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Mannan A, Chakma K, Dewan G, Saha A, Chy NUHA, Mehedi HMH, Hossain A, Wnaiza J, Ahsan MT, Rana MM, Alam N. Prevalence and determinants of antibiotics self-medication among indigenous people of Bangladesh: a cross-sectional study. BMJ Open 2024; 14:e071504. [PMID: 38448060 DOI: 10.1136/bmjopen-2022-071504] [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] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES Self-medication with antibiotics (SMA) contributes significantly to the emergence of antimicrobial resistance (AMR), especially in low-income countries including Bangladesh. This study aimed to generate evidence on the self-reported prevalence of antibiotic self-medication and its determinants among indigenous people residing in Bangladesh's Chittagong Hill Tracts (CHT) districts. DESIGN This study used a cross-sectional design with data collected through a survey using a semi-structured questionnaire. SETTING This study was conducted from late January to early July 2021; among different indigenous group populations aged 18 years or more olders residing in the three districts of CHT. PARTICIPANTS A total of 1336 indigenous people residing in Bangladesh's CHT districts were included. PRIMARY OUTCOME AND EXPLANATORY VARIABLES The primary outcome measure was SMA while explanatory variables were socio-demographic characteristics, health status of participants, and knowledge of antibiotics usage and its side effects. RESULTS Among the study participants, more males (60.54%) than females (51.57%) reported using antibiotics. The SMA rate was high among individuals with education levels below secondary (over 50%) and those in the low-income group (55.19%). The most common diseases reported were cough, cold and fever, with azithromycin being the most frequently used antibiotic. Levels of education, family income, having a chronic illness and place of residence were found to be the significant predictors of having good knowledge of antibiotic use as found in the ordered logit model. Findings from a logistic regression model revealed that men had 1.6 times higher odds (adjusted OR (AOR) 1.57; 95% CI 1.12 to 2.19) of SMA than women. Participants with ≥US$893 per month family income had lowest odds (AOR 0.14; 95% CI 0.03 to 0.64) of SMA than those who earned CONCLUSION Male gender, family income, place of residence and knowledge of antibiotics were the significant predictors of antibiotic self-medication. Hence, it is important to streamline awareness-raising campaigns at the community level to mitigate the practice of SMA in indigenous people and ultimately address the devastating effects of Antimicrobial resistance (AMR) in Bangladesh.
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Affiliation(s)
- Adnan Mannan
- Department of Genetic Engineering & Biotechnology, University of Chittagong, Chattogram, Bangladesh
- Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh
| | - Kallyan Chakma
- Department of Genetic Engineering & Biotechnology, University of Chittagong, Chattogram, Bangladesh
- Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh
| | - Gourab Dewan
- Department of Medicine, Rangamati Medical College, Rangamati, Bangladesh
| | - Ayan Saha
- Department of Bioinformatics & Biotechnology, Asian University for Women, Chattogram, Bangladesh
| | | | | | - Amzad Hossain
- Department of Genetic Engineering & Biotechnology, Jagannath University, Dhaka, Bangladesh
| | - Jannatun Wnaiza
- Department of Biochemistry & Biotechnology, University of Science and Technology Chittagong, Chattogram, Bangladesh
| | - Md Tanveer Ahsan
- Department of Pharmacy, University of Chittagong, Chattogram, Bangladesh
| | - Md Mashud Rana
- Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh
- Department of Pharmacology and Therapeutics, Chittagong Medical College, Chattogram, Bangladesh
| | - Nazmul Alam
- Department of Public Health, Asian University for Women, Chattogram, Bangladesh
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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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Mudenda S, Chisha P, Chabalenge B, Daka V, Mfune RL, Kasanga M, Kampamba M, Skosana P, Nsofu E, Hangoma J, Siachalinga L, Hikaambo CN, Chimombe T, Allabi AC, Boya B, Mufwambi W, Saleem Z, Matafwali SK. Antimicrobial stewardship: knowledge, attitudes and practices regarding antimicrobial use and resistance among non-healthcare students at the University of Zambia. JAC Antimicrob Resist 2023; 5:dlad116. [PMID: 37954639 PMCID: PMC10635582 DOI: 10.1093/jacamr/dlad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
