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Hackman HK, Annison L, Arhin RE, Adjei GO, Otu P, Arthur-Hayford E, Annison S, Borteih BB. Self-medication with antibiotics during the COVID-19 pandemic: A cross-sectional study among adults in Tema, Ghana. PLoS One 2024; 19:e0305602. [PMID: 38917123 PMCID: PMC11198810 DOI: 10.1371/journal.pone.0305602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Antibiotic self-medication is one of the common causes of antibiotic resistance of bacterial organisms. The COVID-19 pandemic introduced a new paradigm shift and significantly influenced healthcare behaviors, including an increase in antibiotic self-medication, which contributes to antibiotic resistance. This study was aimed at determining the prevalence of antibiotic self-medication and the possible associated factors during the peak of the COVID-19 pandemic among adult residents of Tema in Ghana from April to July 2021. METHODS Using a cross-sectional design, 400 adults were randomly selected and surveyed using a researcher-assisted questionnaire. Data were analyzed with IBM® SPSS® Statistics Version 22.0, considering associations significant at a 95% confidence interval (p < 0.05). RESULTS Of the 400 respondents, (76%) 304 had practiced antibiotic self-medication within the previous 12 months during the COVID-19 pandemic. Significant factors associated with antibiotic self-medication included gender, age, marital status, education, occupation, and National Health Insurance Scheme subscription. Convenience and avoiding long hospital queues were primary non-medical reasons for antibiotic self-medication, while previous successful experience, easy access to antibiotics, treating symptoms, prophylaxis, and fear of hospital infection were the medical reasons for antibiotic self-medication. Commonly self-administered antibiotics were azithromycin (34%), amoxicillin/clavulanic acid (22%), and metronidazole (16%) for perceived respiratory tract and gastrointestinal tract infections. CONCLUSIONS The high prevalence of antibiotic self-medication observed during the COVID-19 pandemic underscores the need for enhanced public education and stricter enforcement of regulations governing antibiotic sales. The non-medical and medical factors of convenience, avoiding long hospital queues, previous successful experience, easy access to antibiotics, treating symptoms, prophylaxis, and fear of hospital infection which motivated antibiotic self-medication practices require the implementation of antimicrobial stewardship interventions.
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Affiliation(s)
- Henry Kwadwo Hackman
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Lawrence Annison
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Reuben Essel Arhin
- Department of Science Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - George Osei Adjei
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Phyllis Otu
- Department of Science Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Emele Arthur-Hayford
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Sharon Annison
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Bernard Bortei Borteih
- Department of Animal Research Institute, Council for Scientific and Industrial Research (CSIR), Accra, Ghana
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Tettey R, Egyir B, Tettey P, Arko-Mensah J, Addo SO, Owusu-Nyantakyi C, Boateng W, Fobil J. Genomic analysis of multidrug-resistant Escherichia coli from Urban Environmental water sources in Accra, Ghana, Provides Insights into public health implications. PLoS One 2024; 19:e0301531. [PMID: 38787855 PMCID: PMC11125565 DOI: 10.1371/journal.pone.0301531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/18/2024] [Indexed: 05/26/2024] Open
Abstract
Wastewater discharge into the environment in resource-poor countries poses a threat to public health. Studies in this area within these countries are limited, and the use of high-throughput whole-genome sequencing technologies is lacking. Therefore, understanding of environmental impacts is inadequate. The present study investigated the antibiotic resistance profiles and diversity of beta-lactamases in Escherichia coli strains isolated from environmental water sources in Accra, Ghana. Microbiological analyses were conducted on wastewater samples from three hospitals, a sewage and wastewater treatment plant, and water samples from two urban surface water bodies. Confirmed isolates (N = 57) were selected for phenotypic antibiotic resistance profiles. Multi-drug-resistant isolates (n = 25) were genome sequenced using Illumina MiSeq sequencing technology and screened for sequence types, antibiotic resistance, virulence and beta-lactamase genes, and mobile genetic elements. Isolates were frequently resistant to ampicillin (63%), meropenem (47%), azithromycin (46%), and sulfamethoxazole-trimethoprim (42%). Twenty different sequence types (STs) were identified, including clinically relevant ones such as ST167 and ST21. Five isolates were assigned to novel STs: ST14531 (n = 2), ST14536, ST14537, and ST14538. The isolates belonged to phylogroups A (52%), B1 (44%), and B2 (4%) and carried β-lactamase (TEM-1B, TEM-1C, CTX-M-15, and blaDHA-1) and carbapenemase (OXA-1, OXA-181) resistance genes. Dominant plasmid replicons included Col440I (10.2%) and IncFIB (AP001918) (6.8%). Polluted urban environments in Accra are reservoirs for antibiotic-resistant bacteria, posing a substantial public health risk. The findings underscore the need for targeted public health interventions to mitigate the spread of antibiotic-resistant bacteria and protect public health.
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Affiliation(s)
- Rebecca Tettey
- Department of Biological, Environmental, and Occupational Health Science, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Beverly Egyir
- West African Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Prudence Tettey
- Department of Biological, Environmental, and Occupational Health Science, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - John Arko-Mensah
- Department of Biological, Environmental, and Occupational Health Science, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- West African Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Samuel Ofori Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Christian Owusu-Nyantakyi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - William Boateng
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Julius Fobil
- West African Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Tohan MM, Ahmed F, Juie IJ, Kabir A, Howlader MH, Rahman MA. Knowledge attitude and convenience on self-medication practices among university students in Bangladesh exploration using structural equation modeling approach. Sci Rep 2024; 14:10837. [PMID: 38735980 PMCID: PMC11089040 DOI: 10.1038/s41598-024-60931-9] [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: 09/05/2023] [Accepted: 04/29/2024] [Indexed: 05/14/2024] Open
Abstract
Self-medication is a prevalent practice among university students globally and is a significant public health concern. However, previous research has been limited in scope, focusing primarily on adolescents or the general public, leaving a gap in understanding the causal relationships associated with self-medication; thus, this study aimed to investigate the factors influencing self-medication practices among university students in Bangladesh by developing a comprehensive causal model. Data from 417 students across five public universities were collected using the simple random walk technique by a team of 10 members. The study utilized constructs of knowledge, attitude, and convenience related to self-medication as independent variables, while self-medication practice as the dependent variable. One-way ANOVA and structural equation modeling (SEM) were employed to develop a causal model of self-medication practice among university students in Bangladesh. The findings revealed that students with better medication knowledge and adverse drug reactions (ADRs) were more likely to practice self-medication. A positive attitude towards self-medication and ADRs was also significantly associated with higher self-medication practice scores. Additionally, those who perceived self-medication as convenient and prescribed medication as inconvenient had higher self-medication practice scores. The attitude towards self-medication had the most substantial negative effect on self-medication practice, followed by the inconvenience of prescribed medication and the convenience of self-medication. The model explained 87% of the variance in self-medication practice, indicating a good fit for the data. University students in Bangladesh possess intermediate knowledge of medication and primary knowledge of ADRs. They exhibit a positive attitude towards self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Policymakers should focus on evidence-based guidelines to reduce the extent of unnecessary self-medication practice and to enhance the quantity and accessibility of prescribed medications to address the issue effectively.
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Affiliation(s)
- Mortuja Mahamud Tohan
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Faysal Ahmed
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Israt Jahan Juie
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Anamul Kabir
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Md Hasan Howlader
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Md Ashfikur Rahman
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh.
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Ali HT, Barakat M, Abdelhalim AR, Al-Kurd IN, Muhammad MKE, Sharkawy MM, Elbahnasawy M, Amer SA. Unravelling the dilemma of self-medication in Egypt: a cross-sectional survey on knowledge, attitude, and practice of the general Egyptian population. BMC Public Health 2024; 24:652. [PMID: 38429721 PMCID: PMC10905903 DOI: 10.1186/s12889-024-17913-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Self-medication (SM) is a rising public health issue, especially in developing countries. It can be associated with various problems such as the delayed seeking of medical advice, drug interactions, and serious events such as antimicrobial drug resistance. We aimed to evaluate the Egyptian general population's knowledge, attitudes, and practices of SM. METHODS We employed a cross-sectional design between February 7th and March 8th, 2023 using a self-administered questionnaire available in Arabic. The questionnaire was developed based on previous studies and included four domains: sociodemographic data, knowledge, attitude, and practice of SM. We utilized both online (Google Forms) and paper surveys, utilizing convenience and snowball sampling methods. Data were analyzed using R Statistical Software (v4.1.3; R Core Team 2022). RESULTS 1630 Egyptian individuals (838 females and 792 males) from the seven provinces were enrolled, with a median age of 25 years (IQR: 22-40). Around 55.97% and 48.28% of the participants had good knowledge and favorable attitudes regarding SM respectively, while 62.8% had practiced SM in the previous three months. The most frequently used medications were painkillers (60.74%) followed by antibiotics (32.13%) and antipyretics (28.61%). The pharmacist's recommendation was the source of SM for 53.61% while 31.53% used old medications at home. Most participants (59.08%) practiced SM because they thought they had simple or minor symptoms. The multivariate regression analysis revealed that females had significantly higher knowledge of SM than males (aOR: 2.10; 95%CI: 1.64-2.71; p-value < 0.001), with no significant differences in practice (aOR: 1.24; 95%CI: 0.99 - 1.56; p-value = 0.065). Individuals working or studying in the medical field were significantly more knowledgeable about SM (aOR: 4.30; 95%CI: 3.27-5.69; p-value < 0.001) and more likely to practice SM (aOR: 1.65; 95%CI: 1.26-2.17; p-value < 0.001). The odds of SM decreased with favorable attitudes (aOR: 0.44; 95%CI: 0.36-0.55; p-value < 0.001) while surprisingly, knowledge level was not significantly contributing to SM practice (aOR: 1.15; 95%CI: 0.90-1.48; p-value = 0.268). CONCLUSIONS SM is prevalent in Egypt, highlighting the importance of raising awareness and encouraging physician consultation as a priority. Governments, healthcare organizations, and educational institutions need to collaborate to provide the necessary support and resources.
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Affiliation(s)
| | - Mostafa Barakat
- Qena Faculty of Medicine, South Valley University, Qena, 83621, Egypt
| | | | | | | | | | - Mohamed Elbahnasawy
- Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Samar Ahmed Amer
- Department of Public Health and Community Medicine, Family Medicine, Membership at Royal College of General Practice [INT], Ministry Of Health (MOH) Saudi Arabia, Zagazig University, EgyptLondon, UK
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Shitindi L, Issa O, Poyongo BP, Horumpende PG, Kagashe GA, Sangeda RZ. Comparison of knowledge, attitude, practice and predictors of self-medication with antibiotics among medical and non-medical students in Tanzania. Front Pharmacol 2024; 14:1301561. [PMID: 38273839 PMCID: PMC10808591 DOI: 10.3389/fphar.2023.1301561] [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: 09/28/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction: Self-medication with antibiotics (SMA) is a widespread problem in developing nations, including Tanzania. Methods: This study compared knowledge, attitudes, practices, and factors influencing antibiotic SMA among medical and non-medical students. Results: The prevalence of SMA among medical students was 49.1% and 59.2% among non-medical students, respectively. The mean knowledge score of medical students (6.4) was significantly higher (p-value <0.001) than that of non-medical students (5.6). The main factors influencing SMA practices were the availability of antibiotics without a prescription, easy access to pharmacies, and a lack of knowledge about the risks of SMA. This experience was pivotal in influencing medical students to take antibiotics, with a substantial proportion of 67.5% as opposed to 59.4% of non-medical students. Medical students were 1.6 times more likely to self-medicate with antibiotics than non-medical students (Adjusted Odds Ratio (AOR): 1.6; 95% Confidence Interval (CI): 1.2-2.3, p-value = 0.004). Age was also associated with self-medication, with an AOR of 1.1 (95% CI: 1.04-1.2, p-value = 0.006) per year increase in age. Additionally, attitude was associated with self-medication, with an AOR of 1.05 (95% CI: 1.04-1.1, p-value = 0.001) per unit increase in attitude score. Discussion: No significant associations were found between sex, marital status, having children, year of study, knowledge score, and self-medication with antibiotics. This study emphasizes the importance of educational interventions and public awareness campaigns to promote antimicrobial stewardship, appropriate antibiotic use, and preventing pharmacies from dispensing antibiotics without a prescription.
