scholarly journals Point prevalence survey of antibiotic consumption across three hospitals in Ghana

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Obed Kwabena Offe Amponsah ◽  
Kwame Ohene Buabeng ◽  
Alex Owusu-Ofori ◽  
Nana Kwame Ayisi-Boateng ◽  
Katri Hämeen-Anttila ◽  
...  
Keyword(s):  
Susceptibility Testing ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Point Prevalence ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Exact Test ◽  
Susceptibility Data ◽  
Chi Squared

Abstract Background Actionable data on antimicrobial use is important when planning strategic interventions such as antimicrobial stewardship to address the challenge of drug resistance, particularly in resource-constrained settings. Objectives To assess the prevalence of antibiotic use, the pattern of commonly used antibiotics and patient factors that may be associated with the increased use of antibiotics in the study hospitals. Methods This was a cross-sectional study conducted using the WHO Methodology for Point Prevalence Surveys in hospitals. Chi-squared analysis, Fisher’s exact test and logistic regression were employed to analyse statistically the data obtained. Results The overall prevalence of antibiotic use in the hospitals was 60.5%. The commonest indications for antibiotic recommendations were community-acquired infections (36.5%), surgical prophylaxis (26.1%) and hospital-acquired infections (15.7%), among others. Very few (2.7%) of the patients had their samples taken for culture and susceptibility testing to guide therapy. Penicillins (48.7%), cephalosporins (23.5%) and fluoroquinolones (17.4%) were the most commonly prescribed antibiotics. Concurrent malaria infection [adjusted OR (AOR) 0.33, 95% CI 0.11–0.94, P = 0.04] and increasing age (AOR 0.98, 95% CI 0.96–1.00, P = 0.02) were associated with lower risk of antibiotic use. Conclusions The prevalence of antibiotic consumption in the hospitals was lower than that reported in similar studies in Ghana, but high relative to some reports from high-income countries. Most antibiotic therapy was empirical and not guided by culture and susceptibility testing. There is the need for application of the WHO AWaRe classification for the selection of antibiotics and increased use of culture and susceptibility data to guide infectious disease therapy.

scholarly journals Antibiotics stewardship in Ghana: a cross-sectional study of public knowledge, attitudes, and practices

2020 ◽  
Author(s):  
Tamara Jimah ◽  
Ama P. Fenny ◽  
Oladele Ogunseitan
Keyword(s):  
Antibiotic Resistance ◽  
Inappropriate Medication ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Individual Knowledge ◽  
Knowledge Attitudes And Practices

Abstract Background Antibiotic resistance is a major contributing factor to global morbidity and mortality and is associated with inappropriate medication use. However, the level of antibiotic consumption and knowledge about antibiotic resistance in Ghana is inadequately quantified. Our study identifies strategies for improved stewardship of antibiotics to prevent the proliferation of resistant pathogens by assessing the level of antibiotic knowledge, attitudes, and consumption behaviors by region, gender, age, and education in rural and urban Ghana. Methods A cross-sectional study was conducted in 12 communities in the urban Greater Accra and rural Upper West regions of Ghana. A questionnaire survey was administered to 400 individuals aged 18 years and older in selected locations during September-October 2018 to gather data on individual knowledge, attitudes, and practices concerning antibiotics and antibiotic resistance. Multivariate analysis was used to investigate the association between demographic characteristics and knowledge, attitudes, and related behaviors. Results Over 30% (125/400) had not received a doctor’s prescription during their last illness. Seventy percent (278/400) had taken at least one antibiotic in the year prior to the survey. The top five frequently used antibiotics were Amoxicillin , Amoxicillin-clavulanic acid , Ampicillin , Ciprofloxacin , and Metronidazole . Women and older adults had higher knowledge compared to their respective counterparts (p<0.01). Furthermore, prudent antibiotic use was significantly more prevalent in women than men (p<0.05). Although no regional differences were found in overall knowledge, compared to urban residents, individuals residing in rural settings exhibited higher knowledge about the ineffectiveness of antibiotics for viruses like the cold and HIV/AIDS (p<0.001). Two hundred and fifty-two (63%) respondents were unaware of antibiotic resistance. There was generally a low level of self-efficacy among participants regarding their role in preserving the effectiveness of antibiotics. Conclusion Antibiotic knowledge, attitudes, and use varied significantly across demographics, suggesting a context-specific approach to developing effective community interventions.

scholarly journals Prognostic Role of Matrix Metalloproteinase Expression in Meningioma: A Cross-Sectional Study.

