scholarly journals Use of antibiotics to treat humans and animals in Uganda: a cross-sectional survey of households and farmers in rural, urban and peri-urban settings

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Susan Nayiga ◽  
Miriam Kayendeke ◽  
Christine Nabirye ◽  
Laurie Denyer Willis ◽  
Clare I R Chandler ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past ◽  
Chi Squared ◽  
Veterinary Antibiotic ◽  
Prevalence Ratios

Abstract Background Use of antibiotics to treat humans and animals is increasing worldwide, but evidence from low- and middle-income countries (LMICs) is limited. We conducted cross-sectional surveys in households and farms in Uganda to assess patterns of antibiotic use among humans and animals. Methods Between May and December 2018, a convenience sample of 100 households in Nagongera (rural), 174 households in Namuwongo (urban) and 115 poultry and piggery farms in Wakiso (peri-urban) were selected and enrolled. Using the ‘drug bag’ method, participants identified antibiotics they used frequently and the sources of these medicines. Prevalence outcomes were compared between different sites using prevalence ratios (PRs) and chi-squared tests. Results Nearly all respondents in Nagongera and Namuwongo reported using antibiotics to treat household members, most within the past month (74.7% Nagongera versus 68.8% Namuwongo, P = 0.33). Use of metronidazole was significantly more common in Namuwongo than in Nagongera (73.6% versus 40.0%, PR 0.54, 95% CI: 0.42–0.70, P < 0.001), while the opposite was true for amoxicillin (33.3% versus 58.0%, PR 1.74, 95% CI: 1.33–2.28, P < 0.001).Veterinary use of antibiotics within the past month was much higher in Wakiso than in Nagongera (71.3% versus 15.0%, P < 0.001). At both sites, oxytetracycline hydrochloride was the most frequently used veterinary antibiotic, but it was used more commonly in Wakiso than in Nagongera (76.5% versus 31.0%, PR 0.41, 95% CI: 0.30–0.55, P < 0.001). Conclusions Antibiotics are used differently across Uganda. Further research is needed to understand why antibiotics are relied upon in different ways in different contexts. Efforts to optimize antibiotic use should be tailored to specific settings.

scholarly journals ASSESSING PHARMACY STUDENTS’ MIGRATION RELATED ATTITUDES AND INTENTION TO EMIGRATE FROM LITHUANIA

2017 ◽  
Vol 27 (3) ◽  
pp. 123-128
Author(s):  
Gvidas Urbonas ◽  
Indrė Venclovaitė ◽  
Aušra Urbonienė ◽  
Loreta Kubilienė
Keyword(s):  
Pharmacy Students ◽  
Self Report ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Middle Income ◽  
High Unemployment ◽  
Personal Attitude ◽  
Middle Income Countries ◽  
Path Analysis Approach

Lithuania among the middle-income countries is experiencing the brain drain situation when high-educated professionals, including health care specialists, migrate to high-income countries in search for better economic, social and cultural life. The objective of the study was to identify the potential reasons for migration from the perspective of pharmacy students that might come into consideration after they graduate university. A convenience sample (n = 196) of pharmacy students participated in the cross-sectional survey where they gave opinion on why people emigrate from Lithuania, also expressed personal attitude towards emigration, as well as intention to emigrate after the studies on self-report scales. The nonlinear Robust Path Analysis approach was employed for data analysis. The results revealed that high unemployment conceived as a reason to emigrate from Lithuania, as well as personal attitude towards emigration was significantly linked with intent to emigrate after studies. Family or friends living abroad, adverse cultural environment, and lack of entertainment options conceived as a reason to emigrate significantly affected students personal attitude towards emigration from Lithuania. High unemployment as a reason for emigration remained the main factor directly associated with the intention to emigrate. However, investment in social, cultural and human capital should be seen as the next step to reduce the attractiveness of emigration to the future pharmacists.

scholarly journals Psychosocial Factors, Smoke-Free Restrictions, and Media Exposure in Relation to Smoking-Related Attitudes and Behaviors among Adults in Armenia and Georgia

2021 ◽  
Vol 18 (8) ◽  
pp. 4013
Author(s):  
Christina N. Wysota ◽  
Marina Topuridze ◽  
Zhanna Sargsyan ◽  
Ana Dekanosidze ◽  
Lela Sturua ◽  
...  
Keyword(s):  
Smoking Status ◽  
Media Exposure ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Quit Attempts ◽  
Multivariable Regression ◽  
Readiness To Quit ◽  
Perceived Harm

Background: Perceived harm, social influences, smoke-free policies, and media exposure have been understudied in relation to tobacco-related attitudes/behaviors in aggregate or in low and middle-income countries; thus, this study examined these factors collectively in relation to smoking-related outcomes among Armenian and Georgian adults. Methods: Using 2018 cross-sectional survey data (n = 1456), multivariable regression analyses examined these factors in relation to smoking status, perceived harm among nonsmokers, and readiness to quit and past-year quit attempts among smokers. Results: Significant predictors (p < 0.05) of current smoking (27.3%) included lower perceived harm, more smoking friends, and fewer home and vehicle restrictions. Among nonsmokers, more home and restaurant/bar restrictions, fewer vehicle restrictions, greater anti-tobacco media exposure, and less pro-tobacco media exposure predicted greater perceived harm. Among smokers, greater perceived social acceptability of smoking, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted readiness to quit (12.7% of smokers). More smoking friends, more home restrictions, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted past-year quit attempts (19.2%). Conclusions: Findings support the importance of smoke-free policies but were counterintuitive regarding the roles of social and media influences, underscoring the need to better understand how to address these influences, particularly in countries with high smoking rates.

scholarly journals Assessing Factors Associated with TB Awareness in Nepal: A National and Subnational Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5124
Author(s):  
Yoko Iwaki ◽  
Santosh Kumar Rauniyar ◽  
Shuhei Nomura ◽  
Michael C. Huang
Keyword(s):  
Socioeconomic Factors ◽  
Influential Factors ◽  
Regional Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Information And Communication ◽  
High Level

Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.