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Affiliation(s)
- Lusajo Shitindi
- Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Omary Issa
- Department of Pharmaceutics and Pharmacy Practice, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Baraka P. Poyongo
- Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Pius Gerald Horumpende
- Department of Biochemistry and Molecular Biology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute (KCRI), Moshi, Tanzania
- Lugalo Infectious Diseases Hospital and Research Centre, General Military Hospital (GMH) and Military College of Medical Sciences (MCMS), Dar es Salaam, Tanzania
| | - Godeliver A. Kagashe
- Department of Pharmaceutics and Pharmacy Practice, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Raphael Z. Sangeda
- Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Asante AA, Bandoh DA, Kenu E. Self-medication with antibiotics among out-patient attendants at Madina Polyclinic prior to medical consultation. Ghana Med J 2023; 57:308-315. [PMID: 38957850 PMCID: PMC11215222 DOI: 10.4314/gmj.v57i4.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Abstract
Objectives The study aimed to determine the prevalence of self-medication with antibiotics among attendants of the Out-patient Department (OPD) at Madina Polyclinic before seeking medical consultation and associated factors. Design Cross-sectional study. Setting The study was conducted at Madina Polyclinic. Participants The study involved 319 general OPD attendants aged 18 years and above accessing healthcare services at the Madina Polyclinic between May and June 2019. Main outcome measures The prevalence of antibiotic self-medication and the factors associated with this practice. Results From the study, 46.4% (95% CI 40.8%- 52.0%) had self-medicated with antibiotics before presenting for medical consultation at the hospital. Less than half of the respondents (44.5%) had adequate knowledge about the use of antibiotics. Having a tertiary level of education was significantly associated with self-medication (aOR= 8.09, 95% CI 2.31-28.4, p = 0.001), whilst adequate knowledge on the use of antibiotics reduced the odds of self-medication by 53% (aOR= 0.47, 95% CI 0.23- 0.66, p<0.001). The level of education modified the relationship between knowledge and self-medication with antibiotics. Conclusion The practice of antibiotic self-medication is rife among OPD attendants. Therefore, adequate public education on the use of antibiotics and the effects of using them inappropriately must be done. The Antimicrobial Resistance (AMR) policy ought to be reinforced and made known to all, especially among the pharmacies that dispense antibiotics indiscriminately. Funding None declared.
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Affiliation(s)
- Adelaide A Asante
- University of Ghana School of Public Health, Department of Epidemiology and Disease Control, College of Health Sciences, Accra, Ghana
| | - Delia A Bandoh
- University of Ghana School of Public Health, Department of Epidemiology and Disease Control, College of Health Sciences, Accra, Ghana
| | - Ernest Kenu
- Internal Medicine Department, Korle-Bu Teaching Hospital, Accra, Ghana
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Sampah J, Owusu-Frimpong I, Aboagye FT, Owusu-Ofori A. Prevalence of carbapenem-resistant and extended-spectrum beta-lactamase-producing Enterobacteriaceae in a teaching hospital in Ghana. PLoS One 2023; 18:e0274156. [PMID: 37903118 PMCID: PMC10615269 DOI: 10.1371/journal.pone.0274156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/18/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Carbapenem-resistant Enterobacteriaceae (CRE) and Extended-spectrum beta-lactamase (ESBL) production among Gram-negative Enterobacteriaceae is an increasing global challenge due to the high morbidity and mortality associated with their infections, especially in developing countries where there are little antibiotic treatment options. Despite these challenges, few studies in Ghana have described the burden of CRE. Therefore, this study aimed to determine the prevalence of carbapenem-resistant Enterobacteriaceae isolated from patients at the Cape Coast Teaching Hospital (CCTH) in the Central region of Ghana. METHODOLOGY/PRINCIPAL FINDINGS Enterobacteriaceae isolates were collected from April to July 2019 at the bacteriology unit of CCTH using a consecutive sampling method. Isolates were identified by standard microbiological techniques and confirmed using API 20E. Kirby Bauer disc diffusion method was used to determine the antibiogram of isolates. Isolates were also subjected to ESBL testing using the single-disc combination method. Carbapenem-resistant isolates were identified by the Kirby Bauer disc diffusion method and then examined genotypically for the presence of blaKPC-1, blaIMP-1, blaVIM-1, blaNDM-1, and blaOXA-48 genes via polymerase chain reaction (PCR). Of the 230 isolates comprising E. coli (40.9%), Citrobacter spp. (32.6%), K. pneumoniae (9.1%), P. mirabilis (6.1%), P. vulgaris (5.2%), Enterobacter spp (3.5%)., K. oxytoca (2.2%), and Serratia marcenses (0.4%). Most isolates were from urine 162(70.4%) and wound samples. The isolates showed high resistance to ampicillin 171 (74.3%) and cefuroxime 134(58.3%). The prevalence of MDR was 35.2% (81), with E. coli 40(42.6%) being the majority that exhibited MDR. Of the 230 isolates, 113(49.1%) were ESBL producers, with E. coli 54(57.5%) accounting for the majority, while Serratia marcenses was the least. Of the 13 (5.7%) CRE isolates that showed resistance towards carbapenem in the disc diffusion method, 11 showed the presence of the blaNDM-1 gene, while all isolates showed the presence of the blaOXA-48 gene. CONCLUSION The prevalence of carbapenem resistance and ESBL-producing Enterobacteriaceae pathogens among patients at the Cape Coast Teaching Hospital is high and alarming. Therefore, it is imperative to consider effective infection prevention and control measures should be implemented at the hospital to prevent the rapid spread of these dangerous organisms.
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Affiliation(s)
- James Sampah
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Laboratory Department, St. Patrick’s Hospital, Offinso, Ghana
| | - Isaac Owusu-Frimpong
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Frank Twum Aboagye
- CSIR-Water Research Institute, Biomedical and Public Health Research Unit, Accra, Ghana
| | - Alex Owusu-Ofori
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Clinical Microbiology Unit, Laboratory Services Directorate Komfo Anokye Teaching Hospital, Kumasi, Ghana
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Boakye-Yiadom E, Najjemba R, Thekkur P, Labi AK, Gil-Cuesta J, Asafo-Adjei K, Mensah P, van Boetzelaer E, Jessani NS, Orish VN. Use and Quality of Blood Cultures for the Diagnosis of Bloodstream Infections: A Cross-Sectional Study in the Ho Teaching Hospital, Ghana, 2019-2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6631. [PMID: 37681771 PMCID: PMC10487590 DOI: 10.3390/ijerph20176631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/22/2023] [Accepted: 08/17/2023] [Indexed: 09/09/2023]
Abstract
Blood Culture and Drug Susceptibility Testing (CDST) remains vital for the diagnosis and management of bloodstream infections (BSIs). While the Ghana National Standard Treatment Guidelines require CDST to be performed in each case of suspected or clinically diagnosed BSI, these are poorly adhered to in the Ho Teaching Hospital (HTH). This study used secondary medical and laboratory records to describe blood CDST requests by clinicians and the quality of CDST processes for the diagnosis of BSI among patients admitted to HTH from 2019 to 2021. Of 4278 patients, 33% were infants. Pneumonia and neonatal sepsis cases were 40% and 22%, respectively. Only 8% (351/4278) had blood CDST requested. Of 94% (329/351) blood CDST processed and reported, only 7% (22/329) were culture-positive, with likely contaminants being recovered from 16% (52/329) of the specimens. The duration from admission to request was 2 days (IQR: 0-5), and Further qualitative studies must be conducted to understand the reasons for low blood CDST utilisation among clinicians and the patient outcomes. Targeted interventions are required to enhance the utilisation of blood CDST by clinicians and the quality of laboratory processes.
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Affiliation(s)
- Emily Boakye-Yiadom
- Department of Microbiology and Immunology, University of Health and Allied Sciences, Ho PMB 31, Volta Region, Ghana;
- Laboratory Department, Ho Teaching Hospital, Ho P.O. Box MA 374, Volta Region, Ghana; (K.A.-A.); (P.M.)
| | | | - Pruthu Thekkur
- International Union Against Tuberculosis and Lung Disease, 68 Boulevard Saint Michel, 75006 Paris, France;
| | - Appiah-Korang Labi
- Ghana Country Office, World Health Organization, 7 Ameda Street, Roman Ridge, Accra P.O. Box MB 142, Ghana;
| | - Julita Gil-Cuesta
- Luxembourg Operational Research Unit, Operational Centre Brussels, Médecins Sans Frontières, Rue Arbre Benit 46, 1050 Brussels, Belgium;
| | - Karikari Asafo-Adjei
- Laboratory Department, Ho Teaching Hospital, Ho P.O. Box MA 374, Volta Region, Ghana; (K.A.-A.); (P.M.)
| | - Prosper Mensah
- Laboratory Department, Ho Teaching Hospital, Ho P.O. Box MA 374, Volta Region, Ghana; (K.A.-A.); (P.M.)
| | - Elburg van Boetzelaer
- Luxembourg Operational Research Unit, Médecins Sans Frontières, 68 Rue de Gasperich, L-1617 Luxembourg, Luxembourg;
| | - Nasreen S. Jessani
- Centre for Evidence-Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Tygerburg 7505, South Africa;
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Verner Ndudri Orish
- Department of Microbiology and Immunology, University of Health and Allied Sciences, Ho PMB 31, Volta Region, Ghana;
- Sickle Cell Disease Unit, Department of Internal Medicine, Ho Teaching Hospital, Ho P.O. Box MA 374, Volta Region, Ghana
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Nakakande J, Taremwa IM, Nanyingi M, Mugambe S. The Utility of Internet-Enabled Antibiotic Self-Medication and Its Associated Factors Among Patients Attending Private Clinics in Kawempe Division in Kampala Capital City, Uganda: Community-Based Cross-Sectional Study. Drug Healthc Patient Saf 2023; 15:85-91. [PMID: 37035632 PMCID: PMC10081524 DOI: 10.2147/dhps.s405072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/28/2023] [Indexed: 04/04/2023] Open
Abstract
Introduction The expanding practice of internet-based antibiotic self-medication raises public health concerns as it increases antibiotic resistance and introduces avoidable risks. This study aims to examine the utility of internet-enabled antibiotic self-medication and its associated factors among patients attending private clinics in Kawempe division in Kampala Capital City, Uganda. Methods This was an analytical cross-sectional study that enrolled participants attending private clinics in Kawempe Division's randomly selected zones. These were interviewed using a structured questionnaire, and the data were analyzed using STATA version 12 software. Logistic regression analysis was used, and variables with p ≤ 0.05 were considered as significantly associated with internet-enabled antibiotic self-medication. Results Out of the 313 respondents, 246 (79%) reportedly had ever used internet sources to self-medicate with antibiotics. Factors such as being male; single; had knowledge of antibiotics; believed that Internet should be used for antibiotic self-medication; Distance to the nearest medical center/hospital from your residence/workplace of about 5 km and residing near a drug shop/pharmacy that gives antibiotics without a prescription increased internet-enabled antibiotic self-medication. Furthermore, the variables of more than three household members; common practice of antibiotic self-medication in a household; did not agree that one can recover from the illness without a doctor's prescription and medical workers who did not explain adequately the antibiotics medication given for the illness decreased internet-enabled antibiotic self-medication. Conclusion This study found that internet-enabled antibiotic self-medication practice is highly utilized and is associated with a variety of individual, household, and healthcare system factors. This necessitates strict adherence to national drug policy regulations governing antibiotic use. Furthermore, community health education is critical in combating such medication practices.
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Affiliation(s)
- Joan Nakakande
- Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
- Correspondence: Joan Nakakande; Ivan Mugisha Taremwa, Email ;
| | - Ivan Mugisha Taremwa
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Miisa Nanyingi
- Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Samuel Mugambe
- Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
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Opoku R, Dwumfour-Asare B, Agrey-Bluwey L, Appiah NE, Ackah M, Acquah F, Asenso PF, Issaka AA. Prevalence of self-medication in Ghana: a systematic review and meta-analysis. BMJ Open 2023; 13:e064627. [PMID: 36963791 PMCID: PMC10439347 DOI: 10.1136/bmjopen-2022-064627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 03/14/2023] [Indexed: 03/26/2023] Open
Abstract
OBJECTIVES This study estimates the prevalence of self-medication and provides an understanding of the reasons for self-medication in Ghana through the synthesis of relevant literature. METHODS A comprehensive search was conducted in PubMed, Science Direct and African Journals Online to identify observational studies published from inception to March 2022. Google scholar and institutional websites were searched for grey literature. We included studies reporting primary data on the prevalence and/or reasons for self-medication in Ghana. Random-effects meta-analysis was used to estimate the prevalence of self-medication. Subgroup analysis was performed with the study population (pregnant women, patients and students), geopolitical zone (coastal, middle and northern) and study setting (rural and urban). Using inductive thematic analysis, reasons for self-medication were classified and tallied under key themes. RESULTS Thirty studies involving 9271 participants were included in this review. The pooled prevalence of self-medication in Ghana was 53.7% (95% CI 46.2% to 61.0%; I²=98.51%, p<0.001). Prevalence of self-medication was highest among pregnant women (65.5%; 95% CI 58.1% to 72.5%; I2=88%), in the middle belt of the country (62.1%; 95% CI 40.9% to 82.0%; I²=98%; p<0.001) and in rural settings (61.2%; 95% CI 36.5% to 84.5%; I²=98%; p<0.001). The most cited reasons for self-medication included long waiting time at health facilities (73.3%), previous use of drugs (66.7%) and the perceived unseriousness of diseases (53.3%). CONCLUSION This study has revealed that self-medication is still an unresolved public health challenge in Ghana, with a high prevalence estimate. Self-medication is influenced by inconveniences associated with accessing healthcare coupled with poor health seeking behaviours. There is the need for improved access to quality healthcare and the promotion of appropriate health-seeking behaviours.
