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Ghiga I, Pitchforth E, Stålsby Lundborg C, Machowska A. Family doctors' roles and perceptions on antibiotic consumption and antibiotic resistance in Romania: a qualitative study. BMC PRIMARY CARE 2023; 24:93. [PMID: 37038124 PMCID: PMC10084585 DOI: 10.1186/s12875-023-02047-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 03/27/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a major global health issue, bringing significant health burden and costs to societies. Increased antibiotic consumption (ABC) is linked to AMR emergence. Some of the known drivers of ABC are antibiotics over-prescription by physicians and their misuse by patients. Family doctors are recognised as important stakeholders in the control of ABC as they prescribe antibiotics and are considered a reliable source of medical information by patients. Therefore, it is important to explore their perceptions, especially in Romania, which has the highest ABC among European Union Member States. Furthermore, there is no published research exploring Romanian family doctors' perceptions regarding this phenomenon. METHODS This was a qualitative study with data collection via semi-structured interviews among 12 family doctors. Manifest and latent content analysis was used to gain an in-depth understanding of their perceptions. Findings were mapped onto the domains of the Behaviour Change Wheel to facilitate a theory driven systematization and analysis. RESULTS Two main subthemes emerged: i) factors affecting ABC and prescribing and ii) potential interventions to tackle ABC and antibiotic resistance. The factors were further grouped in those that related to the perceived behaviour of family doctors or patients as well as those that had to do with the various systems, local contexts and the COVID-19 pandemic. An overarching theme: 'family doctors in Romania see their role differently when it comes to antibiotic resistance and perceive the lack of patient education or awareness as one of the major drivers of ABC' was articulated. The main findings suggested that the perceived factors span across the capability, opportunity and motivational domains of the behaviour change wheel and could be addressed through a variety of interventions - some identified by the participants. Findings can also be viewed through cultural lenses which shed further light on the family doctor- patient dynamic when it comes to antibiotics use. CONCLUSION Potential interventions to tackle identified factors emerged, revolving mostly on efforts to educate patients or the public. This exploratory research provides key perspectives and facilitates further research on potential interventions to successfully address AMR in Romania or similar settings.
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Affiliation(s)
- Ioana Ghiga
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Emma Pitchforth
- Primary Care Research Group, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | | | - Anna Machowska
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
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Pogurschi EN, Petcu CD, Mizeranschi AE, Zugravu CA, Cirnatu D, Pet I, Ghimpețeanu OM. Knowledge, Attitudes and Practices Regarding Antibiotic Use and Antibiotic Resistance: A Latent Class Analysis of a Romanian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127263. [PMID: 35742513 PMCID: PMC9224212 DOI: 10.3390/ijerph19127263] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 02/04/2023]
Abstract
Considering the major limitations of the latest studies conducted in Romania on the knowledge, attitudes and practices (KAPs) of antibiotic use and antibiotic resistance, we conducted this study to assess this major public health threat. A cross-sectional survey based on a validated questionnaire was conducted among the general population of Romania for a period of 5 months, i.e., September 2021-January 2022. The questionnaire was distributed using Google Form and it covered demographic characteristics and KAP assessments consisting of 12 items on knowledge, 10 items on attitudes and 3 items on practices. Latent class analyses (LCAs) were conducted to group respondents based on their responses. The response rate was 77%, of which females responded in a greater number (n = 1251) compared to males (n = 674). For most of the respondents (67.32%, n = 1296), the education level was high school, while 23.58% (n = 454) of respondents were college graduates. One in three Romanians (33.3%) know the WHO predictions related to this topic. Overall, the Romanian population is less disciplined when it comes to completing antibiotic treatments, as 29.19% of the respondents stop the course of antibiotic administration if their symptoms improve. The key findings from the present study may help policy makers in designing targeted interventions to decrease confusion, ambiguity or misconceptions about antibiotic use.