2020 ◽  
Author(s):  
Maryam Ahmad Sharifuddin ◽  
Sharifah Emilia Tuan Sharif ◽  
Hasnan Jaafar
Keyword(s):  
Cross Sectional Study ◽  
Low Grade ◽  
High Grade ◽  
Sectional Study ◽  
Cross Sectional ◽  
Who Grade ◽  
Exact Test ◽  
Immunohistochemical Markers ◽  
Chi Squared ◽  
The Difference

Abstract Background: Meningioma is the most common intracranial tumor in adults. In addition to the extent of tumor surgical resection and WHO grade, angiogenesis is a prognostic factor that is influenced by MMP-2. Our study examined the association of these prognostic factors with MMP-2 expression in meningioma. Methods: A cross-sectional study of patients diagnosed with meningioma between January 2008 and December 2017 was conducted. All samples were re-reviewed and subjected to immunohistochemical staining for Ki67, MMP-2, and CD34. Pearson’s chi-squared test and Fisher’s exact test were used to examine the association of MMP-2 expression with the WHO grade and microvascular density (MVD). Results: The study included 99 patients aged 23–75. Most patients were female (73.7%). This study included 85 cases of low-grade meningioma (grade I) and 14 cases of high-grade meningioma (grade II, 11; grade III, 3). The most common subtypes were meningothelial, transitional, and fibroblastic. In total, 62 of 85 patients with low-grade meningioma and 10 of 14 patients with high-grade meningioma exhibited high MMP-2 expression, and the difference in the rates between the groups was not significant. Most patients in this study displayed MVD scores of 1+ (54/99) and 2+ (33/99). Of the 54 patients with an MVD score of 1+, 42 exhibited high MMP-2 expression. MMP-2 was expressed by all patients with meningioma. Conclusion: In the future, more samples are required, in high-grade tumors, to prevent bias, and more specific immunohistochemical markers should be used to evaluate angiogenesis.

scholarly journals Antimicrobial use across six referral hospitals in Tanzania: a point prevalence survey

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042819
Author(s):  
Jeremiah Seni ◽  
Siana G Mapunjo ◽  
Rachel Wittenauer ◽  
Richard Valimba ◽  
Andy Stergachis ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Referral Hospital ◽  
Antimicrobial Use ◽  
Prevalence Survey ◽  
Regional Referral Hospital ◽  
Point Prevalence Survey ◽  
Referral Hospitals