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Affiliation(s)
- Richmond Opoku
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Bismark Dwumfour-Asare
- Department of Environmental Health & Sanitation Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Mampong, Ashanti, Ghana
| | - Lawrencia Agrey-Bluwey
- Department of Health Administration & Education, University of Education Winneba Faculty of Science Education, Winneba, Central, Ghana
| | - Nana Esi Appiah
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
- Maxillofacial Surgery Unit, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
| | - Michael Ackah
- Department of Public Health Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Mampong, Ashanti, Ghana
| | - Francis Acquah
- Department of Health Administration & Education, University of Education Winneba Faculty of Science Education, Winneba, Central, Ghana
| | - Priscilla Fordjour Asenso
- Department of Public Health Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Mampong, Ashanti, Ghana
| | - Abdul-Aziz Issaka
- Department of Public Health Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Mampong, Ashanti, Ghana
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Tadesse YB, Kassaw AT, Belachew EA. Evaluating self-medication practices in Ethiopia. J Pharm Policy Pract 2023; 16:47. [PMID: 36945071 PMCID: PMC10029313 DOI: 10.1186/s40545-023-00553-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Self-medication with antibiotics has become an important factor driving antibiotic resistance and it masks the signs and symptoms of the underlying disease and hence complicates the problem, increasing drug resistance and delaying diagnosis. This study aimed to assess the extent of self-medication practice with antibiotics and its associated factors among adult patients attending outpatient departments (OPD) at selected public Hospitals, in Addis Ababa, Ethiopia. METHODS Facility-based cross-sectional study was employed. A systematic random sampling technique was used to include the study participants. Self-administered with structured questionnaires were applied among patients who visited outpatient departments at selected public Hospitals, in Addis Ababa. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26. Descriptive statistics such as frequencies and percentages were used for the present categorical data. The data are presented in pie charts, tables, and bar graphs. Furthermore, bivariable and multivariable binary logistic regression analyses were used to identify significant associations. Statistical significance was declared at p value < 0.05. RESULTS Out of 421 respondents interviewed, 403 (95.7%) participants completed questionnaires. Among the respondents, 71% had generally practiced self-medication. Among these, 48.3% had self-medication with antibiotics, while 51.7% had used other drugs. The most commonly cited indication for self-medication practice was abdominal pain 44.9%, followed by Sore throat 21% commonly used antibiotics are amoxicillin (57%), ciprofloxacin (13%), amoxicillin/clavulanic (10%), erythromycin (8%), cotrimoxazole (7%), and doxycycline (5%). CONCLUSIONS Self-medication with antibiotics was common among the study participants. The prevalence of general self-medication was 71%, whereas that of self-medication with antibiotics was 48.3%. In general, the potentially dangerous effects of SMP seem to be underestimated by patients with OPD patients.
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Affiliation(s)
- Yabibal Berie Tadesse
- Pharmaceutical Chemistry Department, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia.
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Alzoubi A, Nasor EM, Suliman EMO, AlQaderi N, AbbasTanira SHI, Abdi SAH, Mustafa S, Kheirallah K. A Comparative Piloting of Determinants of Self-Medication Among University Students in the MENA Region; UAE and Jordan as an Example. Patient Prefer Adherence 2023; 17:699-709. [PMID: 36960181 PMCID: PMC10028299 DOI: 10.2147/ppa.s405279] [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] [Received: 01/18/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023] Open
Abstract
PURPOSE Unsupervised self-medication (SM) is a global public health concern. University students are particularly vulnerable due to misperceptions of improved academic performance and thus are at risk of dependence, addiction, and drug overdose. Past studies have shown an alarming prevalence of SM among university students in the Middle East and North Africa (MENA) region. However, there is a scarcity of reports from the region dissecting determinants of SM. Therefore, this study aimed to determine the prevalence and epidemiological correlates of SM among university students and its perceived impact on their academic performance. METHODS Two countries in the MENA region were surveyed in a cross-sectional design; UAE and Jordan. Through a stratified sampling technique, undergraduate students in both healthcare and non-healthcare majors of study were recruited to participate. A structured, self-administered questionnaire developed for the purpose of this study was distributed to consented participants via the university's official email. Statistical analyses were performed using SPSS. Descriptive and inferential statistics were used to analyze data. A p-value <0.05 was considered statistically significant. RESULTS A total of 362 students participated in the study (74% were females, 60% were from the UAE, and 59% were in healthcare majors). Significantly higher prevalence rates and adjusted odds of SM were found among females, students from Jordan, and those in healthcare majors, particularly for paracetamol (90.2% of females [p=0.001], 88.3% from Jordan [p=0.03], 92.5% in healthcare majors [p=0.001]) and antibacterial drugs (48.9% of females [p=0.01], 60.7% from Jordan [p=0.001], 53.3% in healthcare majors [p=0.001]). Majoring in healthcare fields was the most consistent determinant of such practice, while social influences of family and friends represented the chief source of recommendation. Only 21% of respondents assumed SM boosts their academic performance. CONCLUSION Our pilot study underlines the predominant determinants of SM among university students in the MENA region, namely female gender, students from Jordan, and those in healthcare majors. Informed data-driven awareness campaigns to mitigate such practice should be designed to focus on these susceptible populations.
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Affiliation(s)
- Abdallah Alzoubi
- Department of Pathological Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Correspondence: Abdallah Alzoubi, Department of Pathological Sciences, College of Medicine, Ajman University, P.O. Box 346, Ajman, United Arab Emirates, Tel +971 6 705 5340, Fax +971 6 743 8888, Email
| | - Eiman M Nasor
- Department of Pathological Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates
| | - Elaf M O Suliman
- Department of Pathological Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates
| | - Nour AlQaderi
- Department of Pathological Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates
| | - Shahd H I AbbasTanira
- Department of Pathological Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates
| | - Syed Ali Hussein Abdi
- Department of Pathological Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates
| | - Shadi Mustafa
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid Kheirallah
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Saha A, Marma KKS, Rashid A, Tarannum N, Das S, Chowdhury T, Afrin N, Chakraborty P, Emran M, Mehedi HMH, Hussain MI, Barua A, Mistry SK. Risk factors associated with self-medication among the indigenous communities of Chittagong Hill Tracts, Bangladesh. PLoS One 2022; 17:e0269622. [PMID: 35696405 PMCID: PMC9191716 DOI: 10.1371/journal.pone.0269622] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background In developing countries like Bangladesh, self-medication has become a predicament associated with health risks and clinical complications. To date, no studies have been conducted on the practice of self-medication among the indigenous population living in Chittagong Hill Tract (CHT). Objectives This study was aimed to determine the prevalence of self-medication and analyzing the factors associated with it among the indigenous population in CHT. Methods This cross-sectional study was conducted from late October to early December 2020; among different indigenous group populations residing in the three districts of CHT aged 18 or more. A pre-tested and semi-structured questionnaire was developed to collect data on socio-demographic characteristics, health status, frequency of self-medication, reasons for self-medication in last one year, as well as other variables. Multivariate logistic regression was performed to assess associated factors with self-medication. Results A total of 1350 people from different indigenous populations were interviewed, among whom 49.9% practiced self-medication. The rate of self-prescribed antibiotics usage (80.9%) was significantly higher compared to other drugs. Self-prescribed medications were mostly used for diarrhea and food poisoning (60.6%), cough, cold and fever (51.4%), and headache (51.4%). A common source of self-prescribed medicines was community or retail pharmacy and the most reported reason for self-prescribed medication was the long-distance of healthcare facilities from home. Conclusion The prevalence of self-medication is substantially high among indigenous people and the effect is alarming. Particular concern is the misuse of antibiotics and analgesic drugs. Increasing awareness among the population of the negative effect of self-medication and implementation of proper policies and actions are urgently needed to prevent self-medication among indigenous population in Bangladesh.
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Affiliation(s)
- Ayan Saha
- Department of Genetic Engineering and Biotechnology, East West University, Dhaka, Bangladesh
- * E-mail: ,
| | | | - Afrah Rashid
- Department of Public Health and Bioinformatics, Asian University for Women, Chattogram, Bangladesh
| | - Nowshin Tarannum
- Department of Microbiology, University of Chittagong, Chattogram, Bangladesh
| | - Srabanty Das
- Department of Biochemistry and Molecular Biology, University of Chittagong, Chattogram, Bangladesh
| | | | - Nusrat Afrin
- Department of Pharmacy, University of Chittagong, Chattogram, Bangladesh
| | - Prashanta Chakraborty
- Department of Genetic Engineering and Biotechnology, University of Chittagong, Chattogram, Bangladesh
| | - Md. Emran
- Department of Biochemistry & Biotechnology, University of Science & Technology Chittagong, Chattogram, Bangladesh
| | | | | | - Ashim Barua
- Upazila Health Complex, Alikadam, Bandarban, Bangladesh
| | - Sabuj Kanti Mistry
- ARCED Foundation, Mirpur, Dhaka, Bangladesh
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
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Shembo AKP, Musumari PM, Srithanaviboonchai K, Tangmunkongvorakul A, Dalleur O. A qualitative study on community use of antibiotics in Kinshasa, Democratic Republic of Congo. PLoS One 2022; 17:e0267544. [PMID: 35476752 PMCID: PMC9045656 DOI: 10.1371/journal.pone.0267544] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Resistance to antibiotics is an increasing and major threat to global health. While the large majority of antimicrobial use occurs in the community where antibiotics are available without prescription, we did not find any studies investigating community-level factors influencing the inappropriate use of antibiotics in the Democratic Republic of Congo (DRC), where non-prescription antibiotic use is prevalent. METHODS This qualitative study was conducted from April 1st 2019 to May 5th 2019 and consisting of in-depth semi-structured interviews, utilizing purposive and snowball sampling schemes to recruit adult heads of households in the Pakadjuma slum, in Kinshasa, DRC. Participants with differing medical and educational backgrounds were selected. We employed a thematic analysis approach to explore community knowledge and use of antibiotics in the sampled population. RESULTS A total of 18 participants with a median age of 35 years were interviewed. The majority was female (77.7%), had at least a secondary education (83.4%), and unemployed (61.1%). We found that participants were familiar with the term "antibiotics", but had limited knowledge of the indications and risks of antibiotics, including the risk of antibiotic resistance. Inappropriate use of antibiotics was common and there was frequent self-medication of non-prescribed medicines for a range of non-indicated conditions such as menstruation. Having limited income was the most commonly reported reason for not visiting a health facility for appropriate health care. CONCLUSION Inappropriate use of antibiotics is a widespread practice and is influenced by lack of adequate knowledge of antibiotic use, indications and risks, prevalent self-medication, and financial barriers to accessing appropriate health care. There is need for both community education as well as structural interventions addressing poverty in order to reduce the inappropriate use of antibiotics in the Pakadjuma slum in Kinshasa.
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Affiliation(s)
| | - Patou Masika Musumari
- Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Sakyo-ku, Kyoto, Japan
- Research Institute for Health Sciences, Chiang Mai University, Sriphum, Muang Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, Sriphum, Muang Chiang Mai, Thailand
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Sriphum, Muang, Chiang Mai, Thailand
| | | | - Olivia Dalleur
- Clinical Pharmacy–Louvain Drug Research Institute, Université Catholique de Louvain UCLouvain, Brussels, Belgium
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Amponsah SK, Odamtten G, Adams I, Kretchy IA. A comparative analysis of pattern and attitude towards self-medication among pharmacy and non-pharmacy students in University of Ghana. Pan Afr Med J 2022; 41:254. [PMID: 35734338 PMCID: PMC9188003 DOI: 10.11604/pamj.2022.41.254.31013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 03/06/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction self-medication involves the use of medicines without the input of health professionals. Available studies are not entirely conclusive on self-medication among health science versus non-health science university students. The current study therefore sought to investigate relevant aspects of self-medication among pharmacy and non-pharmacy students. Methods this quantitative cross-sectional research was conducted among undergraduate pharmacy and non-pharmacy students of the University of Ghana from October 1st 2019 to December 6th 2019. Using a questionnaire, interviews were conducted to assess the pattern and attitude towards self-medication among respondents within the last 2 months. Results a total of 337 (163 pharmacy and 174 non-pharmacy) students filled and completed questionnaires. The prevalence of self-medication was 55.2% for pharmacy and 51.1% for non-pharmacy students. Both pharmacy and non-pharmacy students were either accepting or ambivalent towards self-medication. Painkillers were the major class of medications that were self-medicated by both pharmacy (38.5%) and non-pharmacy students (30.7%). The most common reason for self-medication among pharmacy (62.2%) and non-pharmacy (56.2%) students was the need for rapid relief from an illness. Majority of the participants who were self-medicated (27.6% among non-pharmacy and 36.8% among pharmacy students) demonstrated ambivalent attitude towards self-medication. An increase in the study level reduced the likelihood of self-medication in both pharmacy and non-pharmacy students: OR=0.442, CI = 0.266-0.736 for pharmacy students and OR=0.671, CI = 0.456-0.987 for non-pharmacy students. Conclusion self-medication is common students of the University of Ghana. Prevalence of self-medication was higher among pharmacy students than non-pharmacy students. This study provides data for targeted education and sensitisation of self-medication among university students.