Background Antimicrobial resistance (AMR) poses a significant threat to the world and could become humanity's next major challenge. This study assessed non-healthcare students' knowledge, attitude and practices (KAP) towards antimicrobial use (AMU) and AMR at the University of Zambia. Methods This cross-sectional study was conducted among 443 non-healthcare students from August to October 2022 using a structured questionnaire. Data analysis was done using IBM SPSS version 24.0. Results Of the 433 participants, 55.2%, 63.5% and 45% had moderate KAP scores regarding AMU and AMR. The prevalence of self-medication with antibiotics was 76.7%. Male participants were less likely to have good knowledge (OR = 0.524, 95% CI: 0.347-0.792) and positive attitudes (OR = 0.585, 95% CI: 0.364-0.940) towards AMU and AMR compared with females. Students who were studying Engineering and Mining were more likely to have good knowledge of AMR (OR = 1.891, 95% CI: 1.197-2.987) compared with those in Social Sciences. Those who were in their fourth and fifth years were more likely to have positive attitudes towards AMU and AMR (OR = 1.851, 95% CI: 1.147-2.986) compared with those who were in the first, second and third years. Finally, students who practised self-medication were less likely to have good self-reported practice towards AMR (OR = 0.442, 95% CI: 0.278-0.702) compared with those who did not. Conclusions This study demonstrated that non-healthcare students had moderate KAP regarding AMU and AMR. All university students should be provided with education about AMU and AMR through free short courses, seminars, workshops, and AMR and antimicrobial stewardship awareness campaigns.
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Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
- Surveillance and Research Technical Working Group, Antimicrobial Resistance, Zambia National Public Health Institute, Lusaka, Zambia
| | - Patience Chisha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Billy Chabalenge
- Department of Medicines Control, Zambia Medicines Regulatory Authority, Lusaka, Zambia
| | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Ruth Lindizyani Mfune
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Maisa Kasanga
- College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Martin Kampamba
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Phumzile Skosana
- Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Eustus Nsofu
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Jimmy Hangoma
- Department of Pharmacy, School of Health Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Linda Siachalinga
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
- Department of Pharmacy, School of Health Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia
| | | | - Tadious Chimombe
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Aurel Constant Allabi
- Laboratory of Pharmacology and Toxicology, University of Abomey-Calavi and Teaching Hospital of Abomey-Calavi/Sô-Ava, Abomey-Calavi, Benin
| | - Bawa Boya
- Laboratory of Biology and Molecular Typing in Microbiology, University of Abomey-Calavi, Cotonou, Benin
| | - Webrod Mufwambi
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Scott Kaba Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Al-Shami HA, Abubakar U, Hussein MSE, Hussin HFA, Al-Shami SA. Awareness, practices and perceptions of community pharmacists towards antimicrobial resistance and antimicrobial stewardship in Libya: a cross-sectional study. J Pharm Policy Pract 2023; 16:46. [PMID: 36945072 PMCID: PMC10028782 DOI: 10.1186/s40545-023-00555-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Community pharmacists play a vital role in promoting appropriate use of antibiotics in the community. This study evaluated the practices and perceptions of community pharmacists towards antibiotic use, antibiotic resistance, and antimicrobial stewardship in Libya. METHODS A cross-sectional study was conducted among community pharmacists in Libya using a 47-item validated, pre-tested online questionnaire. Data was collected from December 2021 to February 2022 and was analysed using descriptive and inferential analyses. RESULTS Of the 114 questionnaires included in the analysis, 54.4% were females, 78.1% had < 10 year working