ObjectiveTo delineate the prevalence and factors associated with antimicrobial use across six referral hospitals in Tanzania using WHO point prevalence survey (PPS) methodology to inform hospital-specific antimicrobial stewardship programmes.DesignCross-sectional analytical study.SettingSix referral hospitals in Tanzania.ParticipantsPatients irrespective of age and gender (n=948) admitted in the six referral hospital wards before 8:00 hours on each day of the survey were included in December 2019. Using the WHO PPS methodology, data on hospitals, wards, patients, antibiotics, and indications for antibiotics were collected.Outcome measuresWe analysed the prevalence of antibiotic use by referral hospital, ward, indication and patient characteristics as the main outcomes. We also described adherence to the Tanzania Standard Treatment Guidelines (STG) and WHO’s AWaRe categorisation of antibiotics.ResultsApproximately 62.3% of inpatients were prescribed antibiotics, predominantly from the Access group of antibiotics (ceftriaxone, metronidazole or ampicillin–cloxacillin). The overall adherence of antibiotic prescriptions to the Tanzania STG was high (84.0%), with the exception of Sekou Toure Regional Referral Hospital (68.0%) and Maweni Regional Referral Hospital (57.8%). The most common indication for antibiotic prescriptions was community-acquired infections (39.8%). Children less than 2 years of age (OR 1.73, 95% CI 1.02 to 2.92, p=0.039); admission to surgical wards (OR 4.90, 95% CI 2.87 to 8.36, p <0.001); and admission to paediatric wards (OR 3.93, 95% CI 2.16 to 7.15, p <0.001) were associated with increased odds of antibiotic use. Only 2 of 591 patients were prescribed antibiotics based on culture and antimicrobial susceptibility testing results.ConclusionsEmpirical use of antibiotics is common, and the Access group of antibiotics is predominantly prescribed in children less than 2 years and patients admitted to surgical and paediatric wards. Lack of utilisation of antimicrobial susceptibility testing services in these hospitals requires urgent interventions. Routine monitoring of antibiotic use is recommended to be part of antibiotic stewardship programmes in Tanzania.

scholarly journals Prevalence and co-infection of schistosomiasis/hepatitis B among rural populations in endemic areas in Hubei, China

2019 ◽  
Vol 114 (3) ◽  
pp. 155-161 ◽  
Author(s):  
Yupeng Zhang ◽  
Yaofei Xie ◽  
Qi Chen ◽  
Xuyu Chen ◽  
Zhuangzhuang Dong ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Hbv Infection ◽  
Cross Sectional ◽  
Exact Test ◽  
Aged People ◽  
Qualitative Variables ◽  
Chi Squared ◽  
Endemic Areas

Abstract Background Both hepatitis B virus (HBV) infection and schistosomiasis are important public health problems in China. Concurrent infection between HBV and schistosomiasis is often observed in areas where schistosomiasis is endemic. The aim of this study was to determine the prevalence of schistosomiasis and HBV in schistosomiasis-affected areas, to explore whether schistosomiasis patients are more susceptible to HBV and to determine if the prevalence of HBV in high-endemic areas of schistosomiasis is higher than in low-endemic areas. Methods A total of 6526 participants from 13 villages in Hubei province were included in a cross-sectional study and blood samples were collected and examined. Qualitative variables were compared between groups using Pearson’s chi-squared test or Fisher’s exact test as appropriate. Results Of the 6526 participants, the overall prevalence was 8.27% for schistosomiasis and 2.67% for HBV. The prevalence of hepatitis B among participants who were Schistosoma antibody positive (25.37%) was higher than the prevalence in participants who were Schistosoma antibody negative (0.62%; χ2=1169.358, p&lt;0.001, odds ratio 54.659). We also observed that there was no difference in the prevalence of hepatitis B between males and females in areas where schistosomiasis was endemic (χ2=1.827, p=0.177), but the prevalence of hepatitis B in middle-aged people was higher than in other age groups (χ2=47.877, p&lt;0.001). Conclusions There was an association between schistosomiasis and HBV infection. However, more work is needed to find the causal relationship between schistosomiasis and HBV infection.

scholarly journals Evidence for the Continued Occurrence of Chorioretinopathy in Working Sheep Dogs in New Zealand in 2010

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2229
Author(s):  
Adam B. O’Connell ◽  
A. Craig Irving ◽  
Paul L. Hughes ◽  
Naomi Cogger ◽  
Boyd R. Jones ◽  
...  
Keyword(s):  
New Zealand ◽  
Cross Sectional Study ◽  
P Value ◽  
Fisher Exact Test ◽  
Cross Sectional ◽  
Exact Test ◽  
South West ◽  
Chi Squared ◽  
The Relationship