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Affiliation(s)
- Seth Kwabena Amponsah
- Department of Medical Pharmacology, University of Ghana Medical School, Accra, Ghana
| | - Gifty Odamtten
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Ghana, Accra, Ghana
| | - Ismaila Adams
- Department of Medical Pharmacology, University of Ghana Medical School, Accra, Ghana
| | - Irene Akwo Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Accra, Ghana,Corresponding author: Irene Akwo Kretchy, Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Accra, Ghana.
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Demissie F, Ereso K, Paulos G. Self-Medication Practice with Antibiotics and Its Associated Factors Among Community of Bule-Hora Town, South West Ethiopia. Drug Healthc Patient Saf 2022; 14:9-18. [PMID: 35115843 PMCID: PMC8801374 DOI: 10.2147/dhps.s325150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background Self-medication with antibiotics is being practiced worldwide with high prevalence, mostly in developing countries. Several factors induce the practice of self-medication, such as irrational and uncontrolled dispensing of medicinal substances, difficulty accessing health-care systems, and cost of diagnosis. Thus, this study assessed the prevalence of self-medication with antibiotics, and its associated factors among the community of Bule-Hora town, South West Ethiopia. Methods A community-based cross-sectional study design was used. All households residing in Bule Hora town were used as source population and households in the selected kebeles were included by using a systematic random sampling method. Eight hundred twenty-six study participants were selected for the study. Pre-tested structured questionnaires had been used to collect the required data. Then the collected data were checked for completeness and analyzed by using SPSS version 20. Odds ratios with 95% C.I. were used to measure the association between independent variables and outcome and variables with p-value <0.05 had been considered statistically significant. Results Prevalence of self-medication with antibiotics in the past 12 months prior to the data collection was found to be 38.9% [95% CI (1.56, 1.64)]. Being male (AOR = 1.53; 95% CI: 0.489, 0.869) with p value of 0.004, no health insurance scheme (AOR = 2.16; 95% CI: 0.274, 0.779) and availability of some drugs in shop (AOR = 12.98; 95% CI: 0.017, 0.353) with p value of 0.001 were found to be significantly associated with self-medication of antibiotics. Conclusion The study revealed that more than one-third of the respondents practiced self-medication. Availability and irrational dispensing of some drugs in the shops were significantly associated with self-medication practice. Therefore, it is important to educate society on the appropriate use of drugs and discourage the use of prescription drugs without medication order.
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Affiliation(s)
- Fitsum Demissie
- Department of Pharmacy, Institute of Health, Bule-Hora University, Bule-Hora, Oromia, Ethiopia
| | - Kelil Ereso
- Department of Pharmacy, Institute of Health, Bule-Hora University, Bule-Hora, Oromia, Ethiopia
| | - Getahun Paulos
- Department of Pharmaceutics, School of Pharmacy, Institute of Health Sciences, Jimma University, Jimma, Oromia, Ethiopia
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Insights and genetic features of extended-spectrum beta-lactamase producing Escherichia coli isolates from two hospitals in Ghana. Sci Rep 2022; 12:1843. [PMID: 35115628 PMCID: PMC8813988 DOI: 10.1038/s41598-022-05869-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 01/17/2022] [Indexed: 12/18/2022] Open
Abstract
Recently, the emergence and rapid dissemination of extended-spectrum beta-lactamase (ESBL)-producing bacteria, particularly of the family Enterobacteriaceae, has posed serious healthcare challenges. Here, we determined the antimicrobial susceptibility and genetic characteristics of 164 Escherichia coli strains isolated from infected patients in two hospitals in Ghana. In total, 102 cefotaxime-resistant isolates (62.2%) were identified as ESBL-producers. Multilocus sequence typing of the ESBL-producers identified 20 different sequence types (STs) with ST131 (n = 25, 24.5%) as the dominant group. Other detected STs included ST410 (n = 21, 20.6%) and ST617 (n = 19, 18.6%). All identified ESBL-producers harbored blaCTX-M-14, blaCTX-M-15, or blaCTX-M-27, with blaCTX-M-15 (n = 96, 94.1%) being the most predominant ESBL allele. Further analysis showed that the immediate genetic environment around blaCTX-M-15 is conserved within blaCTX-M-15 containing strains. Five of the 25 ST131 isolates were clustered with clade A, one with sub-clade C1, and 19 with the dominant sub-clade C2. The results show that fluoroquinolone-resistant, blaCTX-M-14- and blaCTX- M-15-producing ESBL E. coli ST131 strains belonging to clade A and sub-clades C1 and C2 are disseminating in Ghanaian hospitals. To the best of our knowledge, this is the first report of the ST131 phylogeny in Ghana.
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Jain K, Likhar S, Kot L. Self-medication practice and health-seeking behavior among medical students during COVID 19 pandemic: a cross-sectional study. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_107_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Otoo BA, Amoabeng IA, Darko G, Borquaye LS. Antibiotic and analgesic residues in the environment – Occurrence and ecological risk study from the Sunyani municipality, Ghana. Toxicol Rep 2022; 9:1491-1500. [DOI: 10.1016/j.toxrep.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022] Open
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Kassa T, Gedif T, Andualem T, Aferu T. Antibiotics self-medication practices among health care professionals in selected public hospitals of Addis Ababa, Ethiopia. Heliyon 2022; 8:e08825. [PMID: 35128109 PMCID: PMC8803584 DOI: 10.1016/j.heliyon.2022.e08825] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/08/2021] [Accepted: 01/20/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Self-medication is the first option and response to most illness episodes. Use of antimicrobials without health care professionals' guidance may result in greater probability of inappropriate use, missed diagnosis, delays in appropriate treatment, pathogen resistance and increased morbidity. There is no sector in the health care community which is immune to drug abuse or misuse of which the worst offenders include physicians, nurses and pharmacy professionals. Self-medication among health care professionals may be an indicator that the health professional is neglecting his or her own health. This represents serious issues for both patients and the professionals. OBJECTIVE To assess self-medication practices with antibiotics among health care professionals in selected hospitals of Addis Ababa, Ethiopia. METHOD Facility based cross-sectional study was conducted from April to May, 2017 among 317 health care professionals. Convenient sampling technique was used to select study participants. Data were collected through self-administered questionnaire and analyzed using Statistical Package for Social Sciences software version 20. Binary logistic regression analysis was done to check the relationship between the dependent variable (antibiotic self-medication) and selected independent variables (sex, age, marital status, income, professional qualification and work experience). RESULTS The prevalence of self-medication with antibiotics among health care professionals in one month recall period was found to be 72 (22.7%). The main reasons given for this practice were being familiar with the treatment options, 31 (43.1%) and need for rapid relief, 25 (34.7%). Respiratory problems, 29 (40.3%) and gastro intestinal problems, 28 (38.9%) were the most common illnesses for which self-medication with antibiotics was practiced while penicillins, 30 (41.6%) and fluoroquinolones, 29 (40.3%) constituted the two most commonly used antibiotics for the same. None of the variables had significant association with the practice of self-medication with antibiotics. CONCLUSION Self-medication with antibiotics was common among the study participants. Efforts should be made by health authorities including Drug and Therapeutics Committee, Drugs Regulatory Authority, Hospitals' management and other stakeholders to ensure safe usage of antibiotics.
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Affiliation(s)
- Tsehay Kassa
- Teklehaimanot Health Center, Addis Ababa, Ethiopia
| | - Teferi Gedif
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Temesgen Aferu
- School of Pharmacy, College of Medicine and Health Sciences, Mizan Tepi University, Mizan- Aman, Ethiopia
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Knowledge, Awareness and Practice with Antimicrobial Stewardship Programmes among Healthcare Providers in a Ghanaian Tertiary Hospital. Antibiotics (Basel) 2021; 11:antibiotics11010006. [PMID: 35052883 PMCID: PMC8773036 DOI: 10.3390/antibiotics11010006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 12/31/2022] Open
Abstract
Antimicrobial resistance (AMR) is a significant problem in global health today, particularly in low- and middle-income countries (LMICs) where antimicrobial stewardship programmes are yet to be successfully implemented. We established a partnership between AMR pharmacists from a UK NHS hospital and in Ho Teaching Hospital with the aim of enhancing antimicrobial stewardship knowledge and practice among healthcare providers through an educational intervention. We employed a mixed-method approach that included an initial survey on knowledge and awareness before and after training, followed by qualitative interviews with healthcare providers conducted six months after delivery of training. This study was carried out in two phases in Ho Teaching Hospital with healthcare professionals, including pharmacists, medical doctors, nurses and medical laboratory scientists. Ethical approval was obtained prior to data collection. In the first phase, we surveyed 50 healthcare providers, including nurses (33%), pharmacists (29%) and biomedical scientists (23%). Of these, 58% of participants had engaged in continuous professional development on AMR/AMS, and above 95% demonstrated good knowledge on the general use of antibiotics. A total of 18 participants, which included four medical doctors, five pharmacists, four nurses, two midwives and three biomedical scientists, were interviewed in the second phase and demonstrated greater awareness of AMS practices, particularly the role of education for patients, as well as healthcare professionals. We found that knowledge and practice with AMS was markedly improved six months after the training session. There is limited practice of AMS in LMICs; however, through AMR-focused training, we demonstrated improved AMS skills and practice among healthcare providers in Ho Teaching Hospital. There is a need for continuous AMR training sessions for healthcare professionals in resource-limited settings.
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Aworh MK, Kwaga JKP, Okolocha EC. Assessing knowledge, attitude, and practices of veterinarians towards antimicrobial use and stewardship as drivers of inappropriate use in Abuja, Nigeria. ONE HEALTH OUTLOOK 2021; 3:25. [PMID: 34930491 PMCID: PMC8690525 DOI: 10.1186/s42522-021-00058-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/09/2021] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Antimicrobial resistance (AMR) has recently gained worldwide recognition, as the emergence of multi-drug resistant organisms has led to increased mortality and economic burden. This study aimed to assess knowledge, attitudes, and practices of veterinarians towards rational antimicrobial prescribing and identify factors influencing use. METHODS We interviewed veterinary doctors in Abuja, Nigeria using a 50-point questionnaire distributed via WhatsApp mobile application. The questionnaire inquired about their experiences, knowledge, attitudes, and practices towards AMR and stewardship. We analyzed the data by calculating frequencies and proportions. RESULTS Of 220 registered veterinarians, 144 (65.5%) participated in the survey. Most (52.8%) were within the age group 30 - 39 years; males (72.2%), with a Master's degree (42.4%) and worked in public service (44.4%). Three-quarters (75.7%) had good knowledge of antimicrobials; 47.2% had received training on stewardship while 88.9% reported that they believed that overuse of antimicrobials was the major contributory factor towards AMR. Antimicrobial stewardship regulations are important in veterinary practice. Veterinarians were aware of the occurrence of resistant pathogens and agreed that restricting antimicrobial use in animal health care was necessary to reduce AMR. CONCLUSION Most respondents referred to the veterinary formulary (VF) when in doubt of the appropriate antimicrobial agent to administer. We recommend that the VF be updated following the WHO list of critically-important-antimicrobials (CIA) and veterinarians educated not to use these CIAs in the treatment of food animals.
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Affiliation(s)
- Mabel Kamweli Aworh
- Department of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, New Secretariat, Area 11, Garki, Abuja, Nigeria.
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
- Department of Veterinary Public Health and Preventive Medicine, Ahmadu Bello University, Zaria, Nigeria.
| | - Jacob Kwada Paghi Kwaga
- Department of Veterinary Public Health and Preventive Medicine, Ahmadu Bello University, Zaria, Nigeria
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Wireko S, Asiedu SO, Kini P, Aglomasa BC, Amewu EKA, Asiedu E, Osei-Akoto F, Boahen KG, Obiri-Yeboah D, Amato KR, Kwarteng A. Prevalence of Methicillin-Resistant Staphylococcus Species Among Filarial Lymphedema Patients in Ahanta West District of Ghana. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.786378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundFilarial pathologies such as lymphedema may be associated with complications such as chronic non-healing wounds. Nonetheless, the role of bacterial population colonizing the lymphedematous legs has been posited to worsen the conditions of those living with the infection. These bacteria are usually composed of staphylococcal species partly because they are commensals. Thus, this present study sought to type the methicillin-resistant Staphylococcus aureus (MRSA) prevalence among individuals presenting with filarial lymphedema, particularly as MRSA tends to affect treatments options.MethodsWe recruited individuals (n = 321) with stages I–VII of lymphedema in a cross-sectional study in the Ahanta West district of the Western Region of Ghana. Swabs from lymphedematous limb ulcers, pus, and cutaneous surfaces were cultured using standard culture-based techniques. The culture isolates were later identified using Matrix-assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) mass spectrometry.ResultsA total of 192 Staphylococci species were isolated, with an overall prevalence of 39.7% (95% CI: 35%–44%; N = 483). S. hominis was the most prevalent species (23.95%), followed by S. haemolyticus (20.83%), S. epidermidis (15.10%), S. aureus (10.41%), and S. saprophyticus (9.32%). The remaining 20.34% were distributed among S. wanneri, S. sciuri, S. pasteuri, S. xylosus, S. simulans, S. cohnii, S. caprae, S. lugdunensis, and S. capitis. MRSA, containing mecA gene, was detected in 21 out of 31 Staphylococci isolates tested, with an overall prevalence of 68% (95% CI: 51%–84%). In addition, a virulent gene, Panton–Valentine leukocidin (PVL), which is usually associated with S. aureus, was detected in 20/31 (64.5%) S. aureus in the study.ConclusionThese results suggest that MRSA species may pose a challenge to the treatment of filarial lymphedema with antibiotics particularly, as doxycycline is currently being piloted in some endemic areas to treat the infection. Thus, intensive antimicrobial resistance surveillance should be conducted in endemic areas by health authorities to forestall the dilemma of multidrug resistance not only against lymphatic filariasis (LF) infection but other diseases.