experience (78.1%), and 81.6% had a Bachelor of Pharmacy. Most (78.1%) strongly agreed/agreed that community pharmacists have an important role to play to reduce antibiotic resistance. Overall, the participants had a moderate perception towards antimicrobial resistance (median score: 21.5; IQR [16-28] out of 35.0). More than 40% supply antibiotics when patients requested them specifically, because if they do not supply them, patients will just go to another pharmacy. About 47% strongly agreed/agreed that if a patient cannot afford a full course of antibiotics all in one go, they will give them a smaller amount that they are able to afford at that time, even when a longer duration of treatment is required. Most (66.7%) had no previous involvement in antibiotics awareness campaign due to 'I have never heard about the campaign' (48.7%) and 'I do not have enough time to participate' (22.4%). Overall, the perception towards antimicrobial stewardship was good (20 [13-25] out of 25.0). Raising awareness of rational antibiotic use, including antimicrobial resistance, among pharmacy students (83.4%) and patient education by pharmacists in community pharmacies at the time medicines are supplied to patients (81.6%) were the most common strategies to improve rational use of antibiotics in community pharmacy. CONCLUSIONS Community pharmacists in Libya recognise their role in reducing antimicrobial resistance. They had a moderate perception towards antimicrobial resistance and a good perception towards antimicrobial stewardship. However, inappropriate antibiotic practices were common. The most common strategies to improve rational use of antibiotics in community pharmacy were raising awareness about the rational antibiotic use among pharmacy students and patient education by community pharmacists at the time antibiotics are dispensed to patients. Regulations are needed to restrict dispensing antibiotics without prescription among community pharmacists.
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Affiliation(s)
- Hiba A Al-Shami
- Anaesthesia and Emergency Medicine Department, College of Medical Technology, Benghazi, 141, Benghazi, Libya
| | - Usman Abubakar
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
| | - Maryam S E Hussein
- Anaesthesia and Emergency Medicine Department, College of Medical Technology, Benghazi, 141, Benghazi, Libya
| | - Hanin F A Hussin
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Benghazi, 141, Benghazi, Libya
| | - Sondos A Al-Shami
- Faculty of Pharmacy, Libyan International Medical University, 141, Benghazi, Libya
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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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Development and Psychometric Evaluation of the Antibiotic Knowledge and Consumption Tool (AKCT). Antibiotics (Basel) 2022; 11:antibiotics11121744. [PMID: 36551401 PMCID: PMC9774259 DOI: 10.3390/antibiotics11121744] [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: 11/09/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/09/2022] Open
Abstract
Knowledge of antibiotics and awareness of microbial resistance are essential for appropriate antibiotic consumption. This study aimed to develop and validate a measure of antibiotic knowledge and consumption (AKCT) and to make it available in the Arabic language and context. The tool was developed and applied on individuals ≥ 18 years, with mastery of Arabic or English. Exploratory factor analysis using principal-component analysis tested the psychometric properties of the items. AKCT scores were compared with the Infectious Numeracy Test (INT) scores to establish convergent validity. Cronbach’s α > 0.7 measured reliability. Three hundred-eighty-six participants completed the questionnaire, achieving a 95.3% response rate. Five components were retained after factor analysis: Side-effects and resistance, Access to antibiotics, Recovery after use, Antibiotics use indications, and Body response. Cronbach’s α = 0.85. The mean ± SD of AKCT = 9.82 ± 3.85 (range = 7−20); lowest scores were related to “Side-effects and resistance” (2.32 ± 2.00, max = 7) and “Antibiotic use indications” (1.61 ± 1.29, max = 5). Scores on the AKCT and INT positively correlated. The AKCT is a valuable, valid, and reliable tool developed for measurement of antibiotic knowledge and consumption behaviors to identify specific areas needing improvements; hence, targeted interventions are devised.