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Affiliation(s)
- Elena Narcisa Pogurschi
- Public Health and Food Safety Laboratory, Department Formative Science in Animal Breeding and Food Industry, Faculty of Animal Productions Engineering and Management, University of Agronomic Sciences and Veterinary Medicine of Bucharest, 011464 Bucharest, Romania;
| | - Carmen Daniela Petcu
- Department Animal Production and Public Health, Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine of Bucharest, 050097 Bucharest, Romania;
| | | | - Corina Aurelia Zugravu
- Department-Fundamental Disciplines, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania;
| | - Daniela Cirnatu
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania;
| | - Ioan Pet
- Department of Biotechnologies, Bioengineering, Faculty of Animal Resources, Banat University of Agricultural Science and Veterinary Medicine “Regele Mihai I al Romaniei”, 300645 Timisoara, Romania;
| | - Oana-Mărgărita Ghimpețeanu
- Department Animal Production and Public Health, Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine of Bucharest, 050097 Bucharest, Romania;
- Correspondence: ; Tel.: +40-724529434
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Wagner CE, Prentice JA, Saad-Roy CM, Yang L, Grenfell BT, Levin SA, Laxminarayan R. Economic and Behavioral Influencers of Vaccination and Antimicrobial Use. Front Public Health 2020; 8:614113. [PMID: 33409264 PMCID: PMC7779682 DOI: 10.3389/fpubh.2020.614113] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/01/2020] [Indexed: 01/07/2023] Open
Abstract
Despite vast improvements in global vaccination coverage during the last decade, there is a growing trend in vaccine hesitancy and/or refusal globally. This has implications for the acceptance and coverage of a potential vaccine against COVID-19. In the United States, the number of children exempt from vaccination for “philosophical belief-based” non-medical reasons increased in 12 of the 18 states that allowed this policy from 2009 to 2017 (1). Meanwhile, the overuse and misuse of antibiotics, especially in young children, have led to increasing rates of drug resistance that threaten our ability to treat infectious diseases. Vaccine hesitancy and antibiotic overuse exist side-by-side in the same population of young children, and it is unclear why one modality (antibiotics) is universally seen as safe and effective, while the other (vaccines) is seen as potentially hazardous by some. In this review, we consider the drivers shaping the use of vaccines and antibiotics in the context of three factors: individual incentives, risk perceptions, and social norms and group dynamics. We illustrate how these factors contribute to the societal and individual costs of vaccine underuse and antimicrobial overuse. Ultimately, we seek to understand these factors that are at the nexus of infectious disease epidemiology and social science to inform policy-making.
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Affiliation(s)
- Caroline E Wagner
- Department of Bioengineering, McGill University, Montreal, QC, Canada
| | - Joseph A Prentice
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Chadi M Saad-Roy
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, United States
| | - Luojun Yang
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, United States.,Fogarty International Center, National Institutes of Health, Bethesda, MD, United States
| | - Simon A Levin
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Princeton Environmental Institute, Princeton University, Princeton, NJ, United States
| | - Ramanan Laxminarayan
- Princeton Environmental Institute, Princeton University, Princeton, NJ, United States.,Center for Disease Dynamics, Economics & Policy, Washington, DC, United States
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Kandasamy G, Sivanandy P, Almaghaslah D, Khobrani M, Chinnadhurai M, Vasudevan R, Almeleebia T. Knowledge, attitude, perception and practice of antibiotics usage among the pharmacy students. Int J Clin Pract 2020; 74:e13599. [PMID: 32593188 DOI: 10.1111/ijcp.13599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/23/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Resistance to antibiotics causes negative impact on health of the patients. Antibiotic resistance is the major global concern that has to be nullified for the better health outcome. The knowledge on antibiotics is very essential for the students who undertake pharmacy and health science courses. Hence a study was aimed to assess the level of knowledge, attitude, perception and practice on antibiotics usage among the pharmacy students of King Khalid University, KSA. MATERIALS AND METHODS A prospective online questionnaire based survey was carried out among the pharmacy students about knowledge, attitude perception and practice of antibiotics using 5-point "Likert scale" and true/false responses. The responses range from strongly agree to strongly disagree, and always to never were recorded. The data were analysed by using simple descriptive statistics. RESULTS Out of 300 students approached 212 responded and the response rate was found to be 71%. In this study, most (95%) of the students were aware of the emerging problem of antibiotic resistance due to inappropriate use of antibiotics. Majority (89%) of the students agreed the inappropriate use of antibiotics can increase the overall cost of treatment. However, over half of the (54%) students were not aware of the antibiotic resistance that may be a nation-wide problem of Kingdom of Saudi Arabia. The net positive response (NPR) and net other response (NOR) of all items in perception on antibiotics received more or less equal responses. CONCLUSION The knowledge of antibiotics usage among the students are considerably good compared with previous studies. However, the attitude, perception and practice on antibiotics usage among the pharmacy students are very poor. It alarms the need of appropriate education to enlighten antibiotic awareness for the better disease prevention and health outcomes for the benefit of patient community.
