMC10145934 DOI: 10.3390/medicina59040645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives. The intensive care unit (ICU), especially in an infectious disease hospital, is both an area with a high consumption of antibiotics (atb) and a "reservoir" of multidrug-resistant bacteria. We proposed the analysis of antibiotic therapy practices in such a department that treated, in conditions of a pandemic wave, patients with COVID-19 and its complications. Materials and Methods. This was a retrospective transversal study of 184 COVID-19 patients treated in the ICU of a regional infectious disease hospital of Iaşi, Romania, in a 3-month interval of 2020 and 2021. Results. All the included patients (Caucasians, 53% males, with a median age of 68 years, and a Charlton comorbidity index of 3) received at least one antibiotic during their stay in the ICU (43% also had antibiotics prior to hospital admission and 68% in the Infectious Diseases ward). Only 22.3% of the ICU patients had only one antibiotic. A total of 77.7% of them started with an association of two antibiotics, and 19.6% of them received more than three antibiotics. The most-used ones were linezolid (77.2%), imipenem (75.5%), and ceftriaxone (33.7%). The median atb duration was 9 days. No change in the number or type of atb prescription was seen in 2021 (compared to 2020). Only 9.8% of the patients had a microbiological confirmation of bacterial infection. A total of 38.3% of the tested patients had elevated procalcitonin levels at ICU admission. The overall fatality rate was 68.5%, with no significant differences between the two analyzed periods or the number of administered antibiotics. More than half (51.1%) of the patients developed oral candidiasis during their stay in the ICU, but only 5.4% had C. difficile colitis. Conclusion. Antibiotics were widely used in our ICU patients in the presence of a reduced microbiological confirmation of a bacterial co-infection, and were justified by other clinical or biological criteria.
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Affiliation(s)
- Andrei Vâţă
- Department of Infectious Diseases, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Florin Manuel Roşu
- Department of Dento-Alveolar Surgery, Anesthesia, Sedation and Medical-Surgical Emergencies, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Olivia Simona Dorneanu
- Microbiology Department, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | | | - Ştefana Luca
- Department of Plastic Surgery and Reconstructive Microsurgery, "St Spiridon" County Emergency Hospital, 700111 Iasi, Romania
| | - Isabela Ioana Loghin
- Department of Infectious Diseases, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ioana Diandra Miftode
- Department of Radiology, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Cătălina Mihaela Luca
- Department of Infectious Diseases, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Egidia Gabriela Miftode
- Department of Infectious Diseases, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
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Veliz PT, Zhou W, Smith S, Larson JL. Substance Use and the Self-Management of Persistent Symptoms of COVID-19. Subst Use Misuse 2023; 58:835-840. [PMID: 36942996 DOI: 10.1080/10826084.2023.2184208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Background: Understanding the self-management practices of persistent symptoms of SARS-Cov-2 (COVID-19) is critical given the misinformation that has been presented about this disease in the U.S. The purpose of this descriptive study is to assess the self-management of persistent symptoms of COVID-19 with commonly used and misused substances (i.e., alcohol, marijuana and commonly prescribed medications) among adults in the U.S. Methods: The data for this study comes from a cross-sectional survey of U.S. adults that was designed to broadly assess symptom burden, persistent symptom patterns, self-efficacy for symptom management and self-management strategies among people who experienced persistent/Long COVID. Multiple logistic regression analyses were used to assess how symptom length of COVID-19 was associated with the use of several substances to manage these persistent symptoms. Results: The analysis found that adults who had COVID-19 symptoms that persisted for 13 weeks or longer had higher rates of using alcohol (27.3%), marijuana (30.9%) and prescription tranquilizers (21.4%) to manage these symptoms when compared to their adult peers who had COVID-19 symptoms persist for only 4 weeks or less. For instance, the odds of indicating the use of marijuana (AOR = 4.21 95% CI = 1.68,10.5) to manage COVID-19 related symptoms was roughly four times higher for respondents who had COVID-19 symptoms persist for 13 weeks or longer when compared to respondents whose COVID-19 symptoms persisted for only 4 weeks or less. Conclusion: The findings suggest that screening of substance use disorders should be considered among healthcare providers who are treating adults who have persistent symptoms of COVID-19.
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Affiliation(s)
- Philip T Veliz
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Weijiao Zhou
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sheree Smith
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Janet L Larson
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
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25
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Swed S, Motawea KR, Bohsas H, Alibrahim H, Rakab A, Hafez W, Shaheen N, Almoshantaf MB, Ahmad S, Safdar S, Khairy LT, Bakkour A, Muwaili AHH, Muwaili DHH, Abdelmajid FAA, Ahmad EMS, Patwary MM, Ghaith HS, Albuni MK, Battikh E, Sawaf B, Elsayed M, Elkalagi NKH, Shoib S. Public Attitudes Towards COVID-19, Antibiotic Resistance, Preventive Measures: A Multi Center Cross-Sectional Study in the Arab Countries. J Epidemiol Glob Health 2023; 13:91-104. [PMID: 36820995 PMCID: PMC9947435 DOI: 10.1007/s44197-023-00092-6] [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: 07/10/2022] [Accepted: 01/26/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND AND AIM COVID-19 has shown how crucial awareness of the need to protect public health is to global security. Antibiotic resistance due to antibiotic misuse is seen as a worldwide health issue. Antibiotic use was significant during the COVID-19 epidemic, according to several nations. This research aims to investigate public attitudes on COVID-19, antibiotic resistance, and preventive measures during the COVID-19 pandemic in the Middle East. METHODS An online quantitative cross-sectional study in 17 Arabic nations was carried out between January 3 and March 4, 2022, using a structured questionnaire to evaluate participants' knowledge of COVID-19, their attitudes toward the new standard during the pandemic, and their use of antibiotics, and their resistance to them. The research was available to all Arabic people over 18 nations in the middle east. A convenient snowball sampling technique was used. SPSS version 20.0 was used to analyze the data. To analyze the results, binominal logistic regression was utilized. Statistical significance was defined as a p value of 0.05. RESULTS Of the 6145 responders, 24.1% believed COVID-19 might spread to asymptomatic people, whereas 13.6% thought using antibiotics would accelerate recovery from any illness. Moreover, half of the respondents said antibiotics only work against bacteria (64.6%). 70.8% of participants adopted the necessary safety measures. More than a third of respondents strongly supported placing foreign immigrants in quarantine (33%). However, more than 50% of those surveyed (52.5%) firmly supported using face masks in all public settings. Individuals with a medical education background had 2.6 times more appropriate understanding of antibiotic resistance than others. Furthermore, participants in the 30-49 age range had a better handle on the use of antibiotics and antibiotic resistance than other respondents by 1.1 times. CONCLUSION Arab Health authorities should reconsider this health issue as soon about the inadequate level of awareness toward antibiotic use, resistance, and preventative practices during COVID-19. Many suggested strategies, especially solving the irregular antibiotic prescriptions during a COVID19 pandemic, should be implemented to increase public awareness of COVID19.
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Affiliation(s)
- Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | | | | | - Amine Rakab
- Assistant Professor of Clinical Medicine, Medicine, Weill Cornell Medical College, Al Rayyan, Qatar
| | - Wael Hafez
- NMC Royal Hospital, 16Th Street, Khalifa City, Abu Dhabi, UAE
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
| | - Nour Shaheen
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | | | | | | | - Agyad Bakkour
- Faculty of Medicine, Albaath University, Homs, Syria
| | | | | | | | | | - Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, 9208 Bangladesh
- Environmental Science Discipline, Life Science School, Kulna University, Khulna, 9208 Bangladesh
| | | | | | - Elias Battikh
- Department of Internal Medicine, Damascus University, Damascus, Syria
| | - Bisher Sawaf
- Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | | | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir India
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26
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Nandi A, Pecetta S, Bloom DE. Global antibiotic use during the COVID-19 pandemic: analysis of pharmaceutical sales data from 71 countries, 2020-2022. EClinicalMedicine 2023; 57:101848. [PMID: 36776504 PMCID: PMC9900305 DOI: 10.1016/j.eclinm.2023.101848] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Despite bacterial coinfection rates of less than 10%, antibiotics are prescribed to an estimated 75% of patients with COVID-19, potentially exacerbating antimicrobial resistance. We estimated the associations of COVID-19 cases and vaccinations with global antibiotic sales during the first two years of the COVID-19 pandemic. METHODS We obtained monthly data on broad-spectrum antibiotic sales volumes (cephalosporins, penicillins, macrolides, and tetracyclines) in 71 countries during March 2020-May 2022 from the IQVIA MIDAS® database. These data were combined with country-month-level COVID-19 case and vaccination data from Our World in Data. We used least squares (pooled) and fixed-effects panel data regression models, accounting for country characteristics, to estimate the associations between antibiotic sales volumes and COVID-19 cases and vaccinations per 1000 people. FINDINGS Sales of all four antibiotics fell sharply during April and May 2020, followed by a gradual rise to near pre-pandemic levels through May 2022. In fixed-effects regression models, a 10% increase in monthly COVID-19 cases was associated with 0.2%-0.3% higher sales of cephalosporins, 0.2%-0.3% higher sales of penicillins, 0.4%-0.6% higher sales of macrolides, and 0.3% higher sales of all four antibiotics combined per 1000 people. Across continents, a 10% increase in monthly COVID-19 cases was associated with 0.8%, 1.3%, and 1.5% higher macrolides sales in Europe, North America, and Africa respectively. Sales of other antibiotics across continent were also positively associated with COVID-19 cases, although the estimated associations were smaller in magnitude. No consistent associations were observed between antibiotic sales and COVID-19 vaccinations. Results from pooled regression analysis were similar to those from the fixed-effects models. INTERPRETATION Antibiotic sales were positively associated with COVID-19 cases globally during 2020-2022. Our findings underline that antibiotic stewardship in the context of COVID-19 remains essential. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Arindam Nandi
- The Population Council, New York, USA
- One Health Trust, Washington DC, USA
- Corresponding author. Dag Hammarskjold Plaza, New York, NY, 10017, USA.