A study in conducted 1987 by Hughes et al., found that 39% of working sheep dogs had multifocal retinitis. One of the identified causes was ocular larval migrans, which were a result of migrating ascarid larvae. Since that paper was published, anthelmintic use in farm dogs has been highly recommended. There has been no follow-up study to determine if fundic lesions are still present. The current study aimed to investigate the prevalence of chorioretinopathy in working sheep dogs in the South-West, Waikato, New Zealand. This was a cross-sectional study of 184 working sheep dogs and 51 owners, undertaken in 2010 with owners sampled from New Zealand’s South-West Waikato and Tux North Island Dog Trial Championship. Two-way tables were used to explore the relationship between variables. Significance of association was assessed using a Chi-squared or Fisher exact test as appropriate, with a p-value of <0.05 considered significant. Overall prevalence of chorioretinopathy in the working sheep dogs was 44/184 (24%). A significantly higher prevalence of chorioretinopathy was shown in dogs with increasing age, from 2 years to >8 years (p = 0.0007) and in males (p < 0.0001). This study concluded that lesions of chorioretinopathy are still present in working sheep dogs in New Zealand.

scholarly journals Knowledge, attitudes and perceptions of antibiotic use and resistance among patients in South Africa: A cross-sectional study

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Elise Farley ◽  
Dena Van den Bergh ◽  
Renier Coetzee ◽  
Annemie Stewart ◽  
Tom Boyles
Keyword(s):  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Crisis ◽  
Attitudes And Perceptions ◽  
Chi Squared ◽  
High Knowledge ◽  
Treat All ◽  
African Patients

Background: Antibiotic resistance (ABR) is a global health crisis. We conducted a cross-sectional survey to describe South African patients’ (n = 782) ABR knowledge, attitudes and perceptions (KAP), differences in KAP between public (n = 379, 48%) and private (n = 403, 52%) practice respondents and associations between attitudes, perceptions and knowledge scores.Methods: Knowledge scores (15 questions) were placed into low (0% – 53%) and high ( 54%) categories (below and above overall mean). Comparisons were conducted using chi-squared and t-tests.Results: Of all respondents, 72% believed it was the human body that becomes resistant to antibiotics, 66% stated that antibiotics are good for treating viruses and 25% of patients believed that people should be given antibiotics on demand. Mean knowledge scores were lower in public sector respondents (public 45%, s.d. 15%; private 60%, s.d. 30%; p ≤ 0.001). Public practice patients with high knowledge scores were more likely to report both negative KAP (antibiotic prescriptions justify doctors’ visits, scientists will discover new antibiotics) and protective KAP (finishing a course of antibiotics, antibiotics do not treat all illnesses). Private practice patients with high knowledge scores were marginally less likely to report negative KAP (wanting antibiotics after long illnesses or when very sick) and more likely to report protective KAP (antibiotics have side effects and are a strong treatment).Conclusion: Our study shows differences in KAP by practice type and that greater knowledge increases the likelihood of protective attitudes, perceptions and behaviours.

scholarly journals Antibiotics stewardship in Ghana: a cross-sectional study of public knowledge, attitudes, and practices among communities.

2020 ◽  
Author(s):  
Tamara Jimah ◽  
Ama P. Fenny ◽  
Oladele Ogunseitan
Keyword(s):  
Antibiotic Resistance ◽  
Inappropriate Medication ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Individual Knowledge ◽  
Knowledge Attitudes And Practices

