Antibiotic knowledge, attitudes and practices: new insights from cross-sectional rural health behaviour surveys in low-income and middle-income South-East Asia

IntroductionLow-income and middle-income countries (LMICs) are crucial in the global response to antimicrobial resistance (AMR), but diverse health systems, healthcare practices and cultural conceptions of medicine can complicate global education and awareness-raising campaigns. Social research can help understand LMIC contexts but remains under-represented in AMR research.ObjectiveTo (1) Describe antibiotic-related knowledge, attitudes and practices of the general population in two LMICs. (2) Assess the role of antibiotic-related knowledge and attitudes on antibiotic access from different types of healthcare providers.DesignObservational study: cross-sectional rural health behaviour survey, representative of the population level.SettingGeneral rural population in Chiang Rai (Thailand) and Salavan (Lao PDR), surveyed between November 2017 and May 2018.Participants2141 adult members (≥18 years) of the general rural population, representing 712 000 villagers.Outcome measuresAntibiotic-related knowledge, attitudes and practices across sites and healthcare access channels.FindingsVillagers were aware of antibiotics (Chiang Rai: 95.7%; Salavan: 86.4%; p<0.001) and drug resistance (Chiang Rai: 74.8%; Salavan: 62.5%; p<0.001), but the usage of technical concepts for antibiotics was dwarfed by local expressions like ‘anti-inflammatory medicine’ in Chiang Rai (87.6%; 95% CI 84.9% to 90.0%) and ‘ampi’ in Salavan (75.6%; 95% CI 71.4% to 79.4%). Multivariate linear regression suggested that attitudes against over-the-counter antibiotics were linked to 0.12 additional antibiotic use episodes from public healthcare providers in Chiang Rai (95% CI 0.01 to 0.23) and 0.53 in Salavan (95% CI 0.16 to 0.90).ConclusionsLocally specific conceptions and counterintuitive practices around antimicrobials can complicate AMR communication efforts and entail unforeseen consequences. Overcoming ‘knowledge deficits’ alone will therefore be insufficient for global AMR behaviour change. We call for an expansion of behavioural AMR strategies towards ‘AMR-sensitive interventions’ that address context-specific upstream drivers of antimicrobial use (eg, unemployment insurance) and complement education and awareness campaigns.Trial registration numberClinicaltrials.gov identifier NCT03241316.

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Knowledge, Attitudes and Practices Related to HIV Stigma and Discrimination Among Healthcare Workers in Oman

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2020.20.01.005 ◽

2020 ◽

Vol 20 (1) ◽

pp. 29

Author(s):

Samir Shah ◽

Ali Elgalib ◽

Adil Al-Wahaibi ◽

Maha Al-Fori ◽

Prasanna Raju ◽

...

Keyword(s):

Work Experience ◽

Healthcare Workers ◽

Social Stigma ◽

Healthcare Providers ◽

High Rate ◽

Access To Health Services ◽

Cross Sectional ◽

Attitudes And Practices ◽

Stigma And Discrimination ◽

Knowledge Attitudes And Practices

Objectives: Stigma and discrimination undermine the quality of life of people with HIV and their access to health services. This study aimed to assess HIV-related knowledge, attitudes and practices among healthcare workers (HCWs) in Oman. Methods: This cross-sectional study took place between July and November 2016. A questionnaire was distributed to 1,400 government HCWs to determine HIV-related knowledge, attitudes and practices. Results: A total of 1,281 HCWs participated (response rate = 92%). Routine tasks, such as dressing wounds, drawing blood and touching clothes, were a cause of concern for 24–52% of HCWs. Only 69% correctly answered questions regarding the transmission of HIV via eating/drinking and mosquito bites. Compared to other HCWs, doctors had significantly higher knowledge (mean = 0.46, 95% confidence interval [CI]: 0.19 to 0.73; P <0.001), attitude (mean = 0.77, 95% CI: 0.31 to 1.24; P = 0.001) and practice (mean = 2.07, 95% CI: 1.59 to 2.55; P <0.001) scores. Expatriates also scored significantly higher in knowledge (mean = 1.08, 95% CI: 0.93 to 1.23; P <0.001), attitude (mean = 1.23, 95% CI: 0.98 to 1.48; P <0.001) and practice (mean = 1.08, 95% CI: 0.82 to 1.34; P <0.001) compared to Omani nationals. Finally, those with >15 years’ work experience scored significantly higher on knowledge (mean = −0.60, 95% CI: −1.12 to −0.08; P = 0.025) and attitude (mean = −0.99, 95% CI: −1.87 to −0.10; P = 0.029) compared to those with less experience. Conclusion: The high rate of HIV-related stigma among HCWs in Oman should be rectified in order to achieve the 90-90-90 target set by the Joint United Nations Programme on HIV/AIDS.Keywords: HIV; Social Stigma; Social Discrimination; Knowledge; Attitude; Professional Practice; Healthcare Providers; Oman.