| | - Simone Pecetta
- Research and Development Center, GlaxoSmithKline, Siena, Italy
| | - David E. Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Prevalence and influencing factors of self-medication during the COVID-19 pandemic in the Arab region: a multinational cross-sectional study. BMC Public Health 2023; 23:180. [PMID: 36707840 PMCID: PMC9880368 DOI: 10.1186/s12889-023-15025-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The novel coronavirus pandemic (COVID-19) has begun with a wave of misinformation and fear of infection. This may have led people to self-medicate inappropriately. The World Health Organization describes self-medication (SM) as utilizing medicines to relieve symptoms or health conditions without consulting a physician. Inappropriate drug use is a burden on both health resources and patient health in the Arab region. This study aimed to detect the prevalence and influencing factors of self-medication among the general Arab population during the COVID-19 pandemic. METHODS A multinational cross-sectional study was conducted among the general population of ten Arab countries from early August to late October 2021. Participants aged 18 years or older could join the study via social media platforms. A convenience sampling technique was used. A developed and validated web-based questionnaire was used to collect data on self-medication practice, associated influencing factors, information sources, commonly used medications, and commonly treated conditions. Descriptive, univariate, and multivariate regression analyses were applied using IBM SPSS v 26 and R v 4.0.0 software. RESULTS A total of 8163 participants completed the questionnaire, and 518 participants were excluded from the analysis due to inconsistencies in their data. Almost two-thirds (62.7%) of participants reported practicing self-medication during the COVID-19 pandemic. At the country level, Egypt had the highest prevalence of self-medication practice (72.1%), while Palestine had the lowest prevalence (40.4%). The most commonly used drugs were analgesics, antipyretics, and vitamins (86, 65.1, and 57.1%, respectively), while antitussives and antibiotics scored 47.6 and 43.3%, respectively. Experience with similar health conditions (74.6%) and urgency of the problem (47.2%) were the most frequent factors that led to self-medication. Additionally, 38.2% of the self-medicated participants (SMPs) used drugs as prophylaxis against COVID-19. Pharmacist consultation was the most common source of information about self-medication (66.7%). Multivariate analysis showed that predictors of self-medication were older age (p = 0.008), presence of chronic illness (p = 0.015), and having monthly income or medical insurance that does not cover the treatment cost (p = 0.001, p < 0.001, respectively). CONCLUSION Self-medication is considered a common practice across the Arab population. It is necessary to regulate policies and raise awareness among the public about self-medication.
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Deutou Wondeu AL, Talom BM, Linardos G, Ngoumo BT, Bello A, Ndassi Soufo AM, Momo AC, Doll C, Tamuedjoun AT, Kiuate JR, Cappelli G, Russo C, Perno CF, Tchidjou HK, Scaramella L, Galgani A. The COVID-19 wave was already here: High seroprevalence of SARS-CoV-2 antibodies among staff and students in a Cameroon University. J Public Health Afr 2023; 14:2242. [PMID: 36798849 PMCID: PMC9926561 DOI: 10.4081/jphia.2023.2242] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/03/2022] [Indexed: 01/28/2023] Open
Abstract
Background Seroprevalence studies, to estimate the proportion of people that has been infected by SARS-CoV-2 are importance in African countries, where incidence is among the lowest in the world. Objective This study aimed at evaluating the exposure to SARS-CoV-2 within a university setting of Cameroon. Methods A cross-sectional study performed in December 2020 - December 2021, among students and staffs of the Evangelical University of Cameroon. COVID-19 antigen rapid detection test (RDT) was performed using Standard Q Biosensor, and one year after SARS-CoV-2 antibody-test was performed within the same population using RDT and chemiluminescence immunoassay (CLIA). Results 106 participants were enrolled (80% students), female sex was the most represented. Positivity to SARS-CoV-2 was 0.0% based on antigen RDTs. The seroprevalence of SARSCoV- 2 antibodies was estimated at 73.6% (95% CI. 64.5-81.0) for IgG and 1.9% (95% CI. 0.2-6.8) for IgM/IgG with RDTs, and 91.9% (95% CI. 84.7-96.4) for anti-nucleocapsid with CLIA. 95.3% (101) reported having developed at least one of the known COVID-19 symptoms (cough and headache being the most common). 90.3% (28) of people who experienced at least one of these symptoms developed IgG antibodies. 40.6% (43) of participants took natural herbs, whereas 55.7% (59) took conventional drugs. The most used herb was Zingiber officinale, while the most used drugs were antibiotics. Conclusion In this Cameroonian University community, SARS-CoV-2 seroprevalence is high, with a greater detection using advanced serological assays. This indicates a wide viral exposure, and the need to adequate control measures especially for those experiencing any related COVID-19 symptoms.
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Affiliation(s)
- Andrillene Laure Deutou Wondeu
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
- Department of Biology and Interdipartimental Center for Comparative Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Beatrice Metchum Talom
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | | | - Barnes Tanetsop Ngoumo
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Aïchatou Bello
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Aurele Marc Ndassi Soufo
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Aimé Cesaire Momo
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Christian Doll
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Jena, Jena, Germany
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Corporate Member of Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Alaric Talom Tamuedjoun
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Jules-Roger Kiuate
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Giulia Cappelli
- Institute for Biological Systems, National Research Council, Rome, Italy
| | | | | | | | - Lucia Scaramella
- Unit of Food Biotechnology, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M.Aleandri”, Rome, Italy
| | - Andrea Galgani
- Department of Biology and Interdipartimental Center for Comparative Medicine, University of Rome Tor Vergata, Rome, Italy
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Kiragga AN, Najjemba L, Galiwango R, Banturaki G, Munyiwra G, Iwumbwe I, Atwine J, Ssendiwala C, Natif A, Nakanjako D. Community purchases of antimicrobials during the COVID-19 pandemic in Uganda: An increased risk for antimicrobial resistance. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001579. [PMID: 36963050 PMCID: PMC10021632 DOI: 10.1371/journal.pgph.0001579] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 01/16/2023] [Indexed: 02/25/2023]
Abstract
Self-Medication (SM) involves the utilization of medicines to treat self-recognized symptoms or diseases without consultation and the irrational use of over-the-counter drugs. During the COVID-19 pandemic, the lack of definitive treatment led to increased SM. We aimed to estimate the extent of SM for drugs used to treat COVID-19 symptoms by collecting data from pharmacy sale records. The study was conducted in Kampala, Uganda, where we extracted data from community pharmacies with functional Electronic Health Records between January 2018 and October 2021 to enable a comparison of pre-and post-COVID-19. The data included the number of clients purchasing the following drugs used to treat COVID-19 and its symptoms: Antibiotics included Azithromycin, Erythromycin, and Ciprofloxacin; Supplements included Zinc and vitamin C, while Corticosteroids included dexamethasone. A negative binomial model was used to estimate the incident rate ratios for each drug to compare the effect of COVID-19 on SM. In the pre- COVID-19 period (1st January 2018 to 11th March 2020), 19,285 customers purchased antibiotics which included; Azithromycin (n = 6077), Ciprofloxacin (n = 6066) and Erythromycin (n = 997); health supplements including Vitamin C (430) and Zinc (n = 138); and Corticosteroid including Dexamethasone (n = 5577). During the COVID-19 pandemic (from 15th March 2020 to the data extraction date in October 2021), we observed a 99% increase in clients purchasing the same drugs. The number of clients purchasing Azithromycin increased by 19.7% to 279, Ciprofloxacin reduced by 58.8% to 96 clients, and those buying Erythromycin similarly reduced by 35.8% to 492 clients. In comparison, there were increases of 170%, 181%, and 377% for Vitamin C, Zinc, and Dexamethasone, respectively. The COVID-19 pandemic underscored the extent of SM in Uganda. We recommend future studies with a representation of data from pharmacies located in rural and urban areas to further study pandemics' effect on antimicrobials prescriptions, including obtaining pharmacists' perspectives using mixed methods approaches.