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Kretchy JP, Adase SK, Gyansa-Lutterodt M. The prevalence and risks of antibiotic self-medication in residents of a rural community in Accra, Ghana. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e01006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Dillard LK, Wu CZ, Saunders JE, McMahon CM. A scoping review of global aminoglycoside antibiotic overuse: A potential opportunity for primary ototoxicity prevention. Res Social Adm Pharm 2021; 18:3220-3229. [PMID: 34711521 DOI: 10.1016/j.sapharm.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/05/2021] [Accepted: 10/19/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Aminoglycosides are widely used, broad-spectrum antibiotics with significant potential for ototoxicity. Global efforts to prevent ototoxicity must account for aminoglycoside overuse and non-prescription use. OBJECTIVES The goals of this study were to a) estimate the prevalence of aminoglycoside overuse by synthesizing evidence on self-medication, over the counter (OTC) availability, and household antibiotic storage for later use, and to report the specific aminoglycosides used and the predictors of overuse, and b) leverage this information to comment on potential risk of ototoxicity. METHODS Two systematic search strings were conducted to extract peer-reviewed articles published from 2005 to 2020. The first focused on overuse of aminoglycoside antibiotics. The second focused on potentially ototoxic effects of aminoglycosides related to drug overuse. RESULTS A total of 26 articles were included (first search string: n = 21; second search string: n = 5). The prevalence of aminoglycoside self-medication was high and household storage and OTC availability of aminoglycosides was common. Gentamicin was the most commonly overused aminoglycoside. No studies provided information on antibiotic dosing or resultant toxicities, including ototoxicity. CONCLUSIONS The limited available evidence indicates that antibiotic overuse (self-medication, home storage, and non-prescription availability) is relatively common, especially in low resource settings, and that aminoglycoside antibiotics comprise a variable, but concerning, proportion of non-prescribed antibiotics. Additional evidence is needed to evaluate the relationship between these dispensing patterns and ototoxicity.
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Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA.
| | - Cecilia Z Wu
- Mass General Brigham Home Care, Department of Staff Education, Waltham, MA, USA
| | - James E Saunders
- Section of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Catherine M McMahon
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
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Khairy WA, Nasser HA, Sarhan MD, El Shamy AA, Galal YS. Prevalence and Predictors of Self-Medication with Antifungal Drugs and Herbal Products Among University Students: A Cross-Sectional Study from Egypt. Risk Manag Healthc Policy 2021; 14:2191-2200. [PMID: 34079406 PMCID: PMC8166349 DOI: 10.2147/rmhp.s308400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Purpose Irrational use of drugs for self-medication (SM) is a worldwide public health problem which results in treatment failure, economic loss, and increased burden of morbidity and mortality. Thus, the purpose of this study was to explore SM with antifungal drugs and herbal products among university students in Egypt. Methods A cross-sectional sectional study was conducted over 7 months among 403 university students in Egypt. The students were invited to complete a self-administered questionnaire through an online Google form. Questionnaire items included socio-demographic characteristics of the students, practice of and attitude towards SM with antifungal drugs, and SM with herbal products. Results Prevalence of SM with antifungal drugs among students stood at 38.2%. The main reasons for SM with antifungal drugs were perceiving their health problem as being minimal, followed by having fears of a doctor’s visit. About 73% of the students thought that SM was not a safe practice. Older age (AOR = 1.5, 95% CI= 1.3–1.8), affiliation to a private university (AOR = 3.7, 95% CI= 2.2–6.4), and being a medical student (AOR =2.4, 95% CI= 1.3–4.5) were the significant predictors of SM with antifungal drugs. A high prevalence of SM with herbal products (70.7%) was reported, with most students having used some form of herbal weight loss preparation (64%). Being a Cairo resident (AOR= 2.4, 95% CI =1.5–3.8, P<0.05) and being a medical student (AOR= 2.1, 95% CI =1.3–3.4, P<0.05) were the significant predictors of SM with herbal products. Conclusion In the current study, SM was common among Egyptian university students. Providing counseling and public health education to university students with regards to SM is crucial. Implementing strict regulations and the full enforcement of excitant laws pertaining to the use of medication supplies is also needed. Herbal products should face the scrutiny of evidence-based medicine. Further studies are needed to evaluate the impact of SM among university students.
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Affiliation(s)
- Walaa Ahmed Khairy
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hebatallah A Nasser
- Microbiology Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Mai D Sarhan
- Family Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aliaa Ali El Shamy
- Microbiology Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Yasmine Samir Galal
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Yeika EV, Ingelbeen B, Kemah BL, Wirsiy FS, Fomengia JN, van der Sande MAB. Comparative assessment of the prevalence, practices and factors associated with self-medication with antibiotics in Africa. Trop Med Int Health 2021; 26:862-881. [PMID: 33942448 DOI: 10.1111/tmi.13600] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate and compare the prevalence, reasons, sources and factors associated with self-medication with antibiotics (SMA) within Africa. METHODS Systematic review and meta-analysis. An electronic search of PubMed and Google Scholar databases was performed for observational studies conducted between January 2005 and February 2020. Two reviewers independently screened abstracts and full texts using the PRISMA flowchart and performed quality assessment of eligible studies. Both qualitative and quantitative syntheses were carried out. RESULTS Forty studies from 19 countries were eligible for qualitative synthesis. The prevalence of SMA in Africa ranged from 12.1% to 93.9% with a median prevalence of 55.7% (IQR 41-75%). Western Africa was the sub-region with the highest reported prevalence of 70.1% (IQR 48.3-82.1%), followed by Northern Africa with 48.1% (IQR 41.1-64.3%). We identified 27 antibiotics used for self-medication from 13 different antibiotic classes. Most frequently used antibiotics were penicillins (31 studies), tetracyclines (25 studies) and fluoroquinolones (23 studies). 41% of these antibiotics belong to the WHO Watch Group. The most frequent indications for SMA were upper respiratory tract infections (27 studies), gastrointestinal tract symptoms (25 studies) and febrile illnesses (18 studies). Common sources of antibiotics used for self-medication were community pharmacies (31 studies), family/friends (20 studies), leftover antibiotics (19 studies) and patent medicine stores (18 studies). The most frequently reported factor associated with SMA was no education/low educational status (nine studies). CONCLUSIONS The prevalence of SMA is high in Africa and varies across sub-regions with the highest prevalence reported in Western Africa. Drivers of SMA are complex, comprising of socio-economic factors and insufficient access to health care coupled with poorly implemented policies regulating antibiotic sales.
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Affiliation(s)
| | - Brecht Ingelbeen
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ben-Lawrence Kemah
- University Hospitals North Midlands, Stoke-on-Trent, UK.,Health Education & Research Organization, Buea, Cameroon
| | | | - Joseph Nkeangu Fomengia
- École de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium.,Sintieh Research Academy, Yaoundé, Cameroon
| | - Marianne A B van der Sande
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Global Health, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
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Chen J, Sidibi AM, Shen X, Dao K, Maiga A, Xie Y, Hesketh T. Lack of antibiotic knowledge and misuse of antibiotics by medical students in Mali: a cross-sectional study. Expert Rev Anti Infect Ther 2020; 19:797-804. [PMID: 33251896 DOI: 10.1080/14787210.2021.1857731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objectives: Misuse of antibiotics, especially in low-and-middle-income countries is a major contributor to antimicrobial resistance. Medical students are antibiotic consumers and prescribers in the future. This study aimed to assess antibiotic knowledge and utilization among medical students in the Republic of Mali, and to determine the relationship between knowledge and health-seeking behavior in relation to antibiotic use.Methods: A cross-sectional survey was conducted in the only public medical university in Mali. The questionnaire explored knowledge about antibiotics of medical students, and health behaviors for self-limiting illness. Data were analyzed in SPSS.Results: A total of 446 medical students completed the questionnaire. The average knowledge score was 4.12 out of 10. Students with clinical experience performed higher (4.79 vs 3.74, p< 0.01); 391(87.7%) medical students reported experience of self-limiting diseases in the past year. Of these 197(50.4%) went to see a doctor, 160 (81.2%) of whom were prescribed antibiotics: 151 medical students self-treated, with 121(80.1%) using antibiotics.Conclusions: This study shows poor knowledge and massive misuse of antibiotics among medical students in Mali. Promoting education on the mechanism of antibiotics, antimicrobial resistance and rational antibiotic use among medical students should be a priority in the medical school curriculum.
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Affiliation(s)
- Jie Chen
- Centre for Global Health, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Xiaohui Shen
- Institute for Global Health, University College London,London, UK
| | - Kalo Dao
- Department of Tropical Infectious Diseases, University of Science, Technique and Technologies of Bamako, Bamako, Mali
| | - Alain Maiga
- Department of Tropical Infectious Diseases, University of Science, Technique and Technologies of Bamako, Bamako, Mali
| | - Ying Xie
- Centre for Global Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Therese Hesketh
- Centre for Global Health, Zhejiang University School of Medicine, Hangzhou, China.,Institute for Global Health, University College London,London, UK
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Bekoe SO, Orman E, Asare-Nkansah S, Sørensen AML, Björklund E, Adosraku RK, Hansen M, Styrishave B. Detection and quantification of antibiotic residues in urine samples of healthy individuals from rural and urban communities in Ghana using a validated SPE-LC-MS/MS method. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-020-03742-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Egyir B, Obeng-Nkrumah N, Kyei GB. COVID-19 pandemic and antimicrobial resistance: Another call to strengthen laboratory diagnostic capacity in Africa. Afr J Lab Med 2020; 9:1302. [PMID: 33102171 PMCID: PMC7567179 DOI: 10.4102/ajlm.v9i1.1302] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/07/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Beverly Egyir
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, University of Ghana, Accra, Ghana
| | - George B Kyei
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Self-Medication Practices among the Adolescent Population of South Karnataka, India. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:9021819. [PMID: 32963558 PMCID: PMC7492945 DOI: 10.1155/2020/9021819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 01/14/2020] [Accepted: 06/24/2020] [Indexed: 11/17/2022]
Abstract
Introduction Self-medication is used every day in the form of self-care of our health. Different studies in India have shown that more than 50% of the adolescent population takes self-medication every day for their health. Self-medication is an important concern at the global level, and it is an important issue in the health area. Aims To determine the prevalence of self-medication among adolescents, identifying the commonly used drugs as self-medication and finding the association between self-medication and selected demographic variables are important. Materials and Methods In a descriptive cross-sectional survey, 220 adolescents were enrolled through cluster random sampling. A self-administered questionnaire (developed by the researcher) along with a demographic profile sheet to assess the prevalence of self-medication and commonly used drugs was exercised. In the study, self-medication was defined as the consumption of medication without the prescription of the physician in the past year. Data analysis was performed by descriptive and inferential statistics using SPSS 16.0 software, and the significance of p value (<0.05) was considered. Results Around 120 (54.5%) adolescents were in the age group of 17 years; among them, 123 (55.9%) were females. The prevalence of self-medication was found to be 173 (78.6%). Antipyretics were consumed by 147 (78.6%) adolescents and antitussives by 120 (54.5%). It was observed that 110 (50%) of the adolescents preferred allopathic system of medication. It was also reported that 52 (23.6%) adolescents self-medicated continuously (i.e., for a month). The results also showed that factors like the type of family (χ2 = 9.615, p < 0.05), father's education (χ2 = 13.791, p < 0.05), mother's education (χ2 = 14.633, p < 0.05), and distance from a nearest medical store (χ2 = 17.290, p < 0.05) were associated with self-medication. Conclusion The present study has shown that the prevalence of self-medication is high among adolescents, and most of them had taken it without consulting a doctor. The study concludes that it is important to create awareness among adolescents regarding self-medication.