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Affiliation(s)
- Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Palanisamy Sivanandy
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Dalia Almaghaslah
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Moteb Khobrani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Maheswari Chinnadhurai
- Department of Pharmacy Practice, College of Pharmacy, Shaqra University, Shaqra, Saudi Arabia
| | - Rajalakshimi Vasudevan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Tahani Almeleebia
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
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Goswami N, Dahal P, Shrestha S, KC B, Mallik SK. <p>Community Pharmacy Personnel Understanding of Antibiotic Dispensing in Eastern Nepal</p>. Healthc Policy 2020; 13:1513-1522. [PMID: 32982509 PMCID: PMC7490080 DOI: 10.2147/rmhp.s264192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022] Open
Abstract
Background Objective Methods Results Conclusion
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Affiliation(s)
- Nikita Goswami
- Purbanchal University College of Medical and Allied Sciences, Purbanchal University, Sundar Haraicha, Gothgaun, Morang, Nepal
| | - Prasanna Dahal
- Purbanchal University College of Medical and Allied Sciences, Purbanchal University, Sundar Haraicha, Gothgaun, Morang, Nepal
- Correspondence: Prasanna Dahal Purbanchal University College of Medical and Allied Sciences, Purbanchal University, Sundar Haraicha, Gothgaun, Morang56611, NepalTel +9779852049828 Email
| | - Shakti Shrestha
- School of Pharmacy, Pharmacy Australia Center of Excellence, The University of Queensland, Brisbane, QLD4102, Australia
| | - Bhuvan KC
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan47500, Bandar Sunway Selangor Darul Ehsan, Malaysia
| | - Shyam Kumar Mallik
- Purbanchal University College of Medical and Allied Sciences, Purbanchal University, Sundar Haraicha, Gothgaun, Morang, Nepal
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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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Haque M, Rahman NAA, McKimm J, Sartelli M, Kibria GM, Islam MZ, Binti Lutfi SNN, Binti Othman NSA, Binti Abdullah SL. Antibiotic Use: A Cross-Sectional Study Evaluating the Understanding, Usage and Perspectives of Medical Students and Pathfinders of a Public Defence University in Malaysia. Antibiotics (Basel) 2019; 8:E154. [PMID: 31546812 PMCID: PMC6784178 DOI: 10.3390/antibiotics8030154] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Antimicrobial prescribing behaviors are often influenced by the local culture and prescribing appropriateness of medical doctors and other health care professionals. Globally, antimicrobial utilization practices have a profound impact on antimicrobial resistance and are a tremendous public health concern. The aim of this survey was to explore the knowledge and attitudes of medical students from the National Defence University of Malaysia regarding antimicrobial usage and antimicrobial resistance. Research design and methods: This was a cross-sectional study. The study population consisted of undergraduate medical students in each year group from the National Defence University of Malaysia. Students receive limited formal training on the use of antibiotics in their curriculum, and most of this learning is opportunistic whilst on clinical placement. Universal sampling was used as the study population was small. Data were collected utilizing a previously validated instrument regarding antibiotic use. Simple descriptive statistics were used to generate frequencies and percentages with SPSS V21. This research was approved by the Centre for Research and Innovation Management, National Defence University of Malaysia. Results: 206 questionnaires were distributed with a response rate of 99.03%, 54% (110) male, and 46% (94) female. Out of the respondents, 65% (132) had used antibiotics in the last year. Respondents displayed a moderate level of knowledge about antibiotics. Conclusions: This study revealed that the older the student was, or when the year of study and total knowledge score was higher, the students were less likely to stop antimicrobials when they felt better or use leftover antibiotics without consulting a doctor. Therefore, the nearer the students were to graduation, the better their knowledge and skills were, and this translated into their own behaviors regarding use of antimicrobials. This finding has clear implications for curriculum design and the inclusion of formal teaching throughout the medical program on antimicrobial use and antimicrobial resistance (AMR). However, more research is needed on this topic, including the prescribing habits and antibiotic use of practicing doctors.