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Affiliation(s)
- Agnes N Kiragga
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- African Population and Health Research Center, Nairobi, Kenya
| | - Leticia Najjemba
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ronald Galiwango
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- African Center of Excellence in Bioinformatics and Data Intensive Sciences, Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Center for Computational Biology, Uganda Christian University, Mukono, Uganda
| | - Grace Banturaki
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
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Hafidz F, Adiwibowo IR, Kusila GR, Ruby M, Saut B, Jaya C, Baros WA, Revelino D, Dhanalvin E, Oktavia A. Out-of-pocket expenditure and catastrophic costs due to COVID-19 in Indonesia: A rapid online survey. Front Public Health 2023; 11:1072250. [PMID: 37033026 PMCID: PMC10081577 DOI: 10.3389/fpubh.2023.1072250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background The Corona Virus Disease 2019 (COVID-19) pandemic has created a substantial socioeconomic impact, particularly in developing countries such as Indonesia. Purposes/objectives This study aimed to describe the COVID-19-related out-of-pocket spending of Indonesian citizens and the proportion of whom experienced catastrophic health spending during the COVID-19 pandemic using the patient's perspective. Methodology We conducted a rapid cross-sectional online survey across provinces in Indonesia to capture participants' experiences due to COVID-19. Data were collected between September 23rd to October 7th of 2021 including demographics, income, and expenditures. Descriptive statistics were used to analyze the respondents' characteristics. Patients's perspective of total cost was estimated from out-of-pocket of COVID-19 direct costs and compared them to total expenditure. If the proportion of COVID-19 total costs exceeded 40% of the total expenditure, the respondents were deemed to have faced catastrophic costs. Results A total of 1,859 respondents answered the questionnaire. The average monthly income and expenditure of respondents were 800 USD, and 667 USD respectively. The monthly expenditure was categorized into food expenditure (367 USD) and non-food expenditure (320 USD). The average of COVID-19-related monthly expenditure was 226 USD, including diagnostic expenditure (36 USD), preventive expenditure (58 USD), medical expenditure (37 USD for COVID-19 treatment; and 57 USD for post-COVID-19 medical expenses), and non-medical expenditure (30 USD). Analysis showed that 18.6% of all respondents experienced catastrophic costs while 38.6% of the respondents who had COVID-19 treatment experienced catastrophic costs. Conclusion The high proportion of catastrophic costs among respondents suggests the need for COVID-19 social protection, especially for COVID-19 diagnostic and prevention costs. The survey findings have led the government to increase the benefit coverage other than medical costs at the hospitals.
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Affiliation(s)
- Firdaus Hafidz
- Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- *Correspondence: Firdaus Hafidz
| | - Insan Rekso Adiwibowo
- Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gilbert Renardi Kusila
- Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mahlil Ruby
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | - Benyamin Saut
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | - Citra Jaya
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | | | - Dedy Revelino
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | - Erzan Dhanalvin
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | - Ayunda Oktavia
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
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Tan ML, Rahman S, Robinson F, Sani MHM. Psychological effects on self-medication during the pandemic COVID-19 in WP Labuan: A development of questionnaire and pilot-testing. Pharm Pract (Granada) 2023; 21:2779. [PMID: 37090453 PMCID: PMC10117300 DOI: 10.18549/pharmpract.2023.1.2779] [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: 11/11/2022] [Accepted: 12/13/2022] [Indexed: 04/09/2023] Open
Abstract
Introduction Self-Medication, which is a practice to self-treat using medicine without consulting a medical practitioner or a doctor, is a common practice and the Pandemic Covid-19 may have caused people to resort to self-medication in order to reduce the infectivity of the Covid-19. Objective To validate and develop an instrument in Bahasa Melayu to assess the psychological distress and self-medication during pandemic Covid-19 in WP Labuan. Methods A pilot study was conducted among 160 participants in WP Labuan. Reliability testing on internal consistency and content validity was performed on the adapted Covid-19 Peritraumatic Distress Index (CPDI) as well as domain on knowledge, practice and attitude of self-medication. Result A panel of seven experts evaluated the research instrument for content validity and it was found to have good content item validity. The CPDI domain showed good internal consistency of Cronbach's Alpha of 0.919. The mean (SD) CPDI score of the respondents in WP Labuan was 32.55 (15.98). 64.2% of the respondents experienced psychological distress. The variable for Area (town/countryside) was found to be statistically significant (p<0.05) to be associated with self-medication during the pandemic. Conclusion The instrument established sound reliability and validity and therefore, can be an effective tool for assessing psychological distress and self-medication in the Malaysian population.
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Affiliation(s)
- Michelle L Tan
- Pharmacy Services Division, Ministry of Health Malaysia, Malaysia.
| | - Shamsur Rahman
- Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Malaysia.
| | - Freddie Robinson
- Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Malaysia
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Saleem Z, Godman B, Cook A, Khan MA, Campbell SM, Seaton RA, Siachalinga L, Haseeb A, Amir A, Kurdi A, Mwita JC, Sefah IA, Opanga SA, Fadare JO, Ogunleye OO, Meyer JC, Massele A, Kibuule D, Kalungia AC, Shahwan M, Nabayiga H, Pichierri G, Moore CE. Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future. Antibiotics (Basel) 2022; 11:1824. [PMID: 36551481 PMCID: PMC9774141 DOI: 10.3390/antibiotics11121824] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
There are serious concerns with rising antimicrobial resistance (AMR) across countries increasing morbidity, mortality and costs. These concerns have resulted in a plethora of initiatives globally and nationally including national action plans (NAPs) to reduce AMR. Africa is no exception, especially with the highest rates of AMR globally. Key activities in NAPs include gaining a greater understanding of current antimicrobial utilization patterns through point prevalence surveys (PPS) and subsequently instigating antimicrobial stewardship programs (ASPs). Consequently, there is a need to comprehensively document current utilization patterns among hospitals across Africa coupled with ASP studies. In total, 33 PPS studies ranging from single up to 18 hospitals were documented from a narrative review with typically over 50% of in-patients prescribed antimicrobials, up to 97.6% in Nigeria. The penicillins, ceftriaxone and metronidazole, were the most prescribed antibiotics. Appreciable extended prescribing of antibiotics up to 6 days or more post-operatively was seen across Africa to prevent surgical site infections. At least 19 ASPs have been instigated across Africa in recent years to improve future prescribing utilizing a range of prescribing indicators. The various findings resulted in a range of suggested activities that key stakeholders, including governments and healthcare professionals, should undertake in the short, medium and long term to improve future antimicrobial prescribing and reduce AMR across Africa.
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Affiliation(s)
- Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Aislinn Cook
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | | | - Stephen M. Campbell
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
- Centre for Epidemiology and Public Health, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Ronald Andrew Seaton
- Queen Elizabeth University Hospital, Govan Road, Glasgow G51 4TF, UK
- Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland, Delta House, 50 West Nile Street, Glasgow G1 2NP, UK
| | - Linda Siachalinga
- College of Pharmacy, Yeungnam University, Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
| | - Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Afreenish Amir
- Department of Microbiology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi 46000, Pakistan
| | - Amanj Kurdi
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
- Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil 44001, Iraq
- Center of Research and Strategic Studies, Lebanese French University, Erbil 44001, Iraq
| | - Julius C. Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Private Bag 0713 UB, Gaborone 00704, Botswana
| | - Israel Abebrese Sefah
- Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Volta Region, Hohoe PMB 31, Ghana
| | - Sylvia A. Opanga
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya
| | - Joseph O. Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado Ekiti 362103, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti 360211, Nigeria
| | - Olayinka O. Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos 100271, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja 100271, Nigeria
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Amos Massele
- Department of Clinical Pharmacology and Therapeutics, Hurbert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania
| | - Dan Kibuule
- Department of Pharmacology & Therapeutics, Busitema University, Mbale P.O. Box 236, Uganda
| | - Aubrey C. Kalungia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia
| | - Moyad Shahwan
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
| | - Hellen Nabayiga
- Management Science Department, Strathclyde Business School, University of Strathclyde, 199 Cathedral Street, Glasgow G4 0QU, UK
| | - Giuseppe Pichierri
- Microbiology Department, Torbay and South Devon Foundation Trust, Lowes Bridge Torbay Hospital, Torquay TQ2 7AA, UK
| | - Catrin E. Moore
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK
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Soriano-Moreno DR, Fernandez-Guzman D, Sangster-Carrasco L, Quispe-Vicuña C, Grados-Espinoza P, Ccami-Bernal F, Morocho-Alburqueque N, Coba-Villan N, Velasquez-Fernandez R, Nieto-Gutierrez W. Factors Associated With Drug Consumption Without Scientific Evidence in Patients With Mild COVID-19 in Peru. J Patient Saf 2022; 18:e1189-e1195. [PMID: 35858482 PMCID: PMC9696683 DOI: 10.1097/pts.0000000000001053] [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] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate the factors associated with the consumption of drugs without scientific evidence in patients with mild COVID-19 infection in Peru. METHODS An analytical cross-sectional study was carried out including 372 adult patients with a history of mild COVID-19 disease. Factors associated with drug consumption were evaluated by Poisson regressions with robust variance adjustment using the bootstrapping resampling method. RESULTS Seventy-two percent consumed some medication without scientific evidence, with antibiotics (71%) and ivermectin for human use (68%) being the most commonly used. Factors associated with the consumption of drugs to treat mild COVID-19 infection were thinking that the drugs are not effective (adjusted prevalence ratio, 0.55; 95% confidence interval, 0.41-0.74) and not being informed about the efficacy of the drugs (adjusted prevalence ratio, 0.48; 95% confidence interval, 0.36-0.65). CONCLUSIONS Education of the population seems to be the main factor that increases the consumption of drugs without scientific evidence in the Peruvian population to treat mild COVID-19.