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Jimah T, Fenny AP, Ogunseitan OA. Antibiotics stewardship in Ghana: a cross-sectional study of public knowledge, attitudes, and practices among communities. ONE HEALTH OUTLOOK 2020; 2:12. [PMID: 33829133 PMCID: PMC7993532 DOI: 10.1186/s42522-020-00021-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 05/11/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Antibiotic resistance is a major contributing factor to global morbidity and mortality and is associated with inappropriate medication use. However, the level of antibiotic consumption and knowledge about antibiotic resistance in Ghana is inadequately quantified. Our study identifies strategies for improved stewardship of antibiotics to prevent the proliferation of resistant pathogens by assessing the level of antibiotic knowledge, attitudes, and consumption behaviors by region, gender, age, and education in rural and urban Ghana. METHODS A cross-sectional study was conducted in 12 communities in the urban Greater Accra and rural Upper West regions of Ghana. A questionnaire survey was administered to 400 individuals aged 18 years and older in selected locations during September-October 2018 to collect data on individual knowledge, attitudes, and practices concerning antibiotics and antibiotic resistance. Multivariate analysis was used to investigate the association between demographic characteristics and knowledge, attitudes, and related behaviors. RESULTS Over 30% (125/400) had not received a doctor's prescription during their last illness. Seventy percent (278/400) had taken at least one antibiotic in the year prior to the survey. The top five frequently used antibiotics were Amoxicillin, Amoxicillin-clavulanic acid, Ampicillin, Ciprofloxacin, and Metronidazole. Women and older adults had higher knowledge compared to their respective counterparts (p < 0.01). Furthermore, prudent antibiotic use was significantly more prevalent in women than men (p < 0.05). Although no regional differences were found in overall knowledge, compared to urban residents, individuals residing in rural settings exhibited higher knowledge about the ineffectiveness of antibiotics for viruses like the cold and HIV/AIDS (p < 0.001). Two hundred and fifty-two (63%) respondents were unaware of antibiotic resistance. There was generally a low level of self-efficacy among participants regarding their role in preserving the effectiveness of antibiotics. CONCLUSION Antibiotic knowledge, attitudes, and use varied significantly across demographics, suggesting a context-specific approach to developing effective community interventions.
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Affiliation(s)
- Tamara Jimah
- Department of Population Health & Disease Prevention, Anteater Instruction and Research Building, University of California, 653 E Peltason Drive, Irvine, CA 92697 USA
| | - Ama P. Fenny
- Institute of Statistical, Social and Economic Research, University of Ghana, Legon, Accra, Ghana
| | - Oladele A. Ogunseitan
- Department of Population Health & Disease Prevention, Anteater Instruction and Research Building, University of California, 653 E Peltason Drive, Irvine, CA 92697 USA
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Cambaco O, Alonso Menendez Y, Kinsman J, Sigaúque B, Wertheim H, Do N, Gyapong M, John-Langba J, Sevene E, Munguambe K. Community knowledge and practices regarding antibiotic use in rural Mozambique: where is the starting point for prevention of antibiotic resistance? BMC Public Health 2020; 20:1183. [PMID: 32727445 PMCID: PMC7389384 DOI: 10.1186/s12889-020-09243-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Antibiotic misuse and other types of unnecessary use of antibiotics can contribute to accelerate the process of antibiotic resistance, which is considered a global concern, mostly affecting low-and middle-income countries (LMICs). In Mozambique there is limited evidence on community knowledge and practices regarding antibiotics and antibiotic resistance. As part of the ABACUS project, this paper describes knowledge and practices of antibiotic use among the general population in the semi-rural district of Manhiça to inform evidence-based communication intervention strategies for safer antibiotic use. METHODS The study was conducted in Manhiça, a semi-rural district of Southern Mozambique. Sixteen in-depth interviews and four focus group discussions (FGDs) were conducted with community members to explore lay knowledge and practices regarding antibiotics and awareness of antibiotic resistance. The qualitative data was analysed using a combination of content and thematic analysis. The SRQR guidelines for reporting qualitative studies was performed. RESULTS Although participants did not hold any consistent knowledge of antibiotics, their visual recognition of amoxicillin (distinct red yellow capsule) was acceptable, but less so for different types and brands of antibiotics. The majority of participants were aware of the term 'antibiotic', yet the definition they gave was rarely backed by biomedical knowledge. Participants associated antibiotics with certain colours, shapes and health conditions. Participants reported common habits that may contribute to resistance: not buying the full course, self-medication, sharing medicines and interruption of treatment. Most had never heard of the term 'antibiotic resistance' but were familiar with the phenomenon. They often understood the term 'resistance' as treatment failure and likened 'resistance' to non-compliance, ineffective medication, disease resistance or to an inability of the physical body to respond to it. CONCLUSION There is a broad understanding of the importance of medication compliance but not specifically of antibiotic resistance. In addition, there is a recognized gap between knowledge of responsible drug compliance and actual behaviour. Future qualitative research is required to further explore what determines this behaviour. The existing ability to visually identify amoxicillin by its distinct red and yellow appearance is informative for future awareness and behavioural change campaigns that may incorporate visual aids of antibiotics.
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Affiliation(s)
- Olga Cambaco
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | | | - John Kinsman
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Betuel Sigaúque
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Heiman Wertheim
- Department of Medical Microbiology and Center for Infectious Diseases, Radboudumc, Nijmegen, Netherlands
| | - Nga Do
- Oxford University Clinical Research Unit, Hanoi, Vietnam
| | - Margaret Gyapong
- Centre for Health Policy and Implementation Research, Kintampo, Ghana
| | | | - Esperança Sevene
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Khátia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique.
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique.
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Khatony A, Soroush A, Andayeshgar B, Abdi A. Nursing students' perceived consequences of self-medication: a qualitative study. BMC Nurs 2020; 19:71. [PMID: 32724298 PMCID: PMC7382074 DOI: 10.1186/s12912-020-00460-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 07/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background Self-medication associates with many problems and complications, and is considered as a global health issue. Regarding a lack of information about perception of nursing students, as a part of healthcare workers, in this issue, the current study was aimed to explore the perceived consequences of self-medication from the perspective of nursing students. Methods This qualitative study was conducted using semi-structured individual face-to-face interviews. Purposeful sampling method was used for selection of participants. Twelve nursing students in the age range of 21–36 years were enrolled. Five participants were male and seven were female, seven master’s degree and five were undergraduate of bachelor degree. Data were collected using semi-structured interviews and analyzed as content analyses. Results Two categories and seven sub-categories were emerged from the data analysis. The main categories included; positive consequences and negative consequences, and subcategories included; time saving, cost savings, disease treatment, harming the health system, drug resistance, physical complications and death. Conclusion The participants believed that self-medication has some positive and negative consequences in viewpoints of nursing students. Regarding, Self-medication that potentially has dangerous consequences, it is suggested the students will be educated and warned about the adverse effects of self-medication, and the nursing teachers should try to rectify students’ misconceptions about self-medication.
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Affiliation(s)
- Alireza Khatony
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Soroush
- Clinical Research Development Unit, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bahare Andayeshgar
- Clinical Research Development Unit, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Doolat abaad, Nursing Department, School of Nursing and Midwifery, student research committee, Kermanshah University of Medical Sciences, Dolat Abad Street, Kermanshah, Kermanshah province 6718996511 Iran
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Alidu L, Grunfeld EA. 'What a dog will see and kill, a cat will see and ignore it': An exploration of health-related help-seeking among older Ghanaian men residing in Ghana and the United Kingdom. Br J Health Psychol 2020; 25:1102-1117. [PMID: 32656938 DOI: 10.1111/bjhp.12454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 06/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health care utilization rates are lower among men; however, little is known about how men's health care utilization is affected by migration. The aim of this study was to explore health-related help-seeking decisions among older Ghanaian men residing in the United Kingdom and in Ghana. METHODS Twenty-six men aged 50 years or over were recruited from community locations within two large cities in the UK and Ghana. Face-to-face semi-structured interviews were undertaken to explore the illness and help-seeking experiences of older men. RESULTS Help-seeking experiences differed among the Ghanaian men living in the UK and in Ghana. Three themes were identified that impacted on help-seeking decisions: (1) pluralistic approaches to managing health and illness and (2) perceptions of formal health services in Ghana and UK and (3) financial constraints and masculinity norms as barriers to help-seeking. CONCLUSION This is the first study to look at help-seeking decisions among older men residing in the UK and Ghana. Findings highlight how older migrant men's explanatory models of their health encompass enduring faith-based beliefs around causation of illness and approaches to management, as well as the use of pluralistic approaches to managing health. This study supports the call for culturally sensitive community-based interventions to increase engagement and facilitate improved health outcomes for migrant populations, particularly older men.
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Affiliation(s)
- Lailah Alidu
- Population Evidence and Technology, University of Warwick Medical School, Coventry, UK
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Pierce J, Apisarnthanarak A, Schellack N, Cornistein W, Maani AA, Adnan S, Stevens MP. Global Antimicrobial Stewardship with a Focus on Low- and Middle-Income Countries. Int J Infect Dis 2020; 96:621-629. [PMID: 32505875 PMCID: PMC7271868 DOI: 10.1016/j.ijid.2020.05.126] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
Antimicrobial resistance is a global public health crisis. Antimicrobial Stewardship involves adopting systematic measures to optimize antimicrobial use, decrease unnecessary antimicrobial exposure and to decrease the emergence and spread of resistance. Low- and middle-income countries (LMICs) face a disproportionate burden of antimicrobial resistance and also face challenges related to resource availability. Although challenges exist, the World Health Organization has created a practical toolkit for developing Antimicrobial Stewardship Programs (ASPs) that will be summarized in this article.
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Affiliation(s)
- Jacob Pierce
- Virginia Commonwealth University School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, 1000 E Marshall St. Richmond, VA, USA, 23298.
| | - Anucha Apisarnthanarak
- Thammasart University Hospital, 8 95 Phahonyothin Rd, Khlong Nueng, Khlong Luang District, Pathum Thani 12120
| | - Natalie Schellack
- Sefako-Makgatho Health Sciences University, School of Pharmacy, Pretoria. Motlegi St, Ga-Rankuwa Zone 1, Ga-Rankuwa, 0208, South Africa
| | - Wanda Cornistein
- Hospital Universitario Austral Av. Juan Domingo Perón 1500, Pilar Centro, Buenos Aires, Argentina
| | - Amal Al Maani
- Directorate General for Disease Surveillance & Control, MOH. P.O Box: 393, PC 100 Muscat, Oman
| | - Syamhanin Adnan
- Hospital Sungai Buloh (Infectious Disease center) Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia
| | - Michael P Stevens
- Virginia Commonwealth University School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, 1000 E Marshall St. Richmond, VA, USA, 23298
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Hertz JT, Madut DB, Tesha RA, William G, Simmons RA, Galson SW, Maro VP, Crump JA, Rubach MP. Self-medication with non-prescribed pharmaceutical agents in an area of low malaria transmission in northern Tanzania: a community-based survey. Trans R Soc Trop Med Hyg 2020; 113:183-188. [PMID: 30597114 PMCID: PMC6432801 DOI: 10.1093/trstmh/try138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/22/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022] Open
Abstract
Background Self-treatment with antimicrobials is common in sub-Saharan Africa. Little is known about the prevalence of this practice where malaria transmission intensity is low, and little is known about the prevalence of self-treatment with other medications such as antihypertensives and antihyperglycemics. Methods A two-stage randomized population-based cluster survey with selection proportional to population size was performed in northern Tanzania. Self-identified healthcare decision-makers from randomly selected households were asked to report instances of self-medication without a prescription in the preceding year. Associations between self-treatment and sociodemographic characteristics were assessed with Pearson’s chi-squared and the Student’s t-test. Results A total of 718 participants completed the survey, and 344 (47.9%) reported any household member obtaining medication without a prescription. Of these, 85 (11.8%) obtained an antimicrobial and four (0.6%) obtained an antihypertensive or antihyperglycemic. Of respondents reporting self-treatment, 306 (89.0%) selected the medication themselves. Self-treatment with antimicrobials was associated with post-primary education (OR 1.95, 95% CI 1.22–3.16, p=0.005), younger age (43.1 vs 48.7 years, p=0.007) and higher socioeconomic status score (0.42 vs 0.34, p=0.023). Conclusions Self-treatment with antimicrobials in an area of low malaria transmission intensity was uncommon and self-treatment with antihypertensives and antihyperglycemics was rare.