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Antibiotic use numeracy: Developing the infectious numeracy test (INT). Res Social Adm Pharm 2022; 18:3580-3587. [DOI: 10.1016/j.sapharm.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022]
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Pauzi ZM, Hassan BAR, Neo CF, Mohammed AH, Blebil A, Dujaili J. Antibiotic use and resistance in a tertiary care hospital: knowledge and attitude among patients of orthopaedic and surgical wards in Malaysia. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2022. [DOI: 10.1093/jphsr/rmab068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objectives
The prevalence of antimicrobial resistance (AMR) is rising globally as well as in Malaysia. AMR can lead to difficulty in the treatment of chronic infection if being neglected. This study aimed to assess the level of knowledge and attitude about antibiotic usage and AMR.
Methods
A cross-sectional study design was carried out at the Hospital Kuala Lumpur (HKL), Malaysia, where participants were recruited by using the non-probability convenience sampling from the six orthopaedic and four surgical wards. A self-administered questionnaire was used to collect the required data which were then analysed by using SPSS.
Key findings
A total number of 390 adult Malaysians (286 from orthopaedic wards and 104 from surgical wards) were involved in the study. This study showed that the level of knowledge and attitude about antibiotics among the majority of respondents were moderate. However, their knowledge regarding AMR was very low (i.e. lack of knowledge). In contrast, the majority of them (69.8%) showed a positive attitude towards antibiotics. Statistical analysis of data revealed that the level of knowledge of AMR was significantly associated with gender, age, race, marital status, educational level and knowledge about antibiotic resistance terms (P < 0.05) while respondents’ attitude towards antibiotic usage was significantly associated with gender, race, marital status and education level (P < 0.05).
Conclusions
It was necessary to formulate and develop strategies to improve the knowledge and awareness about antibiotics and AMR among health professionals. These might help them to improve their skills in delivering health information to the patients through a proper counselling technique.
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Affiliation(s)
- Zulsairi Mohd Pauzi
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak Alam, Selangor, Malaysia
- Hospital Kuala Lumpur, Jalan Pahang, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Chin Fen Neo
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak Alam, Selangor, Malaysia
- Collaborative Drug Discovery Research (CDDR) Group, Pharmaceutical and Life Sciences Community of Research, Universiti Teknologi MARA, Selangor, Malaysia
| | - Ali Haider Mohammed
- Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Ali Blebil
- Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Juman Dujaili
- Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
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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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Serbian students' knowledge, attitudes and behaviour towards antibiotic use: is there room for improvement? Int J Public Health 2020; 65:1257-1267. [PMID: 32737562 DOI: 10.1007/s00038-020-01448-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES This study has been aimed at evaluating knowledge, attitudes and behaviour of university students regarding the usage of antibiotics focusing on differences between medical and nonmedical students. METHODS This cross-sectional questionnaire-based study was performed on 800 students of the University of Novi Sad, Serbia. RESULTS The identified predictors of adequate antibiotic knowledge were enrolled in medical program, higher grade average and appropriate use of antibiotics during last infection. Multivariate regression identified following predictors of self-medication: being medical student (B = 0.715; p < 0.001), more frequent (B = 0.628; p < 0.001) and irregular (B = 0.584; p = 0.001) antibiotic use, a family member engaged in medical profession (B = 0.789; p < 0.001), living in dormitory (B = 0.679; p = 0.007) or rented apartment (B = 0.621; p = 0.002), using antibiotics until symptoms resolved (B = 1.616; p < 0.001) or until the bottle was finished (B = 0.628; p < 0.001) during the last infection. CONCLUSIONS Although a high number of students showed adequate knowledge about antibiotics, numerous misconceptions were recorded, including self-medication. Further educational interventions are necessary to improve their understanding, perceptions as well as their behaviour towards antibiotic use.