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Affiliation(s)
- David R. Soriano-Moreno
- From the Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima
| | - Daniel Fernandez-Guzman
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola
| | | | - Carlos Quispe-Vicuña
- Sociedad Científica San Fernando, Universidad Nacional Mayor de San Marcos, Lima
| | | | | | - Noelia Morocho-Alburqueque
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura (SOCIEMUNP), Piura, Peru
| | | | - Randy Velasquez-Fernandez
- Universidad Nacional Daniel Alcides Carrión, Facultad de Medicina Humana, Pasco
- Universidad Nacional Mayor de San Marcos
| | - Wendy Nieto-Gutierrez
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
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Arias F, Izquierdo-Condoy JS, Naranjo-Lara P, Alarcón V, Bonilla P, Erazo E, Carrington SJ, Ortiz-Prado E. A Cross-Sectional Analysis of Self-Medication Patterns during the COVID-19 Pandemic in Ecuador. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1678. [PMID: 36422217 PMCID: PMC9698278 DOI: 10.3390/medicina58111678] [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: 10/12/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/22/2022]
Abstract
Background and Objectives: Drug consumption is a widely developed practice around the world. However, sometimes medicines are acquired with or without prescription, a practice termed self-medication, which can have negative impacts on the health of the population. It has been observed that with the arrival of the coronavirus disease 2019 (COVID-19) pandemic, self-medicated drug consumption figures increased in several countries. To describe the patterns of medication, use and the prevalence of self-medication during the COVID-19 pandemic in inhabitants of the capital province of Pichincha, Ecuador. Materials and Methods: A descriptive, cross-sectional study was conducted based on a self-administered online questionnaire from April to June 2022, among residents of the province of Pichincha, Ecuador. Participants were invited through social networks (WhatsApp and Facebook). A total of 401 surveys were included in this study. Consumption patterns (prescription of and treatment with) of medicines during the pandemic were evaluated, as well as the prevalence of self-medication and variables that characterize the way of acquiring medicines. The Chi-square test was used to look for relationships between consumption patterns, self-medication, and the characteristics of the participants. Results: Most participants were female (53.4%), and 59.4% reported having had COVID-19. A total of 244 (60.9%) consumed medications during the pandemic, mostly for the purpose of treating the infection. About half (48.4%) self-medicated. The most used medications were paracetamol (87.3%) and ibuprofen (47.5%). Drugs consumption as a treatment and informal sources of information (TV, social networks, advice) were associated with the practice of self-medication (p < 0.05). Conclusions: A significant percentage of over-the-counter (OTC) and legal drug use was found to persist after the COVID-19 pandemic. Our findings highlight the effects that alternative forms of information sources other than medical personnel can have on drug consumption and self-medication practices.
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Affiliation(s)
- Fabián Arias
- Faculty of Medical Sciences, Universidad Central del Ecuador, Quito 100201, Ecuador
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170507, Ecuador
| | | | - Verónica Alarcón
- Faculty of Medical Sciences, Universidad Central del Ecuador, Quito 100201, Ecuador
| | - Paulina Bonilla
- Faculty of Medical Sciences, Universidad Central del Ecuador, Quito 100201, Ecuador
| | - Elizabeth Erazo
- Faculty of Medical Sciences, Universidad Central del Ecuador, Quito 100201, Ecuador
| | - Sarah J. Carrington
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170507, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170507, Ecuador
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Caira-Chuquineyra B, Fernandez-Guzman D, Alvarez-Arias PM, Zarate-Curi ÁA, Herrera-Añazco P, Benites-Zapata VA. Association between prehospital medication and fatal outcomes in a cohort of hospitalized patients due to coronavirus disease-2019 in a referral hospital in Peru. Travel Med Infect Dis 2022; 50:102472. [PMID: 36257588 PMCID: PMC9573861 DOI: 10.1016/j.tmaid.2022.102472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND To explore the association between the use of prehospital medications and the development of fatal outcomes in patients who required hospitalization due to coronavirus disease-2019 (COVID-19). METHODS This retrospective cohort study included adult patients who were hospitalized due to COVID-19. Demographic, clinical, and laboratory data, prehospital medication history, and fatal outcome development (use of high-flow oxygen therapy, intensive care unit [ICU] admission, or mortality) were extracted from the medical records of patients who were admitted due to COVID-19 to the Carlos Seguín Escobedo National Hospital of Arequipa, Peru during July to September 2021, the period after the second wave of COVID-19 cases in Peru. Survival was analyzed using the Cox proportional hazards model, and crude hazard ratios and adjusted hazard ratios (aHR) with their respective 95% confidence intervals (95% CI) were calculated. RESULTS A total of 192 patients were evaluated, of whom 62% were males and 46.9% did not require oxygen support at admission. Additionally, 64.6% used nonsteroidal anti-inflammatory drugs, 35.4% used corticosteroids, 28.1% used macrolides or ceftriaxone, 24.5% used ivermectin, and 21.9% used warfarin before hospitalization. Of the patients, 30.2% developed a fatal outcome during follow-up. The multivariate analysis revealed that prehospital corticosteroid use was independently associated with the fatal outcome due to COVID-19 with an aHR = 5.29 (95%CI: 1.63-17.2). CONCLUSION Prehospital corticosteroid use was associated with a 5-fold increased risk of fatal outcome development.
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Affiliation(s)
- Brenda Caira-Chuquineyra
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru; Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru
| | - Daniel Fernandez-Guzman
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru; Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
| | | | - Ángel A Zarate-Curi
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru; Servicio de Medicina Interna, Hospital Nacional Carlos Alberto Seguín Escobedo, EsSalud, Arequipa, Peru
| | - Percy Herrera-Añazco
- Universidad Privada San Juan Bautista, Lima, Peru; Red Internacional en Salud Colectiva y Salud Intercultural, Ciudad de México, Mexico; Instituto de Evaluación de Tecnologías en Salud e Investigación, EsSalud, Lima, Peru
| | - Vicente A Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
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Zhang Z, Ge P, Yan M, Niu Y, Liu D, Xiong P, Li Q, Zhang J, Yu W, Sun X, Liu Z, Wu Y. Self-Medication Behaviors of Chinese Residents and Consideration Related to Drug Prices and Medical Insurance Reimbursement When Self-Medicating: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13754. [PMID: 36360638 PMCID: PMC9656509 DOI: 10.3390/ijerph192113754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Self-medication has become a common phenomenon. Economic factors are important factors that affect the self-medication of residents. This study aimed to investigate the current status of self-medication behaviors in China and explored the related factors affecting considerations associated with medical insurance reimbursement or drug price in self-medication. METHODS A national cross-sectional investigation was conducted among Chinese people over 18 years old under a multi-stage sampling method through a questionnaire, which includes demographic sociological characteristics, self-medication behaviors and scales. The Chi-square test was used to analyze whether the respondents consider medical insurance reimbursement or drug price as an important factor when purchasing over-the-counter (OTC) drugs. Logistic regression was used to examine the associated factors of considering medical insurance reimbursement or drug price. RESULTS In total, 9256 respondents were included in this study; 37.52% of the respondents regarded drug prices as an important consideration, and 28.53% of the respondents attached great importance to medical insurance reimbursement. Elderly respondents who lived in the central region, had medical insurance, and had lower levels of health literacy were more likely to consider the medical insurance reimbursement, while respondents with high monthly family income as well as students were less likely to consider the same issue (p < 0.05). Respondents settled in the central and western regions, students, those without fixed occupations, those who suffered from chronic diseases, or those with lower health literacy were more likely to consider drug prices, while the respondents with bachelor degrees, urban population and high per capita monthly income were less likely to consider the drug prices (p < 0.05). CONCLUSION Self-medication behaviors with OTC drugs were prevalent in China, and consideration factors of medical insurance reimbursement or drug prices were related to socio-demographic characteristics and health literacy. There is a need to take measures to reduce the economic burden of self-medication, improve the health literacy of residents and strengthen public health education.