The impact of COVID-19 on oncologists: Experience from Egyptian physicians.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13514-e13514
Author(s):  
Abeid Mohamed Athman Omar ◽  
Marwa Ramadan ◽  
Yomna Khamis ◽  
Abdelsalam A. Ismail
Keyword(s):  
Family Support ◽  
Occupational Safety ◽  
Family Members ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Burnout Rate ◽  
Almost All ◽  
The Impact

e13514 Background: The unprecedented emergence of coronavirus disease (COVID-19) has disrupted the patients' and physicians' daily activities, including cancer care. However, little is known on how COVID-19 has impacted oncologists from low and middle-income countries. Methods: We conducted a cross-sectional survey among eighty-eight practicing oncologists in Alexandria governorate, Egypt. An electronic, anonymized self-reporting survey was distributed in February 2020 to collect information on occupational safety measures, the prevalence of COVID-19 among respondents, workload, and family support during the pandemic Results: Out of 88 contacted oncologists, 75% completed the survey (n=66). Nearly half (45%) of respondents were residents, 36% were specialists, and 18% were consultants. The mean age of respondents was 34.79 years (SD ±10.42). More than half of the respondents were not comfortable managing cancer patients during the pandemic (56%) and did not feel well-protected at the workplace (58%). However, most (79%) had managed a cancer patient with COVID-19 more than once. Furthermore, almost all participants (98%) have worked with an infected colleague. Nevertheless, to more than half (54%), it made no difference working with a colleague who was previously infected. Most physicians (79%) felt overwhelmed with workload than the pre-pandemic period. Despite being COVID-19 negative, nearly half reported their family members had reduced contact with them due to the fear of being infected. In contrast, 24% are now getting more family support, whereas 27% are experiencing the same contact level as before the COVID-19 era. Physicians lacking family support had a significantly higher burnout rate than those who had family support (p=0.038). However, the burnout rate was similar regardless of doctors' rank, or treating COVID-19 patients, or feeling protected at work. The majority of the participants (75%) had experienced COVID-19 like symptoms, and one third (n=21) were confirmed COVID-19 infected: residents - 52%, specialists - 33%, and consultants - 14%. Nevertheless, we found no association between the rank and being infected with COVID-19 (p=0.632). Most participants thought they were infected at the hospital (38% by patients; 24% by colleagues), and 14% by family members. However, there was no significant association between being infected and feeling protected at work (p=0.823). Most of the infected physicians (61%) received moral support from both the family and colleagues, and 33% received family support only. There was no association between burnout rate and being COVID-19 infected (p=0.719). Conclusions: One-third of the oncologists were COVID-19 positive. Besides, most oncologists feel overwhelmed with workload and experience more burnout than before the COVID-19 era, and it worsens if one lacks family support.

scholarly journals Cross-sectional study on the awareness, susceptibility and use of heated tobacco products among adolescents in Guatemala City, Guatemala

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039792
Author(s):  
Anna Gottschlich ◽  
Sophia Mus ◽  
Jose Carlos Monzon ◽  
James F Thrasher ◽  
Joaquin Barnoya
Keyword(s):  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Tobacco Prevention ◽  
Guatemala City ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Middle Income ◽  
The Past

ObjectivesHeated tobacco products (HTPs) are increasingly marketed worldwide, yet limited research on HTPs has been conducted in low and middle-income countries (LMICs) or among adolescents. Guatemala is one of the few LMICs where HTPs are available. This study examined prevalence and correlates of HTP awareness, susceptibility and use among adolescents in Guatemala.Design, setting and participantsA cross-sectional survey on HTP awareness, susceptibility and use was conducted among 2870 students between the ages of 13 and 17 in private schools in Guatemala City, Guatemala.Primary and secondary outcome measuresThe primary outcome was susceptibility to future use of HTP among school-aged current and never smokers in Guatemala. We also explored awareness and use of HTPs. Multivariate binomial regression models were used to explore associations between these outcomes and both sociodemographic factors and established smoking correlates.ResultsOf all students (n=2870), about half were aware of HTPs (52.4%) and susceptible to future or continued use (52.4%). Whereas 8.4% of students had tried HTPs in the lifetime (but not in the last month), only 2.9% used HTPs in the past month. Independent correlates of HTP susceptibility and ever-use included: use of other tobacco products (current smoking: adjusted OR (AOR)=10.53 and 6.63, respectively; current e-cigarette use: AOR=21.87 and 10.40, respectively), moderate alcohol consumption (AOR=1.49 and 1.19, respectively), marijuana use in the past 30 days (AOR=3.49 and 2.29, respectively) and having friends who use HTPs (AOR=1.83 and 7.28, respectively).ConclusionsAmong this sample of adolescents in Guatemala City, where tobacco control is weak, the prevalence of HTP use was low but susceptibility to future use was high. Tobacco prevention and intervention strategies for cigarettes and e-cigarettes should now also include HTPs, which tend to be used by similar adolescent populations (ie, those who use other substances or are exposed to tobacco through family and friends).

scholarly journals Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Jiayao Xu ◽  
Xiaomin Wang ◽  
Kai Sing Sun ◽  
Leesa Lin ◽  
Xudong Zhou
Keyword(s):  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Clinical Settings ◽  
Cross Sectional Survey ◽  
Self Medication ◽  
Cross Sectional ◽  
Prescribing Behavior ◽  
The Past ◽  
Outpatient Settings ◽  
The Impact

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.

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