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Self-Medication with Antibiotics among Nursing Students in Serbia: Pilot Study. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Healthcare professionals should serve as promoters of rational antibiotic use in attempt to decrease antibiotics misuse within the process of self-medication. Current pilot study was undertaken with the aim to identify potential predictors of self-medication with antibiotics (SMA) and to describe SMA practice among nursing students in Serbia. Data have been collected during the period March-May, 2016 in Medical school of bachelor degree, in Belgrade. Self-reported questionnaire served as a data source. Descriptive statistic was used to analyse study sample characteristics. Chi-square test was used to test differences between groups. Study sample have included 138 participants. Almost half of them, 43.8%, practice SMA. Life style (smoking, alcohol consumption, sleeping habits and physical activity) and socio-demographic characteristics (excepted school grade) were not shown as SMA determinants. Time & money savings were stated as the most frequent reason for SMA, while common cold, sore throat and cough were the most common conditions cured through SMA. Pharmacists’ recommendations and previous positive experience were specified as the most important in the process of antibiotics selection, indicated by 50.0% and 37.5% participants, respectively. Amoxicillin was the most frequently used antibiotic in SMA, used by 50% of participants who practice SMA. High proportion of SMA and observed practice among nursing students in Serbia call for efforts with regards to relevant education about rational antibiotic use, actual clinical guidelines and potential consequences of misuse.
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Gupta MK, Vohra C, Raghav P. Assessment of knowledge, attitudes, and practices about antibiotic resistance among medical students in India. J Family Med Prim Care 2019; 8:2864-2869. [PMID: 31681657 PMCID: PMC6820394 DOI: 10.4103/jfmpc.jfmpc_504_19] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/22/2019] [Accepted: 09/05/2019] [Indexed: 11/06/2022] Open
Abstract
Context: To reduce the magnitude of antimicrobial resistance, there is a need to strengthen the knowledge for future prescribers regarding use and prescription of antibiotics. Before that, it is required to have a conclusive evidence about knowledge, attitude, and practices of that group. Aim: To assess the knowledge, attitudes, and the practices of medical students in India with respect to antibiotic resistance and usage. Settings and Design: It was a cross-sectional study which was done online through Google forms for a period of 4 months from July to October 2018. Materials and Methods: A structured questionnaire containing a five-point Likert scale was sent to medical students across India by sharing link through contacts of Medical Students Association of India. Respondent-driven sampling technique was also adopted for the study. Statistical Analysis Used: Descriptive statistics, parametric (Chi-square), and nonparametric (Kruskal--Wallis and Mann--Whitney U) tests. Results: A total of 474 responses were received from 103 medical colleges across 22 states of India. The mean score of knowledge was 4.36 ± 0.39. As compared to first year students, knowledge was significantly higher among students of all the years. As much as 83.3% students have consumed antibiotics in previous year of the survey. Around 45% of medical students accepted that they buy antibiotics without a medical prescription. Conclusion: The knowledge level of medical students was quite satisfactory. As far as attitude and practices are concerned, there is a substantial need for improvements.