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Affiliation(s)
- Ziwei Zhang
- School of Public Health, Peking University, Beijing 100191, China
| | - Pu Ge
- Institute of Chinese Medical Sciences, University of Macau, Macao 999078, China
| | - Mengyao Yan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100006, China
| | - Yuyao Niu
- Faculty of Arts and Humanities, University of Macau, Macao 999078, China
| | - Diyue Liu
- International School of Public Health and One Health, Hainan Medical University, Haikou 571199, China
| | - Ping Xiong
- Institute of Chinese Medical Sciences, University of Macau, Macao 999078, China
| | - Qiyu Li
- School of Humanities and Management, Jinzhou Medical University, Jinzhou 121001, China
| | - Jinzi Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin 150076, China
| | - Wenli Yu
- School of Foreign Languages, Weifang University of Science and Technology, Weifang 262700, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing 100191, China
| | - Zhizhong Liu
- School of Finance and Trade, Liaoning University, Shenyang 110036, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing 100191, China
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Facebook as a source of access to medicines. PLoS One 2022; 17:e0275272. [PMID: 36227918 PMCID: PMC9560064 DOI: 10.1371/journal.pone.0275272] [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: 01/24/2022] [Accepted: 09/13/2022] [Indexed: 11/22/2022] Open
Abstract
Over the last decade, we've observed an enormous social media development, which have recently become commercial services. Hence, we aimed to verify if Facebook might be considered as a source of access to medicines. We also intended to identify prescription (Rx) and over the counter (OTC) medicines if available on that platform. The study was conducted from January 2019 to July 2020. We investigated offers of pharmaceuticals posted on Facebook (individual posts and communities) between 2016 and 2019. Medicines were divided into Rx and OTC brands and in accordance with their possible therapeutic use. We verified whether the medicines were for sale, to exchange, or available for free. Posts and groups were investigated for example, by entering the phrase "for free," followed by a city in Poland. Out of 409 offers, 380 (92.91%) concerned Rx brands and 29 (7.09%) OTC brands. 315 (77.02%) medications were available "for free". In 47 (11.49%) cases, an "exchange" was expected, and 47 (11.49%) announcements were marked as "for sale". Cardiovascular medicines (n = 125; 30.56%) were the most popular. There were also antidiabetics (n = 38; 9.29%) and antipsychotics (n = 28; 6.84%). We also found clear candidates for misuse. These were opioids (n = 7; 1.71%), benzodiazepines (n = 2; 0.48%), clomifene (n = 1; 0.24%), and letrozole (n = 1; 0.24%). Facebook provides the possibility of uncontrolled access to medicines. The majority of offers concerned Rx brands, including opioids and benzodiazepines. Medicines offered on Facebook were mainly accessible for free. The scope and the number of medications offered on Facebook should make this issue a hazardous phenomenon.
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Pérez Jorge G, Rodrigues dos Santos Goes IC, Gontijo MTP. Les misérables: a Parallel Between Antimicrobial Resistance and COVID-19 in Underdeveloped and Developing Countries. Curr Infect Dis Rep 2022; 24:175-186. [PMID: 36211535 PMCID: PMC9531231 DOI: 10.1007/s11908-022-00788-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 12/02/2022]
Abstract
Purpose of Review The COVID-19 pandemic has been responsible for more than 6.3 million deaths worldwide. During the pandemic, the indiscriminate use of antibiotics has increased, contributing to the spread of multidrug-resistant bacteria. In this review, we aim to determine the spread and impact of antibiotic treatments in patients with COVID-19, focusing on underdeveloped and developing countries. Recent Findings Meta-analysis revealed that bacterial co-infections and secondary infections are relatively rare in COVID-19 patients, corresponding to less than 20% of hospitalized patients. Even so, most of these patients have received antibiotic treatments. Summary This review discusses how the COVID-19 pandemic could increase the emergence of multidrug-resistant strains to currently available antibiotics. Initially, we discussed the spread and impact of multidrug resistance of ESKAPE pathogens associated with nosocomial infections and analyzed their risk of secondary infections in patients with COVID-19. Then we highlight three factors related to the spread of resistant bacteria during the current pandemic: overprescription of antibiotics followed by self-medication. Finally, we discussed the lack of availability of diagnostic tests to discriminate the etiologic agent of a disease. All these factors lead to inappropriate use of antibiotics and, therefore, to an increase in the prevalence of resistance, which can have devastating consequences shortly. The data compiled in this study underscore the importance of epidemiological surveillance of hospital isolates to provide new strategies for preventing and controlling infections caused by multidrug-resistant bacteria. In addition, the bibliographic research also highlights the need for an improvement in antibiotic prescribing in the health system.
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Affiliation(s)
- Genesy Pérez Jorge
- Departamento de Genética, Evolução, Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Rua Monteiro Lobato 255, Campinas, SP 13083-862 Brazil
- Laboratorio de Investigaciones Biomédicas, Universidad de Sucre, Cra. 28 #5-267, Sincelejo, Sucre, Colômbia
| | - Isabella Carolina Rodrigues dos Santos Goes
- Departamento de Genética, Evolução, Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Rua Monteiro Lobato 255, Campinas, SP 13083-862 Brazil
| | - Marco Tulio Pardini Gontijo
- Departamento de Genética, Evolução, Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Rua Monteiro Lobato 255, Campinas, SP 13083-862 Brazil
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, 10 Duke Medicine Cir, Durham, NC 27710 USA
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Jirjees F, Barakat M, Shubbar Q, Othman B, Alzubaidi H, Al-Obaidi H. Perceptions of COVID-19 symptoms, prevention, and treatment strategies among people in seven Arab countries: A cross-sectional study. J Infect Public Health 2022; 15:1108-1117. [PMID: 36137360 PMCID: PMC9462932 DOI: 10.1016/j.jiph.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/13/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUP the widespread COVID-19 infection worldwide has resulted in the inability of healthcare facilities to receive all infected patients; therefore, most are treated at home. In addition, factors such as high mortality, types and severity of symptoms, and the prevalence of unreliable information have prompted patients to resort to self-treatment. OBJECTIVES To assess prevention, treatment, degree of symptoms, and sources of information among patients with COVID-19 in Arab countries METHOD: A cross-sectional study was conducted in seven Arab countries: Algeria, Egypt, Iraq, Lebanon, Libya, Tunisia, and the United Arab of Emirates. People who have recovered from COVID-19 completed the study questionnaire. Score of symptoms during and after COVID-19 infection has been calculated by giving the participants a list of 13 symptoms. RESULTS A total of 3519 participants completed the survey. Mostly females (68.3%), and aged between 18 and 40 years old (59.4%). Prophylaxis treatments, including vaccines and antibiotics, have been used in around 40% of the participants. The total average score of symptoms during the infection period was found 7.31 ± 3.66 out of 13. However, the symptoms score upon recovery was low (0.48 ± 1.11 score). The significant associations with increased incidence of symptoms during infection were reported with older people, married, divorced or widowed, people with chronic diseases, and obese. Moreover, significant associations with decreased symptoms were reported with those who worked in the health sector, non- or ex-smokers, and vaccinated people. CONCLUSION The use of medication and other treatments to prevent infection with COVID-19 was common among the participants in the seven countries. Taking the vaccine was the only effect on the number of symptoms experienced by patients. Although nearly two years have passed since the onset of the disease, there is still a need to raise treatment awareness among patients at home.
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Affiliation(s)
| | - Muna Barakat
- School of Pharmacy, Applied Science Private University, Jordan
| | | | - Bayan Othman
- School of Pharmacy, Applied Science Private University, Jordan
| | | | - Hala Al-Obaidi
- College of Pharmacy and Health Sciences, Ajman University, UAE
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Shrestha AB, Aryal M, Magar JR, Shrestha S, Hossainy L, Rimti FH. The scenario of self-medication practices during the covid-19 pandemic; a systematic review. Ann Med Surg (Lond) 2022; 82:104482. [PMID: 36059596 PMCID: PMC9419440 DOI: 10.1016/j.amsu.2022.104482] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
| | - Manjil Aryal
- M Abdur Rahim Medical College, Rajshahi University, Dinajpur, Bangladesh
| | - Junu Rana Magar
- Central Institute of Science and Technology, Pokhara University, Kathmandu, Nepal
| | | | - Labiba Hossainy
- Department of Pediatrics, Shaheed Ziaur Rahman Medical College Hospital, Bogra, Bangladesh
| | - Fahmida Hoque Rimti
- Chittagong Medical College, Chittagong, Bangladesh
- Corresponding author. Chittagong Medical College, Chittagong, Bangladesh.
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Kimathi G, Kiarie J, Njarambah L, Onditi J, Ojakaa D. A cross-sectional study of antimicrobial use among self-medicating COVID-19 cases in Nyeri County, Kenya. Antimicrob Resist Infect Control 2022; 11:111. [PMID: 36042483 PMCID: PMC9427085 DOI: 10.1186/s13756-022-01150-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
During the COVID-19 pandemic, Nyeri County in Kenya was among the regions reporting a high number of confirmed cases. This exemplified the increased need of addressing potential antimicrobial resistance (AMR) and self-medication during disease outbreaks. This study examined the extent of self-medication with antimicrobials among COVID-19 confirmed cases in the County.