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Affiliation(s)
- Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur 57000, Malaysia.
| | - Nor Azlina A Rahman
- Department of Basic Health, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, Kuantan 25200, Malaysia.
| | - Judy McKimm
- School of Medicine, Swansea University, Swansea, Wales SA2 8PP, UK.
| | - Massimo Sartelli
- Department of Surgery, Macerata Hospital, University of Macerata, Via Giovanni Mario Crescimbeni, 28, 62100 Macerata MC, Italy.
| | - Golam Mohammad Kibria
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur 57000, Malaysia.
| | - Md Zakirul Islam
- Eastern Medical College, Comilla, Kabila, Dhaka-Chittagong Highway, Burichang 3520, Bangladesh.
| | - Siti Nur Najihah Binti Lutfi
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur 57000, Malaysia.
| | - Nur Syamirah Aishah Binti Othman
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur 57000, Malaysia.
| | - Shahidah Leong Binti Abdullah
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur 57000, Malaysia.
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Zhang Y, Wang W, Liu Q, Wu X, Xiang M, Zhao Y, He X, Ma Y. Attitude and behavior of clinical nurse towards self-health care: a cross-sectional survey. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:329. [PMID: 31475199 DOI: 10.21037/atm.2019.06.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Researches focus on the risk factors affecting the health of nurses have been amounting. However, the specific factors about nurse' attitude to health and health-seeking behavior pattern are not well explored. Methods A questionnaire was sent out to all 620 nurses in department of surgery in Peking Union Medical College Hospital (PUMCH) and demographic information, educational background, clinical experience, and attitude to the disease were investigated. Results The survey indicated that 44.44% (N=212) of respondents did not consult physician. Instead, they self-managed their illness, with 60.38% (N=128) of non-consulters taking some medications. Education background (P=0.027) and income (P=0.010) were found to be the main factor affecting whether a doctor was consulted. Those who self-evaluated with well physical condition show higher strict compliance (55.00% vs. 41.64%), lower discount-compliance (43.75% vs. 56.15%), and lower total ignorance (1.25% vs. 2.21%), compared with those who self-evaluated not well (P=0.020). The respondents who thought the work stress was the influencing factor to the health were more likely to feedback a poor health status, worry about their health, fear to suffer from a disease, and complain about suffering from pain or discomfort. Conclusions Half of nurses self-treat, with a large proportion self-prescribing, and do not believe in or comply with the doctor's advice, which warrant a closer look.
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Affiliation(s)
- Yi Zhang
- Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Wenqin Wang
- Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Qiaofei Liu
- Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xinjuan Wu
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Min Xiang
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yanwei Zhao
- Department of internal medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaodong He
- Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yufen Ma
- Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Assessment of General Public's Knowledge and Opinions towards Antibiotic Use and Bacterial Resistance: A Cross-Sectional Study in an Urban Setting, Rufisque, Senegal. PHARMACY 2018; 6:pharmacy6040103. [PMID: 30241307 PMCID: PMC6306938 DOI: 10.3390/pharmacy6040103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/23/2018] [Accepted: 08/08/2018] [Indexed: 12/11/2022] Open
Abstract
Background: Bacterial resistance is a major public health problem worldwide. One solution to this scourge is to sensitize the general public on rational use of antibiotics. Our goal was to assess people’s knowledge and opinions about antibiotic use and bacterial resistance in an urban setting. Method: We performed a cross-sectional study. A convenience sampling was done. A questionnaire was administered to 400 persons during face-to-face interviews. Results: Most respondents thought that antibiotics are effective against colds/flu (69.8%), cough (72.3%) and sore throat (64.4%). At the same time, 42.8% stated that antibiotic therapy can be stopped as soon as the symptoms disappear. Only 8.8% and 41.8% of people knew that handwashing and vaccination prevented bacterial resistance. Globally, 7% of people had a good knowledge. Socio-demographic variables were not associated with the level of knowledge. The main sources of information were entourage and pharmacy staff. Regarding the opinions, 78.3% of surveyed participants the people thought that that people overuse antibiotics. Additionally, 28% said that they have no role to play against bacterial resistance. Conclusion: People living in an urban setting had a low knowledge about antibiotic use and bacterial resistance. There is a need to implement awareness campaigns. Further studies on population practices toward antibiotic use are necessary.