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Affiliation(s)
- Julian T Hertz
- Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, USA
| | - Deng B Madut
- Department of Medicine, Division of Infectious Disease, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, USA
| | | | | | - Ryan A Simmons
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC, USA
| | - Sophie W Galson
- Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, USA
| | | | - John A Crump
- Otago Global Health Institute, University of Otago, Dunedin, New Zealand
| | - Matthew P Rubach
- Department of Medicine, Division of Infectious Disease, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, USA
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Sambakunsi CS, Småbrekke L, Varga CA, Solomon V, Mponda JS. Knowledge, attitudes and practices related to self-medication with antimicrobials in Lilongwe, Malawi. Malawi Med J 2020; 31:225-232. [PMID: 32128032 PMCID: PMC7036431 DOI: 10.4314/mmj.v31i4.2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The use of antimicrobials is associated with the emergence of antimicrobial resistance (AMR), and self-medication increases the risk of the inappropriate use of antimicrobials. This study aims to describe the knowledge, attitudes, and practices (KAP) regarding self-medication with antimicrobials among residents in Lilongwe, Malawi. Methodology This study has a cross-sectional, mixed-methods design. We conducted two focus group discussions (n=15) to describe community attitudes towards self-medication with antimicrobials and used a structured questionnaire to collect data on individual KAP regarding self-medication from 105 respondents. Results Self-medication was common, and the sources of these medicines were market vendors, pharmacies, drugs shared with friends and family and those leftover from previous treatments. The lack of medical supplies, long distances to health facilities, poor attitudes of medical professionals towards patients, and past experience with the disease and treatment are the main factors that influence self-medication. KAP respondents had little knowledge of antimicrobials, their use, or any awareness of AMR. Seventy-four per cent (n=78) were unable to differentiate antimicrobials from other categories of medicines, and 92.4% wrongly responded that antimicrobials could be used to stop a fever. Concerning attitudes towards self-medication, over 54% wrongly believe that antimicrobials are effective in treating common colds. In regard to practice, 53% reported that they would use antimicrobials to treat upper respiratory infections, and 41% agreed that they must complete antibiotic therapy even if they are improving. Logistic regression analysis found that stocking antimicrobials at home for future use significantly promotes self-medication whereas an awareness of AMR would reduce self-medication. Conclusion Self-medication is a public health risk that needs to be addressed urgently. Findings from this study point to the need for multifaceted interventions.
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Affiliation(s)
- Cecilia S Sambakunsi
- Pharmacy Medicines and Poisons Board, Lilongwe 3, Malawi.,College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Lars Småbrekke
- Department of Pharmacy UIT - The Arctic University of Norway, Tromso, Norway
| | - Christine A Varga
- College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Vernon Solomon
- College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - John S Mponda
- Department of Pharmacy, College of Medicine, Blantyre, Malawi
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Appiah VA, Pesewu GA, Kotey FCN, Boakye AN, Duodu S, Tette EMA, Nyarko MY, Donkor ES. Staphylococcus aureus Nasal Colonization among Children with Sickle Cell Disease at the Children's Hospital, Accra: Prevalence, Risk Factors, and Antibiotic Resistance. Pathogens 2020; 9:pathogens9050329. [PMID: 32354004 PMCID: PMC7280972 DOI: 10.3390/pathogens9050329] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to investigate S. aureus carriage among children with sickle cell disease (SCD), including the prevalence, risk factors, and antibiotic resistance. The study was cross-sectional, and involved 120 children with SCD recruited at the Princess Marie Louise Children’s Hospital (PML) in Accra and 100 apparently healthy children from environs of the hospital. Nasal swab samples were collected from the study participants and cultured for bacteria. Confirmation of S. aureus and methicillin-resistant Staphylococcus aureus (MRSA) isolates were done using the tube coagulase test and mecA polymerase chain reaction, respectively. All the S. aureus isolates were tested against standard antimicrobial agents using the Kirby-Bauer method. A structured questionnaire was used to obtain the socio-demographic and clinical data of the study participants. Binary logistic regression was used to identify determinants of S. aureus and MRSA carriage among the study participants. The nasal carriage prevalence of S. aureus was 33.3% (n = 40) and 10% (n = 10) among the participants of the SCD and control groups, respectively. As regards MRSA nasal carriage prevalence, the respective values were 3.33% (n = 4) and 0.00% (n = 0). SCD was significantly associated with S. aureus colonization (p < 0.0001, OR = 4.045), but not MRSA colonization (p = 0.128). In the SCD group, the significant predictors of S. aureus carriage were increasing age (p = 0.003; OR = 1.275) and living in self-contained apartments (p = 0.033; OR = 3.632), whereas male gender (p = 0.018; OR = 0.344) and the practice of self-medication (p = 0.039; OR = 0.233) were protective of S. aureus carriage. In the control group, a history of hospitalization in the past year was a risk factor for the carriage of S. aureus (p = 0.048; OR = 14.333). Among the participants of the SCD and control groups, respectively, the resistance prevalence recorded by S. aureus against the various antibiotics investigated were penicillin (100% each), cotrimoxazole (27.5% vs. 20%), tetracycline (25% vs. 50%), rifampicin (82.5% vs. 50%), erythromycin (30% vs. 20%), clindamycin (32.5% vs. 50%), gentamicin (7.5% vs. 20%), cefoxitin (27.5% vs. 20%), linezolid (30% vs. 40%), and fusidic acid (95% vs. 80%). The proportion of S. aureus isolates that were multidrug resistant (MDR) was 92.5% (37/40) in the SCD group and 100% (10/10) in the control group.
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Affiliation(s)
- Vera A. Appiah
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - George A. Pesewu
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - Fleischer C. N. Kotey
- FleRhoLife Research Consult, Teshie P. O. Box TS 853, Accra, Ghana
- Department of Medical Microbiology, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
| | - Alahaman Nana Boakye
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
- FleRhoLife Research Consult, Teshie P. O. Box TS 853, Accra, Ghana
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - Edem M. A. Tette
- Department of Community Health, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
| | - Mame Y. Nyarko
- Princess Marie Louise Children’s Hospital, Accra P. O. Box GP 122, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
- Correspondence: or ; Tel.: +233-553-527-140
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DeNegre AA, Myers K, Fefferman NH. Impact of chemorophylaxis policy for AIDS-immunocompromised patients on emergence of bacterial resistance. PLoS One 2020; 15:e0225861. [PMID: 31999715 PMCID: PMC6992000 DOI: 10.1371/journal.pone.0225861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/13/2019] [Indexed: 12/20/2022] Open
Abstract
Chemoprophylaxis (antibiotic prophylaxis) is a long relied-upon means of opportunistic infection management among HIV/AIDS patients, but its use represents an evolutionary tradeoff: Despite the benefits of chemoprophylaxis, widespread use of antibiotics creates a selective advantage for drug-resistant bacterial strains. Especially in the developing world, with combined resource limitations, antibiotic misuse, and often-poor infection control, the emergence of antibiotic resistance may pose a critical health risk. Extending previous work that demonstrated that this risk is heightened when a significant proportion of the population is HIV/AIDS-immunocompromised, we work to address the relationship between HIV/AIDS patients' use of antibiotic chemoprophylaxis and the emergence of resistance. We apply an SEIR compartmental model, parameterized to reflect varying percentages of chemoprophylaxis use among HIV/AIDS+ patients in a resource-limited setting, to investigate the magnitude of the risk of prophylaxis-associated emergence versus the individual-level benefits it is presumed to provide. The results from this model suggest that, while still providing tangible benefits to the individual, chemoprophylaxis is associated with negligible decreases in population-wide morbidity and mortality from bacterial infection, and may also fail to provide assumed efficacy in reduction of TB prevalence.
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Affiliation(s)
- Ashley A. DeNegre
- Department of Ecology, Evolution and Natural Resources, Rutgers University, New Brunswick, New Jersey, United States of America
- The Command, Control and Interoperability Center for Advanced Data Analysis (CCICADA), Rutgers University, New Brunswick, New Jersey, United States of America
| | - Kellen Myers
- Department of Ecology & Evolutionary Biology, University of Tennessee, Knoxville, Tennessee, United States of America
- Department of Mathematics, University of Tennessee, Knoxville, Tennessee, United States of America
- National Institute for Mathematical and Biological Synthesis (NIMBioS), University of Tennessee, Knoxville, Tennessee, United States of America
- Department of Mathematics, Tusculum University, Greeneville, Tennessee, United States of America
| | - Nina H. Fefferman
- Department of Ecology, Evolution and Natural Resources, Rutgers University, New Brunswick, New Jersey, United States of America
- The Command, Control and Interoperability Center for Advanced Data Analysis (CCICADA), Rutgers University, New Brunswick, New Jersey, United States of America
- Department of Ecology & Evolutionary Biology, University of Tennessee, Knoxville, Tennessee, United States of America
- Department of Mathematics, University of Tennessee, Knoxville, Tennessee, United States of America
- National Institute for Mathematical and Biological Synthesis (NIMBioS), University of Tennessee, Knoxville, Tennessee, United States of America
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Khadim N, Tine JAD, Zahra MF, Omar B, Diongue FB, Diallo AI, Adama F. Self-Medication of Senegalese Women through Social Networks. Health (London) 2020. [DOI: 10.4236/health.2020.124032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zeru N, Fetene D, Geberu DM, Melesse AW, Atnafu A. Self-Medication Practice and Associated Factors Among University of Gondar College of Medicine and Health Sciences Students: A Cross-Sectional Study. Patient Prefer Adherence 2020; 14:1779-1790. [PMID: 33061320 PMCID: PMC7535137 DOI: 10.2147/ppa.s274634] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/15/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Self-medication is the use of medicines by individuals to treat self-recognized illnesses or symptoms without any medical supervision. Such practices may cause antimicrobial resistance, which causes treatment failure, economic loss, serious health hazards, missed diagnosis, delayed appropriate treatment, drug dependency, and adverse drug effects. However, empirical evidence is limited to the current status of its practices and associated factors among university students. Thus, the aim of this study was to assess the magnitude and associated factors of self-medication practices among medicine and health science students at the University of Gondar. METHODS An institution-based cross-sectional study was employed from February to March 2017. A total of 792 randomly selected students were surveyed with a self-administered structured questionnaire. Epi Info version 7 and SPSS version 20 were used for data entry and analysis, respectively. Binary logistic regression analysis was performed. In multivariable analysis, P-value <0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to identify associated factors. RESULTS Self-medication practice was found to be 52.4% (95% CI: (49%, 56%)) among university students. For most students, the major reason for using self-medication was taking the illness as less serious (71.1%). Females (AOR: 1.48; 95% CI: 1.08-2.01), income category (USD 44.01-175.87) (AOR: 0.47; 95% CI: 0.29-0.78), sixth year students (AOR: 8.71; 95% CI: 4.04-18.77) and health officer students (AOR: 2.36; 95% CI: 1.20-4.63) were found to be significantly associated with self-medication practice. CONCLUSION More than half of the students practiced self-medication, which is moderately higher than other findings. Gender, income, year of study, and field of study were the major factors that affected self-medication. Therefore, interventions that can halt the high magnitude of self-medication and factors associated with it are crucial. Special attention should be given to students who stay in the university for longer years.
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Affiliation(s)
- Nuhamin Zeru
- University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Destaw Fetene
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | | | | | - Asmamaw Atnafu
- Department of Health Systems and Policy, University of Gondar, Gondar, Ethiopia
- Correspondence: Asmamaw Atnafu University of Gondar, P.O. Box 196, Gondar, EthiopiaTel +251-918776945 Email
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Muloi D, Fèvre EM, Bettridge J, Rono R, Ong'are D, Hassell JM, Karani MK, Muinde P, van Bunnik B, Street A, Chase-Topping M, Pedersen AB, Ward MJ, Woolhouse M. A cross-sectional survey of practices and knowledge among antibiotic retailers in Nairobi, Kenya. J Glob Health 2019; 9:010412. [PMID: 31489183 PMCID: PMC6708591 DOI: 10.7189/jogh.09.020412] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) driven by antibiotic consumption is a growing global health threat. However, data on antimicrobial consumption patterns in low- and middle-income countries (LMICs) is sparse. Here, we investigate the patterns of antibiotic sales in humans and livestock in urban Nairobi, Kenya, and evaluate the level of awareness and common behaviours related to antibiotic use and AMR amongst human and veterinary pharmacists. METHODS A total of 40 human and 19 veterinary drug store pharmacists were interviewed in Nairobi in 2018 using a standard questionnaire. Data recorded included demographic variables, types of antibiotics sold, antibiotic customers, antibiotic prescribing practices and knowledge of antibiotic use and AMR. RESULTS Our study shows that at the retail level, there is a considerable overlap between antibiotic classes (10/15) sold for use in both human and veterinary medicine. Whilst in our study, clinical training significantly influenced knowledge on issues related to antibiotic use and AMR and respondents had a relatively adequate level of knowledge about AMR, several inappropriate prescribing practices were identified. For example, we found that most veterinary and human drug stores (100% and 52% respectively) sold antibiotics without a prescription and noted that customer preference was an important factor when prescribing antibiotics in half of the drug stores. CONCLUSION Although more research is needed to understand the drivers of antibiotic consumption in both human and animal populations, these findings highlight the need for immediate strategies to improve prescribing practices across the pharmacists in Nairobi and by extension other low- and middle-income country settings.