Methods
A cross-sectional survey using phone-based interviews was conducted in August 2021 among a sample of 280 out of 2317 confirmed COVID-19 cases in the County using a pre-coded questionnaire. Descriptive analyses of frequencies and causal logistic regression were conducted using STATA version 13.
Results
A total of 193 (68.9%) of the respondents indicated developing COVID-19 related symptoms-mainly cough (41.5%), headache (38.3%), and fatigue (34.7%). Over one-fifth (23.4%) of the respondents had self-medicated with antibiotics, 60.6% of whom did so at the onset of symptoms before the confirmatory test, and 51.5% self-medicating more than once. Common antibiotics used were Azithromycin (40.0%) and Amoxycilline (23.3%), with a considerable 21.7% having difficulty remembering the name of the drugs. Only half (50.4%) of the respondents (128/254) were aware of regulations towards self-medication with antibiotics. Age was the only socio-demographic variable significantly related to reduced self-medication, with older persons less likely to self-medicate. On the other hand, developing COVID-19 symptoms, awareness of COVID regulations, and appreciation of the need for self-medication awareness were related to increased self-medication.
Conclusion
Being older, developing COVID-19 symptoms, and appreciating self-medication awareness have influential effects on the use of antimicrobials. Public health interventions should be timely during infectious disease outbreaks to prevent undesirable health-seeking behavior such as irrational antimicrobial use. AMR policies should enhance awareness of the risks of self-medication and address barriers that deter people from timely access of health services during disease outbreaks. Further research should be conducted on the self-medication and AMR nexus, especially during health emergencies.
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Ma H, Ma Y, Ge S, Wang S, Zhao IY, Christensen M. Intrapersonal and interpersonal level factors influencing self-care practices among Hong Kong individuals with COVID-19-A qualitative study. Front Public Health 2022; 10:964944. [PMID: 36091550 PMCID: PMC9449417 DOI: 10.3389/fpubh.2022.964944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/08/2022] [Indexed: 01/24/2023] Open
Abstract
Background The unprecedented crisis during the fifth wave of the COVID-19 pandemic in Hong Kong placed a significant burden on the health care system. Therefore, the Hong Kong government advocated that individuals with no or mild COVID-19 symptoms should self-care at home. This study aimed to understand intrapersonal and interpersonal level factors that shaped self-care practices among home-quarantined individuals with COVID-19 during the peak of the pandemic. Methods This study used convenience and snowball sampling whereby a total of 30 semi-structured telephone interviews were conducted between March and April 2022. Inductive content analysis was used to analyze the data. Results Factors reported at the intrapersonal level included socioeconomic status and housing conditions, information and knowledge about COVID-19, long COVID, and psychological adjustments brought about by home quarantine. Factors identified at the interpersonal level included caregiving responsibilities, family relationships, and social support. Conclusions Findings from this study identified a combination of intra and interpersonal level factors influenced an individual's self-care practices as a result of pandemic-induced quarantine. It was particularly concerning for those individuals in socially and economically deprived groups, where access to services was challenging. This study also raised awareness of the ineffectual and insufficient knowledge individuals held of self-medication and overall COVID-19 management. A key recommendation is developing family-based resilience programmes to support and empower vulnerable families to better cope with the realities of self-quarantine.
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Affiliation(s)
- Haixia Ma
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,Interdisciplinary Centre for Qualitative Research, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Yajing Ma
- School of Public Policy and Management, China University of Mining and Technology, Xuzhou, Jiangsu, China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston, TX, United States
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,WHO Collaborating Center for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Ivy Yan Zhao
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,WHO Collaborating Center for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Martin Christensen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,Interdisciplinary Centre for Qualitative Research, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,*Correspondence: Martin Christensen
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Marcolino MS, Meira KC, Guimarães NS, Motta PP, Chagas VS, Kelles SMB, de Sá LC, Valacio RA, Ziegelmann PK. Systematic review and meta-analysis of ivermectin for treatment of COVID-19: evidence beyond the hype. BMC Infect Dis 2022; 22:639. [PMID: 35870876 PMCID: PMC9308124 DOI: 10.1186/s12879-022-07589-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/05/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The role of ivermectin in the treatment of COVID-19 is still under debate, yet the drug has been widely used in some parts of the world, as shown by impressive market data. The available body of evidence may have changed over the last months, as studies have been retracted and "standards of care" (SOC) used in control groups have changed with rapidly evolving knowledge on COVID-19. This review aims to summarize and critically appraise the evidence of randomized controlled trials (RCTs) of ivermectin, assessing clinical outcomes in COVID-19 patients. METHODS RCTs evaluating the effects of ivermectin in adult patients with COVID-19 were searched through June 22, 2022, in four databases, L.OVE platform, clinical trial registries and pre-prints platforms. Primary endpoints included all-cause mortality and invasive ventilation requirement. Secondary endpoint was the occurrence of adverse events. Risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Meta-analysis included only studies which compared ivermectin to placebo or SOC. Random-effects were used to pool the risk ratios (RRs) of individual trials. The quality of evidence was evaluated using GRADE. The protocol was register in PROSPERO (CRD42021257471). RESULTS Twenty-five RCTs fulfilled inclusion criteria (n = 6310). Of those, 14 compared ivermectin with placebo, in night ivermectin associated with SOC was compared to SOC and two studies compared ivermectin to an active comparator. Most RCTs had some concerns or high risk of bias, mostly due to lack of concealment of the randomization sequence and allocation, lack of blinding and high number of missing cases. Ivermectin did not show an effect in reducing mortality (RR = 0.76; 95%CI: 0.52-1.11) or mechanical ventilation (RR = 0.74; 95%CI: 0.48-1.16). This effect was consistent when comparing ivermectin vs. placebo, and ivermectin associated with SOC vs. SOC, as well as in sensitivity analysis. Additionally, there was very low quality of evidence regarding adverse effects (RR = 1.07; 95%CI: 0.84-1.35). CONCLUSIONS The evidence suggests that ivermectin does not reduce mortality risk and the risk of mechanical ventilation requirement. Although we did not observe an increase in the risk of adverse effects, the evidence is very uncertain regarding this endpoint.
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Affiliation(s)
- Milena Soriano Marcolino
- Department of Internal Medicine, Medical School and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, sala 246, Belo Horizonte, 30130-100 Brazil
- Institute for Health Technology Assessment (IATS/CNPq), Rua Ramiro Barcelos, 2359, Prédio 21|Sala 507, Porto Alegre, Brazil
| | - Karina Cardoso Meira
- Health School, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, s/n-Lagoa Nova, Natal, Rio Grande do Norte, Brazil
| | - Nathalia Sernizon Guimarães
- Instituto de Saúde Coletiva da Universidade Federal da Bahia, R. Basílio da Gama, s/n-Canela, Salvador, Brazil
| | - Paula Perdigão Motta
- Faculdade de Farmácia da Universidade Federal de Minas Gerais, R. Prof. Moacir Gomes de Freitas S/N-Pampulha, Belo Horizonte, Minas Gerais Brazil
| | - Victor Schulthais Chagas
- Department of Internal Medicine, Medical School and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, sala 246, Belo Horizonte, 30130-100 Brazil
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Av. Peter Henry Rolfs, University Campus, Viçosa, Brazil
| | - Silvana Márcia Bruschi Kelles
- Pontifícia Universidade Católica de Minas Gerais, R. do Rosário, 1.081 Bairro Angola, Betim, Brazil
- Unimed-BH, Belo Horizonte, MG Brazil
| | - Laura Caetano de Sá
- Department of Internal Medicine, Medical School and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, sala 246, Belo Horizonte, 30130-100 Brazil
- Faculdade Ciências Médicas de Minas Gerais-FCMMG, Alameda Ezequiel Dias, Belo Horizonte, 275 Brazil
| | | | - Patrícia Klarmann Ziegelmann
- Institute for Health Technology Assessment (IATS/CNPq), Rua Ramiro Barcelos, 2359, Prédio 21|Sala 507, Porto Alegre, Brazil
- Epidemiology e Statistics Department, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, Porto Alegre, RS 2400 Brazil
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Nino-Orrego MJ, Baracaldo-Santamaría D, Patricia Ortiz C, Zuluaga HP, Cruz-Becerra SA, Soler F, Pérez-Acosta AM, Delgado DR, Calderon-Ospina CA. Prescription for COVID-19 by non-medical professionals during the pandemic in Colombia: a cross-sectional study. Ther Adv Drug Saf 2022; 13:20420986221101964. [PMID: 35646306 PMCID: PMC9136451 DOI: 10.1177/20420986221101964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/03/2022] [Indexed: 01/08/2023] Open
Abstract
Background: The COVID-19 pandemic has led to an increase in the behavior of
self-medication (SM). Given the massive release of misleading information
during the pandemic, some pharmacies recommend drugs such as ivermectin,
azithromycin, and hydroxychloroquine that are not useful for preventing or
treating COVID-19 and could expose patients to unnecessary adverse drug
reactions (ADRs), drug-drug interactions (DDIs), disease masking, and
antibiotic resistance. Rationale: SM with drugs advertised for COVID-19 can have consequences, and people
should be aware of approved uses, potential contraindications, and ADRs.