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Affiliation(s)
- Manoj K Gupta
- Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | - Chirag Vohra
- Medical Student, AIIMS, Jodhpur, Rajasthan, India
| | - Pankaja Raghav
- Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
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Alshogran OY, Alzoubi KH, Khabour OF, Farah S. Patterns of self-medication among medical and nonmedical University students in Jordan. Risk Manag Healthc Policy 2018; 11:169-176. [PMID: 30254501 PMCID: PMC6143637 DOI: 10.2147/rmhp.s170181] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background and objective Self-medication practice involves consumption of medicines by one's own initiative or on the consultation of others without the guidance of a physician. Self-medication and use of over-the-counter drugs are prevalent worldwide public health concerns. University students of medical and nonmedical disciplines may have different levels of health education. This study evaluated the prevalence and patterns of self-medication and the attitudes toward this practice among medical and nonmedical university students in Jordan. Methods A descriptive cross-sectional study was conducted in 504 students (medical: 248 and nonmedical: 256). The students were invited to complete a questionnaire that included questions primarily related to patterns of physician visits, self-medication practice, symptoms provoking self-medication, and sources of advice. Results Self-medication was highly prevalent and comparable between medical and nonmedical students (~96%). Headache (81.9%), cold (58.3%), and flu (53%) were the frequent symptoms provoking self-medication among students. Self-medication for headache (86.7% vs 77.3%) and tooth pain (53.1% vs 27%) was significantly higher among medical vs nonmedical students, respectively. Self-treatment with painkillers (82.3% vs 73%) or antiallergy (11.3% vs 5.9%) drugs was significantly higher among medical students, while the use of anti-flu decongestants (47.6% vs 60.2%) was lower compared to nonmedical students, respectively. Nonmedical vs medical students were significantly more dependent on friends (14.8% vs 7.7%) and own experience (7.4% vs 2.4%) as a source of self-medication advice. Conclusion Self-medication is common among Jordanian university students of medical and nonmedical disciplines. This practice, if used irrationally, may constitute a health problem that needs awareness and interventions by health care regulators in Jordan. Future studies are warranted to examine the impact of self-medication on students' health.
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Affiliation(s)
- Osama Y Alshogran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan,
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan,
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Shatha Farah
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Khalifeh MM, Moore ND, Salameh PR. Self-medication misuse in the Middle East: a systematic literature review. Pharmacol Res Perspect 2017; 5. [PMID: 28805984 PMCID: PMC5684864 DOI: 10.1002/prp2.323] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 04/13/2017] [Indexed: 11/10/2022] Open
Abstract
Regulations usually distinguish between prescription‐only (POM) and over‐the‐counter (OTC) medicines. The former requires medical prescription; the latter are available for SM of common minor or easily treated ailments. However, in the Eastern Mediterranean countries, theoretical prescription medicines can easily be purchased without a prescription, as self‐medication (SM) resulting in potential misuse and unnecessary risk for patients. The magnitude of this activity is uncertain. The aim of this article, therefore, is to undertake a comprehensive review to identify the different types of medicines that can easily be purchased as SM in Middle East and recognized as misused. An extensive review of the published literature (1990–2015) was conducted using Pubmed, web of science, Cochrane, and Google Scholar databases, for OTC medicine misuse in the Middle East. A total of 72 papers were identified. Medicines involved in misuse included: codeine containing products, topical anesthetics, topical corticosteroids, antimalarial, and antibiotics. Self‐medication misuse of medicines seemed widespread. Individual treatment patterns were not clearly identified. Studies were not standardized, limiting the comparability between studies and the estimation of the scale of misuse. Pharmacists, friends, or parents were found to be the main sources of SMs. Knowledge and attitudes are an important contributing factor in the misuse of these medications. Strategies and interventions to limit misuse were rarely identified in literature. In conclusion, a massive problem involving a range of medicines was found in Middle East. Standardization of studies is a prerequisite to the understanding and prevention of misuse of self‐medication.