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Sisay M, Mengistu G, Edessa D. Epidemiology of self-medication in Ethiopia: a systematic review and meta-analysis of observational studies. BMC Pharmacol Toxicol 2018; 19:56. [PMID: 30201045 PMCID: PMC6131789 DOI: 10.1186/s40360-018-0248-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/05/2018] [Indexed: 12/05/2022] Open
Abstract
Background Self-medication is the use of drugs to treat self-diagnosed disorders and/or symptoms, or the intermittent or continued use of a prescribed drug for recurrent disease or symptoms. This phenomenon is alarmingly increasing over time despite the occurrence of health-related hazards. This study is, therefore, aimed to quantitatively estimate self-medication practice and possible reasons for it in Ethiopia. Methods Data were identified from major databases and indexing services including EMBASE (Ovid), PubMed, MEDLINE (Ovid), and Google Scholar. Both published and unpublished records addressing self medication practice in Ethiopia without time limit were included for the study. Data were extracted with structured format prepared in Microsoft Excel and exported to OpenMeta[analyst] version 3.3 software for analyses. Pooled estimation of outcomes was performed with DerSimonian-Laird random-effects model at 95% confidence level. Sensitivity and subgroup analyses were also considered. Degree of heterogeneity of studies was presented with I2 statistics. Publication bias was also performed with the help of Comprehensive Meta-Analysis version-3 software and presented with funnel plots of standard error supplemented by Begg’s and Egger’s tests. The study protocol is registered on PROSPERO with reference number ID: CRD42018093790. Results A total of 27 studies with 9586 participants were included for the study. The pooled prevalence of self-medication in Ethiopia was found to be 44.0% (95% confidence interval [CI]: 35.1, 52.8). Geographical-based subgroup analysis revealed that the highest prevalence was observed at the capital of Ethiopia, Addis Ababa, 62.8% (95% CI: 42.3, 83.2). Population based analysis indicated that healthcare professionals and students were the main practitioners of self-medication. Besides, the prevalence of self-medication practice in pregnant women is approximately 22.9% (95% CI: 9.8, 36). The most common reasons to practice self-medication were previous experience of clients and/or familiarity of treatments, 31.3% (95% CI: 21.5, 41.1) and perceived mildness of the illness, 31.1% (95% CI: 26.0, 36.2). The pooled prevalence of analgesics, antimicrobial agents and gastrointestinal drugs were 46.1% (95% CI: 36.2, 56.1), 28.2% (95% CI: 19.6, 36.8), and 14.9% (95% CI: 7.8, 21.9), respectively. Conclusion Self-medication practice becomes a common phenomenon in Ethiopia. The use of prescription-only medications including antimicrobial agents without medical consult has become alarmingly high. This practice will come with potential health related hazards including emergence of antimicrobial resistance. Therefore, there must be a multitude of strategies for reversing the current worrying trends of self-medication. Electronic supplementary material The online version of this article (10.1186/s40360-018-0248-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mekonnen Sisay
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
| | - Getnet Mengistu
- Pharmacology Unit, Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, P.O. Box 1145, Dessie, Ethiopia
| | - Dumessa Edessa
- Department of Pharmacy Practice, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
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