Thus, the aim of this study was to know the drug therapies including natural
products and homeopathic drugs offered by Colombian pharmaceutical
establishments for the prevention and treatment of COVID-19, as well as the
information provided on the safe use of the product. Methods: An observational, cross-sectional mystery shopping study was carried out to
determine the pharmaceutical alternatives for the management of COVID-19
offered by pharmaceutical establishments (drugstores, pharmacies,
homeopathic pharmacies, and nutritional supplements stores) in Colombia, and
information related to the safe use of the product. The study included 482
pharmaceutical establishments from 16 Colombian departments. Data collection
was done through telephone calls to each of the establishments following an
interview protocol pretending to be a patient who presents symptoms related
to COVID-19. Results: About 57.3% (276) of the establishments recommended a product for the
treatment of COVID-19 infection, 66.6% (321) asked whether the caller had
COVID-19 symptoms and what they are, and 44.2% (213) suggested taking a
COVID-19 test. Of 59 drugs suggested by pharmacies, the most recommended
were azithromycin, ivermectin, acetaminophen, ibuprofen, and ASA (aspirin).
From the establishments that recommended a product, dosage was indicated in
85.5% (236) of the pharmaceutical establishments and 14.5% (40) of the
establishments reported the most common adverse effects of this substance.
About 9.4% (26) of the establishments reported possible interactions of the
recommended drugs and substances with food, beverages, or
supplements.Conclusion: Pharmaceutical establishments in
Colombia seem to have significantly contributed to self-medication for
COVID-19 in Colombia during the pandemic. This behavior is inappropriate,
since the mild forms of the disease do not have a specific treatment. Plain Language Summary Self-medication induced by pharmaceutical establishments in Colombia
during the COVID-19 pandemic Background: The COVID-19 pandemic has led to an increase in the
behavior of self-medication (SM). Given the massive release of misleading
information during the pandemic, some pharmacies recommend drugs such as
ivermectin, azithromycin, hydroxychloroquine among others, which are not
useful for preventing or treating COVID-19 and could expose patients to
unnecessary side effects and interactions with other medications. People
should be aware of the approved and non-approved uses, and potential side
effects of these drugs. Rationale: The aim of this study was to
know the drugs, including natural products and homeopathic drugs, offered by
Colombian pharmaceutical establishments for the prevention and treatment of
COVID-19, as well as the information provided on the safe use of the
product. Methods: The study was done using the mystery shopping
method, collecting data through telephone calls to each of the
establishments by a trained individual pretending to be a patient with
COVID-19 symptoms. The study included 482 pharmaceutical establishments from
16 Colombian departments. Results: Of 59 drugs suggested by
pharmacies, the most recommended were azithromycin, ivermectin,
acetaminophen, ibuprofen, and aspirin. The recommended dose was indicated in
85.5% (236) of the pharmaceutical establishments, and 14.5% (40) of them
reported the most common adverse effects of the recommended product. About
9.4% (26) of the establishments reported possible interactions of the
recommended drugs and substances with food, beverages, or supplements.
Conclusion: The majority of the pharmaceutical
establishments included in the study promoted inadequate self-medication for
COVID-19 in Colombia during the pandemic.
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Affiliation(s)
- Maria Jose Nino-Orrego
- Center for Research in Genetics and Genomics (CIGGUR), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Daniela Baracaldo-Santamaría
- Pharmacology Unit, Department of Biomedical Sciences, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Claudia Patricia Ortiz
- Corporación Universitaria Minuto de Dios-UNIMINUTO, Programa de Administración en Salud Ocupacional, Grupo de Investigación en Seguridad y Salud en el Trabajo, Neiva, Colombia
| | | | | | - Franklin Soler
- Observatory of Self-Medication Behavior, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Andrés M. Pérez-Acosta
- Observatory of Self-Medication Behavior, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Daniel Ricardo Delgado
- Grupo de Investigación en Dinámicas Sociales, Universidad Cooperativa de Colombia, Campus Neiva, Neiva, Colombia
| | - Carlos-Alberto Calderon-Ospina
- Center for Research in Genetics and Genomics (CIGGUR), School of Medicine and Health Sciences, Universidad del Rosario, 111221 Bogotá, Colombia. Pharmacology Unit, Department of Biomedical Sciences, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
- Observatory of Self-Medication Behavior, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
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Tuczyńska M, Staszewski R, Matthews-Kozanecka M, Baum E. Impact of Socioeconomic Status on the Perception of Accessibility to and Quality of Healthcare Services during the COVID-19 Pandemic among Poles—Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095734. [PMID: 35565127 PMCID: PMC9104779 DOI: 10.3390/ijerph19095734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 12/07/2022]
Abstract
This pilot study was conducted on the reported hypothesis that the COVID-19 pandemic outbreak had an impact on the accessibility and quality of healthcare services and exacerbated socioeconomic inequalities. The aim was to determine whether economic status and education had an impact on the perception of access and quality to healthcare services during the COVID-19 pandemic and whether, according to patients, accessibility and quality had changed significantly compared to the pre-pandemic period in Poland. The study was based on the authors’ questionnaire and the results were statistically analyzed. Two hundred forty-seven feedback responses were received with a responsiveness rate of 93 percent. Statistically significant differences were found when comparing education level and utilization of healthcare services during the COVID-19 pandemic. A comparison of gender and economic situation, and average monthly income found no statistically significant differences. The outbreak of the COVID-19 pandemic has undoubtedly affected the provision of health services in many countries around the world. One result of the pandemic crisis has been widening socioeconomic inequalities among patients.
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Affiliation(s)
- Magdalena Tuczyńska
- SSC of Maxillofacial and Orthopaedics and Orthodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland
- Correspondence:
| | - Rafał Staszewski
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.-K.); (E.B.)
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.-K.); (E.B.)
- Division of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, 61-701 Poznan, Poland
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Baracaldo-Santamaría D, Pabón-Londoño S, Rojas-Rodriguez LC. Drug safety of frequently used drugs and substances for self-medication in COVID-19. Ther Adv Drug Saf 2022; 13:20420986221094141. [PMID: 35493401 PMCID: PMC9039440 DOI: 10.1177/20420986221094141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/23/2022] [Indexed: 11/15/2022] Open
Abstract
During the COVID-19 pandemic, the behavior of self-medication has increased. The dissemination of misleading information regarding the efficacy of certain drugs or substances for the prevention and treatment of COVID-19 has been the major contributing factor for this phenomenon. Alongside with the increase in self-medication behavior, the inherent risks to this act such as drug-drug interactions, adverse events, drug toxicity, and masking of symptoms have also increased. Self-medication in the context of COVID-19 has led to drug misuse leading in some cases to the development of fatal adverse drug reactions. It is important that during this ongoing pandemic drugs with potential clinical efficacy against COVID-19 are adequately analyzed regarding their efficacy, safety, and monitoring. The aim of this review is to describe the available evidence regarding the efficacy, safety, and monitoring of the drugs and substances that have been shown to be frequently used for self-medication in patients with COVID-19 (hydroxychloroquine, non-steroidal anti-inflammatory drugs, ivermectin, azithromycin, vitamins, aspirin, and chlorine dioxide) to adequately characterize their risks, safe use, monitoring strategies, and to reinforce the concept that these substances should not be used for self-medication and require a medical prescription. Plain Language Summary Drug safety of frequently used drugs and substances for self-medication in COVID-19 Dissemination of information about potential COVID-19 treatments has led individuals to self-medicate and expose themselves to risks such as drug-drug interactions, side effects, antibiotic resistance, and misdiagnosis. There is a need to review the medical literature to evaluate the safety and efficacy of the drugs and substances commonly used by the population for the treatment and prevention of SARS CoV-2 infection. In this review, we included drugs that are frequently used for self-medication and commonly advertised such as ivermectin, hydroxychloroquine, chlorine dioxide, azithromycin, and non-steroidal anti-inflammatory drugs, among others. A brief introduction of the drug and its mechanism of action, followed by a summary of the efficacy in COVID-19 and safety, will be described for each drug in order to promote their responsible use.