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Affiliation(s)
- Malak M Khalifeh
- INSERM U 1219 - Pharmaco-épidémiologie et évaluation de l'impact des produits de santé sur les populations, University de Bordeaux, Bordeaux, France.,Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Nicholas D Moore
- INSERM U 1219 - Pharmaco-épidémiologie et évaluation de l'impact des produits de santé sur les populations, University de Bordeaux, Bordeaux, France
| | - Pascale R Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
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Bilal M, Haseeb A, Khan MH, Arshad MH, Ladak AA, Niazi SK, Musharraf MD, Manji AAK. Self-Medication with Antibiotics among People Dwelling in Rural Areas of Sindh. J Clin Diagn Res 2016; 10:OC08-13. [PMID: 27437263 DOI: 10.7860/jcdr/2016/18294.7730] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/02/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Self-medication with antibiotics is becoming increasingly common due to multiple factors. The public who are using these antibiotics generally do not have full information regarding their proper use, especially the dosages and possible side-effects. Hence, unregulated use of such medicines may cause dangerous adverse effects in the patients. AIM The study was aimed to evaluate the prevalence and practice of self-medication with antibiotics among people dwelling in the rural areas of province Sindh. MATERIALS AND METHODS A cross-sectional survey was performed at Outpatient Department of Civil Hospital Karachi, from January to March 2015. Four hundred rural dwellers who lived in the outskirts of Karachi city area of province Sindh were recruited for the study in the aforementioned time period through non-probability convenience sampling. RESULTS The investigation reported a prevalence of 81.25% among rural dwellers of Sindh with regards to self-medication of antibiotics. The most common reason behind self-medication were economic reasons (88.0%). Amoxicillin (52.0%) was found to be the most self-prescribed antibiotic. Majority of the participants (74.7%) didn't know about the phenomena of antibiotic resistance associated with inadequate use of antibiotics and only 25 subjects identified correctly that the situation would lead to increase resistance. CONCLUSION The self-medication rates with antibiotic are higher in rural areas of Sindh. There is an urgent need for the government to enforce stricter laws on pharmacies dispensing medications, especially antibiotics, without prescriptions. Lastly, provision of cost effective treatment from public sector can significantly reduce self-medication with antibiotics among rural dwellers of Sindh.
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Affiliation(s)
- Muhammad Bilal
- Faculty, Department of Medicine, Dow Medical College. Dow University of Health Sciences , Karachi, Pakistan
| | - Abdul Haseeb
- Faculty, Department of Medicine, Dow Medical College, Dow University of Health Sciences , Karachi, Pakistan
| | - Mohammad Hassaan Khan
- Faculty, Department of Medicine, Medical College, Aga Khan University Hospital , Karachi, Pakistan
| | - Mohammad Hussham Arshad
- Faculty, Department of Medicine, Medical College, Aga Khan University Hospital , Karachi, Pakistan
| | - Asma Akbar Ladak
- Pre-Medical Student, Department of Biological Sciences, The Lyceum , Karachi, Pakistan
| | - Sufyan Khan Niazi
- Pre-Medical Student, Department of Biological Sciences, The Lyceum , Karachi, Pakistan
| | | | - Adil Al-Karim Manji
- Pre-Medical Student, Department of Biological Sciences, Karachi Grammar School , Karachi, Pakistan
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Zhao Y, Ma S. Observations on the Prevalence, Characteristics, and Effects of Self-Treatment. Front Public Health 2016; 4:69. [PMID: 27148515 PMCID: PMC4834428 DOI: 10.3389/fpubh.2016.00069] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/01/2016] [Indexed: 12/04/2022] Open
Abstract
Aims When facing illness, a person may choose self-treatment as an alternative to hospital (and primary care)-based treatment. Despite its important role in health care, the study on self-treatment remains limited. The goal is to collectively report the observations in the literature on the prevalence, characteristics, and effects of self-treatment. Methods Databases (Medline/PubMed and Google Scholar) were searched. Articles were scrutinized for country of origin, sample size, recall period, prevalence, associated factors, etc. Results Published studies have reported that in some regions, the prevalence of self-treatment is high and varies across illness conditions and treatment approaches. Self-medication is the most popular self-treatment approach. Multiple regional, demographic, personal, cultural, and religious factors have been implicated in the pursuit of self-treatment. In addition, accessibility of health care also plays a role. In general, self-treatment has a positive clinical and financial effect. However, there have been concerns on abuse and possible negative effects. Conclusion This article reviews observations made in recent studies on several important aspects of self-treatment. Comprehensive and systematic study is still lacking. Interventions are needed to solve several problems associated with self-treatment.
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Affiliation(s)
- Yinjun Zhao
- Department of Biostatistics, Yale University , New Haven, CT , USA
| | - Shuangge Ma
- Department of Biostatistics, Yale University , New Haven, CT , USA
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