Abstract Background Antibiotic resistance is a major contributing factor to global morbidity and mortality and is associated with inappropriate medication use. However, the level of antibiotic consumption and knowledge about antibiotic resistance in Ghana is inadequately quantified. Our study identifies strategies for improved stewardship of antibiotics to prevent the proliferation of resistant pathogens by assessing the level of antibiotic knowledge, attitudes, and consumption behaviors by region, gender, age, and education in rural and urban Ghana. Methods A cross-sectional study was conducted in 12 communities in the urban Greater Accra and rural Upper West regions of Ghana. A questionnaire survey was administered to 400 individuals aged 18 years and older in selected locations during September-October 2018 to collect data on individual knowledge, attitudes, and practices concerning antibiotics and antibiotic resistance. Multivariate analysis was used to investigate the association between demographic characteristics and knowledge, attitudes, and related behaviors. Results Over 30% (125/400) had not received a doctor’s prescription during their last illness. Seventy percent (278/400) had taken at least one antibiotic in the year prior to the survey. The top five frequently used antibiotics were Amoxicillin, Amoxicillin-clavulanic acid, Ampicillin, Ciprofloxacin, and Metronidazole. Women and older adults had higher knowledge compared to their respective counterparts (p<0.01). Furthermore, prudent antibiotic use was significantly more prevalent in women than men (p<0.05). Although no regional differences were found in overall knowledge, compared to urban residents, individuals residing in rural settings exhibited higher knowledge about the ineffectiveness of antibiotics for viruses like the cold and HIV/AIDS (p<0.001). Two hundred and fifty-two (63%) respondents were unaware of antibiotic resistance. There was generally a low level of self-efficacy among participants regarding their role in preserving the effectiveness of antibiotics. Conclusion Antibiotic knowledge, attitudes, and use varied significantly across demographics, suggesting a context-specific approach to developing effective community interventions.

scholarly journals Work accidents and self-esteem of nursing professional in hospital settings

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Sérgio Valverde Marques dos Santos ◽  
Flávia Ribeiro Martins Macedo ◽  
Luiz Almeida da Silva ◽  
Zelia Marilda Rodrigues Resck ◽  
Denismar Alves Nogueira ◽  
...  
Keyword(s):  
Religious Belief ◽  
Family Income ◽  
Self Esteem ◽  
Cross Sectional Study ◽  
Minas Gerais ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Exact Test ◽  
Chi Squared ◽  
Work Accidents

Abstract Objective: to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. Method: descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. Results: of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. Conclusion: factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work.

scholarly journals Self-medication and adherence to drug treatment: assessment of participants of the Universidade do Envelhecer (the University of Aging) program

2018 ◽  
Vol 21 (6) ◽  
pp. 691-700
Author(s):  
Antonio Leonardo de Freitas Garcia ◽  
Andréia Naomi Madoz Kaya ◽  
Eduardo Antonio Ferreira ◽  
Eliana Fortes Gris ◽  
Dayani Galato
Keyword(s):  
The Elderly ◽  
Cross Sectional Study ◽  
Elderly Persons ◽  
Self Medication ◽  
Cross Sectional ◽  
Exact Test ◽  
Aging Program ◽  
Chi Squared ◽  
The University ◽  
Continuous Use

Abstract Objectives : to evaluate the use of medication (for continuous use and self-medication) and adherence to treatment among elderly and non-elderly participants of the Universidade do Envelhecer (UniSer). Method : an observational, quantitative and cross-sectional study, using the interview technique, was carried out at UniSer with 215 subjects. A structured instrument was used for the collection of sociodemographic variables and self-medication data. The 1986 Morisky-Green-Levine Scale (MGL) and the Brief Medication Questionnaire (BMQ) regimen screening tool were used to assess adherence. Descriptive analyzes of the data were performed, and the chi-squared Test and Fisher’s Exact Test were applied to evaluate the association between variables of interest. Results : of the participants, 127 (59.1%) were elderly (< 60 years old), of whom 81.9% were women. Regarding self-medication, 22.9% of elderly and 21.7% of non-elderly persons practiced it in the previous seven days (p=0.848), even if they considered it dangerous (p=0.472). A total of 45.8% of the elderly and 55.6% of the non-elderly irrationally self-medicated within the analyzed period, while 76.4% of the elderly and 64.8% of the non-elderly used medications of continuous use (p=0.063). A total of 78.8% of the elderly and 76.1% of the non-elderly were not adherent to treatment (p=0.719) according to the MGL scale, while the BMQ Regimen Screen found that 36.7% of the elderly and 41.1% of the non-elderly were not adherent (p=0.595). Conclusion : these findings demonstrate that there were no significant differences between the groups studied and health education actions should be carried out with an emphasis on guidelines on adherence and the rational use of medicines.

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