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Affiliation(s)
- Daniela Baracaldo-Santamaría
- Pharmacology Unit, Department of Biomedical Sciences, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | | | - Luis Carlos Rojas-Rodriguez
- Pharmacology Unit, Department of Biomedical Sciences, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, 111221, Colombia
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The Impact of Multiplex PCR in Diagnosing and Managing Bacterial Infections in COVID-19 Patients Self-Medicated with Antibiotics. Antibiotics (Basel) 2022; 11:antibiotics11040437. [PMID: 35453189 PMCID: PMC9025156 DOI: 10.3390/antibiotics11040437] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 02/01/2023] Open
Abstract
The multiplex PCR is a powerful and efficient tool that was widely used during the COVID-19 pandemic to diagnose SARS-CoV-2 infections and that has applications for bacterial identification, as well as determining bacterial resistance to antibiotics. Therefore, this study aimed to determine the usability of multiplex PCR, especially in patients self-medicated with antibiotics, where bacterial cultures often give false-negative results. A cross-sectional study was developed in two COVID-19 units, where 489 eligible patients were included as antibiotic takers and non-antibiotic takers. Antibiotic takers used mostly over-the-counter medication; they suffered significantly more chronic respiratory conditions and were self-medicated most often with cephalosporins (41.4%), macrolide (23.2%), and penicillin (19.7%). The disease severity in these patients was significantly higher than in non-antibiotic takers, and bacterial superinfections were the most common finding in the same group (63.6%). Antibiotic takers had longer hospital and ICU admissions, although the mortality rate was not significantly higher than in non-antibiotic takers. The most common bacteria involved in secondary infections were Staphylococcus aureus (22.2%), Pseudomonas aeruginosa (27.8%), and Klebsiellaspp (25.0%). Patients self-medicating with antibiotics had significantly higher rates of multidrug resistance. The multiplex PCR test was more accurate in identifying multidrug resistance and resulted in a quicker initiation of therapeutic antibiotics compared with instances where a bacterial culture was initially performed, with an average of 26.8 h vs. 40.4 h, respectively. The hospital stay was also significantly shorter by an average of 2.5 days when PCR was used as an initial assessment tool for secondary bacterial infections. When adjusted for age, COVID-19 severity, and pulmonary disease, over-the-counter use of antibiotics represented a significant independent risk factor for a prolonged hospitalization (AOR = 1.21). Similar findings were observed for smoking status (AOR = 1.44), bacterial superinfection (AOR = 1.52), performing only a conventional bacterial culture (AOR = 1.17), and a duration of more than 48 h for bacterial sampling from the time of hospital admission (AOR = 1.36). Multiplex PCR may be a very effective method for diagnosing secondary bacterial infections in COVID-19 individuals self-medicating with antibiotics. Utilizing this strategy as an initial screen in COVID-19 patients who exhibit signs of sepsis and clinical deterioration will result in a faster recovery time and a shorter period of hospitalization.
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Dare SS, Eze ED, Echoru I, Usman IM, Ssempijja F, Bukenya EE, Ssebuufu R. Behavioural Response To Self-Medication Practice Before and During Covid-19 Pandemic in Western Uganda. Patient Prefer Adherence 2022; 16:2247-2257. [PMID: 36034331 PMCID: PMC9400814 DOI: 10.2147/ppa.s370954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Self-medication has become a serious public health problem posing great risks, especially with the increasing number of cases of COVID-19 disease globally and in Uganda. This may be partly because of the absence of a recognized treatment for the disease, however, the differing prevalence and nature from country to country may influence human behavioral responses. PURPOSE This study aimed to investigate the behavioral response to self-medication practices during the COVID-19 pandemic and lockdown in comparison to the pre-COVID period in Western Uganda. METHODS A descriptive cross-sectional survey was conducted from June to August 2020 in western Uganda using online Google forms and printed questionnaires to investigate the level of self-medication practice before and during the COVID-19 pandemic. This included 280 participants, aged 18 and above who consented to participate in the study. Participants were selected using a convenience sampling technique, and sampling was done by sending a structured online questionnaire via Google forms and printed questionnaires to participants who did not use the online Google forms. RESULTS Respondents that knew about self-medication were 97% of the 272 participants. Those that are aware of self-medication, have heard about it either through different avenues. Respondents who practiced self-medication before the COVID-19 pandemic were 239 (88%); those who practiced self-medication during the COVID-19 pandemic were 156 (57%); those that did not were 115 (43%). There was a statistically significant decrease in the number of respondents who practice self-medication during the COVID-19 pandemic lockdown compared to the practice before the pandemic lockdown. p < 0.05 at 95% confidence interval (OR = 5.39, 95% CI = 3.48, 8.32). CONCLUSION Our investigation showed adequate knowledge of self-medication and a high level of self-medication practice with a decrease in self-medication practices during the COVID-19 pandemic lockdown compared to the practice before the lockdown.
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Affiliation(s)
- Samuel Sunday Dare
- School of Medicine, Kabale University, Kabale, Uganda
- Correspondence: Samuel Sunday Dare, School of Medicine, Kabale University, P.O. Box 317, Kabale, Uganda, Tel +256757802099, Email
| | | | - Isaac Echoru
- School of Medicine, Kabale University, Kabale, Uganda
| | - Ibe Michael Usman
- Faculty of Biomedical Sciences, Kampala International University Western Campus, Ishaka, Uganda
| | - Fred Ssempijja
- Faculty of Biomedical Sciences, Kampala International University Western Campus, Ishaka, Uganda
| | | | - Robinson Ssebuufu
- Faculty of Clinical Medicine and Dentistry, Kampala International University Teaching Hospital, Ishaka, Uganda
- Uganda Medical and Dental Practitioners Council, Kampala, Uganda
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Treatment paradigms in Parkinson's Disease and Covid-19. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 165:135-171. [PMID: 36208898 PMCID: PMC9148185 DOI: 10.1016/bs.irn.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
People with Parkinson's Disease (PwP) may be at higher risk for complications from the Coronavirus Disease 2019 (Covid-19) due to older age and to the multi-faceted nature of Parkinson's Disease (PD) per se, presenting with a variety of motor and non-motor symptoms. Those on advanced therapies may be particularly vulnerable. Taking the above into consideration, along with the potential multi-systemic impact of Covid-19 on affected patients and the complications of hospitalization, we are providing an evidence-based guidance to ensure a high standard of care for PwP affected by Covid-19 with varying severity of the condition. Adherence to the dopaminergic medication of PwP, without abrupt modifications in dosage and frequency, is of utmost importance, while potential interactions with newly introduced drugs should always be considered. Treating physicians should be cautious to acknowledge and timely address any potential complications, while consultation by a neurologist, preferably with special knowledge on movement disorders, is advised for patients admitted in non-neurological wards. Non-pharmacological approaches, including the patient's mobilization, falls prevention, good sleep hygiene, emotional support, and adequate nutritional and fluid intake, are essential and the role of telemedicine services should be strengthened and encouraged.
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50
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Tekeba A, Ayele Y, Negash B, Gashaw T. Extent of and Factors Associated with Self-Medication among Clients Visiting Community Pharmacies in the Era of COVID-19: Does It Relieve the Possible Impact of the Pandemic on the Health-Care System? Risk Manag Healthc Policy 2021; 14:4939-4951. [PMID: 34934370 PMCID: PMC8683580 DOI: 10.2147/rmhp.s338590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/18/2021] [Indexed: 12/14/2022] Open
Abstract
Background Self-medication is one aspect of self-care that has been shown to benefit primary health care. When done correctly, it provides significant benefits to customers, such as self-reliance and cost savings. Inappropriate methods, on the other hand, such as incorrect self-diagnosis and therapy selection, can be disastrous. The COVID-19 pandemic context may benefit the community in easing the burden on the health system. There have been no studies conducted on this possibility in the context of COVID-19 in a selected area, hence the purpose of this study was to determine the extent of and factors associated with self-medication among clients visiting community pharmacies in west Harerghe, Ethiopia from June 1 to 30, 2020. Methods This institution-based cross-sectional study used a systemic random sample of 416 community-pharmacy clients. To collect data, face-to-face interviews were conducted using pretested semistructured questionnaires modified from established techniques. EpiData 3.1 was used to enter data and SPSS 24 for analysis. To determine factors associated with self-medications, bivariate and multivariate logistic regression analyses were performed. AORs with 95% CIs are used to report associations, and the level of significance was set at P<0.05. Results The proportion of people self-medicating was 73.6% (95% CI 69.2%–77.9%). Self-medications were significantly associated with age 18–24 years (AOR 9.28, 95% CI 3.56–24.21) and 25–34 years (AOR 3.54, 95% CI 1.35–9.27), Amhara ethnicity (AOR 1.72, 95% CI 1.01–2.94), current single status (AOR 0.28, 95% CI 0.15–0.51), government employment (AOR 0.31, 95% CI 0.12–0.82), and limited knowledge (AOR 2.31, 95% CI 1.40–3.79). Conclusion Three in four participants practiced self-medication in the era of COVID-19. Repetition was significantly associated with age, ethnicity, current marital status, type of occupation, and knowledge about self-medications. An alternative medical care–delivery system by all health-care providers and increasing community awareness should be promoted.
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Affiliation(s)
- Aklilu Tekeba
- Micheta Community Pharmacy, Daro Lebu Health Office, West Harerghe, Ethiopia
| | - Yohanes Ayele
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Hawassa University, Hawassa, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tigist Gashaw
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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