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Affiliation(s)
- Dishon Muloi
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh, Edinburgh, UK
- Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK
- International Livestock Research Institute, Nairobi, Kenya
- Contributed equally to this work
| | - Eric M Fèvre
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
- International Livestock Research Institute, Nairobi, Kenya
- Contributed equally to this work
| | - Judy Bettridge
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
- International Livestock Research Institute, Nairobi, Kenya
| | - Robert Rono
- International Livestock Research Institute, Nairobi, Kenya
| | - Daniel Ong'are
- International Livestock Research Institute, Nairobi, Kenya
| | - James M Hassell
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
- International Livestock Research Institute, Nairobi, Kenya
| | | | - Patrick Muinde
- International Livestock Research Institute, Nairobi, Kenya
| | - Bram van Bunnik
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh, Edinburgh, UK
- Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK
| | - Alice Street
- Social Anthropology, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Margo Chase-Topping
- Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK
- The Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Amy B Pedersen
- Institute of Evolutionary Biology, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | - Melissa J Ward
- Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Mark Woolhouse
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh, Edinburgh, UK
- Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK
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Nepal A, Hendrie D, Robinson S, Selvey LA. Knowledge, attitudes and practices relating to antibiotic use among community members of the Rupandehi District in Nepal. BMC Public Health 2019; 19:1558. [PMID: 31771595 PMCID: PMC6880381 DOI: 10.1186/s12889-019-7924-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/08/2019] [Indexed: 11/23/2022] Open
Abstract
Background The development of antibiotic resistance is one of the biggest threats to global public health. Inappropriate use of antibiotics is recognised as a leading cause of antibiotic resistance. The aim of this study was to explore the knowledge, attitudes and practices (KAP) towards antibiotic use among adults in Nepal. Methods A quantitative survey was conducted with 220 community members of the Rupandehi district of Nepal, with cluster sampling techniques applied to select households. Interviews were carried out face-to-face using a structured questionnaire. Responses were presented using descriptive analysis, with chi-squared tests and regression analysis applied to identify factors associated with KAP about antibiotic use and the Spearman’s rank order correlation coefficient calculated to examine the relationship between responses to the KAP questions. Results The sample comprised more females (54%) than males, the average age of respondents was 38.5 years and almost 60% of respondents lived in rural areas. Respondents had relatively good knowledge about aspects of antibiotic use other than identifying antibiotics. The concept of antibiotic resistance was well known but imperfectly understood. Half of respondents (50.9%) were unsure whether skipping doses would contribute to the development of antibiotic resistance, 88.2% indicated they would go to another doctor if not prescribed an antibiotic when they thought one was needed and nearly half (47.7%) believed antibiotics helped them get better more quickly if they had a fever. Most respondents reported correct practices accessing and using antibiotics, however, 84.6% at least sometimes preferred an antibiotic when they have a cough and sore throat. Logistic regression showed respondents with higher levels of education tended to have better knowledge, more appropriate attitudes and better practices about antibiotic use. Rural respondents were less likely to have better knowledge about antibiotic use, while females were more likely to report better practices. Conclusion The study provides baseline evidence about the knowledge, attitudes and practices regarding antibiotic use among the population of the Rupandehl district. Its findings will be useful in designing effective and targeted interventions to decrease misconceptions about antibiotic use and to increase awareness about the risks of inappropriate use of antibiotics in the community.
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Affiliation(s)
- Anant Nepal
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia.
| | - Delia Hendrie
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia
| | - Suzanne Robinson
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia
| | - Linda A Selvey
- School of Public Health, The University of Queensland, Herston Rd, Herston, Qld, 4006, Australia
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Gebremariam G, Legese H, Woldu Y, Araya T, Hagos K, GebreyesusWasihun A. Bacteriological profile, risk factors and antimicrobial susceptibility patterns of symptomatic urinary tract infection among students of Mekelle University, northern Ethiopia. BMC Infect Dis 2019; 19:950. [PMID: 31703645 PMCID: PMC6842233 DOI: 10.1186/s12879-019-4610-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 10/31/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Bacterial infection of the urinary tract is among the common reasons for seeking medical attention in the community. Rapidly increasing antibiotic resistance of uropathogens is resulting in limited treatment options. Therefore, knowledge of the current uropathogens and their antibiotic susceptibility is important for better treatment of urinary tract infection. METHODS A cross-sectional study design was conducted from February to September thirty, 2017 among students who came to Mekelle University student's clinics with symptomatic urinary tract infection during the study period.. Mid-stream urine specimens were collected from 341individuals with suspected urinary tract infection for bacteriological identification and antimicrobial susceptibility testing. Data on socio-demographic, clinical and risk factors were also collected using a structured questionnaire. RESULTS Among the 341 study participants, 72(21.1%) showed significant bacteriuria. Escherichia coli (48.6%), Coagulase-negative staphylococci (23%), Staphylococcus aureus (13.5%), and Klebsiella spp. (8.1%) were common bacterial isolates. Resistance to ampicillin (81-100%), amoxicillin/clavulanic acid (77-93.6%), co- trimoxazole (55 72.3%), nalidixic acid (57.4%) and tetracycline (46-55.5%) was seen by most isolates. Multidrug resistance was observed in 73% of the bacterial isolates, and 25.5% of the Gram-negative isolates were extended-spectrum beta-lactamase producers. Being female, a history of urinary tract infection, a history of catheterization and frequent sexual activity were found to be statistically associated with urinary tract infection. CONCLUSION Urinary tract infection is a problem among university students with a prevalence of 21.1%. All isolates have developed resistance to most of the commonly used antibiotics. Therefore, health education on the transmission and causes of urinary tract infection are recommended for the students.
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Affiliation(s)
- Guesh Gebremariam
- Department of Medical Laboratory, College of Medicine and Health Science, Adigrat University, P.O. Box, 50, Adigrat, Ethiopia
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Science, Mekelle University, P.O. Box, 1870, Mekelle, Ethiopia
| | - Haftom Legese
- Department of Medical Laboratory, College of Medicine and Health Science, Adigrat University, P.O. Box, 50, Adigrat, Ethiopia
| | - Yemane Woldu
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Science, Mekelle University, P.O. Box, 1870, Mekelle, Ethiopia
| | - Tadele Araya
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Science, Mekelle University, P.O. Box, 1870, Mekelle, Ethiopia
| | - Kiflom Hagos
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Science, Mekelle University, P.O. Box, 1870, Mekelle, Ethiopia
| | - Araya GebreyesusWasihun
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Science, Mekelle University, P.O. Box, 1870, Mekelle, Ethiopia
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Voidăzan S, Moldovan G, Voidăzan L, Zazgyva A, Moldovan H. Knowledge, Attitudes And Practices Regarding The Use Of Antibiotics. Study On The General Population Of Mureş County, Romania. Infect Drug Resist 2019; 12:3385-3396. [PMID: 31802918 PMCID: PMC6827501 DOI: 10.2147/idr.s214574] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/03/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Currently, antibiotic resistance is a complex issue that affects the whole of society. This resistance is influenced by the irrational and excessive use of antibiotics by the general population. This study aimed to gather information about the knowledge, attitudes and behaviours regarding the issues related to antibiotic consumption in the general population of Mureș County in the Central Region of Romania. METHODS This was a cross-sectional study using a questionnaire as its research instrument, which consisted of 33 questions analysing the respondents' attitude and their knowledge about the use of antibiotics and antibiotic resistance. RESULTS A total of 996 respondents were eligible for the study. Of the total respondents, 62.65% (624 respondents) considered that antibiotics are used to treat a bacterial infection and 61.45% (612 respondents) used an antibiotic at least once in the previous year, with a distribution of 68.7% and 56.8% of the respondents from rural and urban areas, respectively. Antibiotics were taken by 10.34% of the respondents, following recommendations from family/friends, and 22.9% used antibiotics left over from their last prescription. Of those who consumed antibiotics (868 respondents), 65.9% consulted their physician every time before taking the medication. Furthermore, 82.3% of the total of 996 respondents considered that the use of non-prescription antibiotics has a negative effect, and 85.14% had heard about the antibiotic resistance of bacteria. CONCLUSION The majority of respondents had adequate knowledge of antibiotics and their use and were aware of the fact that non-prescription antibiotics can have repercussions both on them as individuals and on the population as a whole.
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Affiliation(s)
- Septimiu Voidăzan
- Department of Epidemiology, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | - Geanina Moldovan
- Department of Community Nutrition, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | | | - Ancuța Zazgyva
- Department of Cell and Molecular Biology, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | - Horațiu Moldovan
- Department of Occupational Medicine, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
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Tuyishimire J, Okoya F, Adebayo AY, Humura F, Lucero-Prisno Iii DE. Assessment of self-medication practices with antibiotics among undergraduate university students in Rwanda. Pan Afr Med J 2019; 33:307. [PMID: 31692864 PMCID: PMC6815470 DOI: 10.11604/pamj.2019.33.307.18139] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/14/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction Antimicrobial resistance (AR) is on a rise as one of the major global public health threats. It is therefore important to assess contributory factors to the rise in the cases of resistance reported. The main objective of this study was to assess the self-medication practices with antibiotics among the University of Rwanda students in Huye Campus. Methods A sample of 570 students from all levels and colleges of the University of Rwanda in Huye Campus were selected using a simple random sampling to participate in this study. A questionnaire was administered to be answered individually by the consented respondents where the self-medication practices with antibiotics in the past 6 months were assessed. The results were statistically analyzed using SPSS v.16. Results The study showed that 12.1% (n=69) practiced self-medication with antibiotics. The major reason for self-medication with antibiotics was illness not serious to have a consultation (50.72%). The main diseases being treated were common cold/fever/cough (47.83%). The most used antibiotic for self-medication was Amoxicillin capsules (59.42%), while the main source of antibiotics was the community pharmacy (72.42%). Conclusion Self-medication with antibiotics is not uncommon among the university students. Regarding the main reasons of self-medication with antibiotics, diseases being treated, and the antibiotics used, it was found that all these may be related to the students' lack of knowledge about the need for rational use of antibiotics and a study was needed to confirm it.
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Affiliation(s)
| | - Funmbi Okoya
- Department of Pharmaceutical Services, Lagos State Ministry of Health, Nigeria
| | | | - Fabrice Humura
- International Pharmaceutical Federation, the Hague, Netherlands
| | - Don Eliseo Lucero-Prisno Iii
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou,China.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
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Donkor ES, Horlortu PZ, Dayie NTKD, Obeng-Nkrumah N, Labi AK. Community acquired urinary tract infections among adults in Accra, Ghana. Infect Drug Resist 2019; 12:2059-2067. [PMID: 31372013 PMCID: PMC6628945 DOI: 10.2147/idr.s204880] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/23/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Urinary tract infection (UTI) is one of the most common bacterial infectious diseases encountered in clinical practice, and accounts for significant morbidity and high medical costs. To reduce its public health burden, there is the need for local research data to address aspects of prevention and management of UTI. The aim of this study was to investigate community-acquired UTI among adults in Accra, Ghana, including the risk factors, etiological agents, and antibiotic resistance. Methods: This was a cross-sectional study involving 307 patients clinically diagnosed with UTI at the Korle Bu and Mamprobi polyclinics in Accra. Urine specimens were collected from the study participants and analyzed by culture, microscopy, and dipstick. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antibiotics by the Kirby Bauer method. Multidrug resistant Enterobacteriaceae isolates were screened for Extended Spectrum β-lactamase (ESBL) production by the double disc method, and isolates that tested positive were analyzed by Polymerase Chain Reaction for ESBL genes. Demographic information and clinical history of study participants were collected. Results: Based on the criteria for laboratory confirmed UTI, 31 (10.1%) of the 307 specimens were positive and the main risk factor of UTI among the study participants was pregnancy (P=0.02, OR=2.43). The most common uropathogen isolated was Escherichia coli (48.9%), followed by Klebseilla sp. (16.1%). Prevalence of resistance was highest for Piperacillin (87.1%) and Amoxicillin+Clavulanic Acid (87.1%) and lowest for Amikacin (12.9%). Prevalence of multidrug resistance among the uropathogens was 80.1% (25) and the most common ESBL gene detected was CTX-M-15. Conclusion: Pregnant women constitute the key risk population of UTI in Accra, while Amikacin remains a suitable drug for the treatment of febrile UTI. The high prevalence of multidrug resistance among the uropathogens highlights the need for surveillance of antimicrobial resistance among these pathogens.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Prince Z Horlortu
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Nicholas TKD Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
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Donkor ES, Dayie NT, Tette EMA. Methicillin-Resistant Staphylococcus aureus in Ghana: Past, Present, and Future. Microb Drug Resist 2019; 25:717-724. [DOI: 10.1089/mdr.2018.0115] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Eric S. Donkor
- Department of Medical Microbiology, University of Ghana, Accra, Ghana
| | | | - Edem M. A. Tette
- Department of Community Health, University of Ghana, Accra, Ghana
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Kalungia AC, Mwambula H, Munkombwe D, Marshall S, Schellack N, May C, Jones ASC, Godman B. Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice. J Chemother 2019; 31:378-387. [DOI: 10.1080/1120009x.2019.1622293] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | | | | | - Sarah Marshall
- Brighton and Sussex Medical Schools, University of Sussex, Falmer, Brighton, UK
| | - Natalie Schellack
- Division of Clinical Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Claire May
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Falmer, Brighton, UK
| | - Anja St. Claire Jones
- Brighton and Sussex University Hospitals, National Health Service, Falmer, Brighton, UK
| | - Brian Godman
- Division of Clinical Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Health Economics Centre, University of Liverpool Management School, Liverpool, UK
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
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