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Knowledge, attitudes, and practices regarding coccidioidomycosis among healthcare providers in four counties in Washington State, 2017

Medical Mycology ◽

10.1093/mmy/myz111 ◽

2019 ◽

Vol 58 (6) ◽

pp. 730-736 ◽

Cited By ~ 1

Author(s):

J Hubber ◽

A Person ◽

L Jecha ◽

D Flodin-Hursh ◽

J Stiffler ◽

...

Keyword(s):

Severe Disease ◽

Healthcare Providers ◽

Knowledge Score ◽

Health Department ◽

Washington State ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Attitudes And Practices ◽

South Central ◽

Knowledge Attitudes And Practices

Abstract Coccidioidomycosis is an emerging infection in Washington State. The epidemiology of the disease in Washington is poorly understood at present; underrecognition and underreporting of coccidioidomycosis is suspected based on reports of only severe disease. We sought to characterize healthcare provider knowledge, attitudes, and practices regarding coccidioidomycosis awareness, diagnosis, and treatment in south-central Washington. We conducted a cross-sectional survey of actively practicing healthcare providers in four counties in south-central Washington, an area recently described as endemic for Coccidioides. Survey results were used to assess awareness of reporting requirements, confidence in ability to diagnose and treat, confidence that knowledge is current, calculated knowledge score, and consideration of risk in patient population. The majority of respondents were unaware of the reporting requirement for coccidioidomycosis in Washington and further unaware that the disease had been reported in the state. Less than a third of survey respondents reported confidence in their ability to diagnose coccidioidomycosis and confidence that their knowledge is current. The majority of respondents never or rarely consider a diagnosis of coccidioidomycosis, and <25% of respondents indicated a working knowledge of serologic tests for the infection. The average knowledge score for respondents was 65%. Previous education, training, or practice regarding coccidioidomycosis was the only identified predictor of confidence and consideration of risk. These data indicate the substantial need for education and training among healthcare providers in south-central Washington and support the concern that a small proportion of existing cases of coccidioidomycosis are reported to the health department.

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Knowledge, Attitudes and Practices of Healthcare Providers on Covid-19 in Kisangani, Democratic Republic of Congo

Asian Journal of Research in Infectious Diseases ◽

10.9734/ajrid/2021/v6i330197 ◽

2021 ◽

pp. 20-28

Author(s):

Ossinga Bassandja ◽

Issa Yakusu ◽

Muyobela Kampunzu ◽

Lofoli Bokota ◽

Baelongandi Folo ◽

...

Keyword(s):

Democratic Republic Of Congo ◽

Healthcare Providers ◽

Negative Attitude ◽

Cross Sectional Study ◽

Cross Sectional ◽

General Hospitals ◽

Attitudes And Practices ◽

Level Of Knowledge ◽

The City ◽

Knowledge Attitudes And Practices

Objective: Our study aimed to determine the level of knowledge, attitudes and practices (KAP) of healthcare providers towards Covid-19 in general hospitals in the city of Kisangani. Methods: A descriptive cross-sectional study was undertaken among the providers of these general hospitals. KAP on Covid-19 were assessed using a survey questionnaire. Results: Female providers were predominant (64%). The majority of respondents were between 25 and 34 years old. 21 were general practitioners (16.7%). The majority had sufficient knowledge (92.2%) provided mainly by radio and television. 77 had a negative attitude towards the possibility of containing the disease; and 88.1% had good practices with regard to Covid-19.

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Evaluation of parents' knowledge, attitudes, and practices regarding self-medication for their children’s dental problems during the COVID-19 pandemic: a cross-sectional survey

BMC Oral Health ◽

10.1186/s12903-021-01466-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Emine Sen Tunc ◽

Emre Aksoy ◽

Hatice Nilden Arslan ◽

Zeynep Kaya

Keyword(s):

Healthcare Providers ◽

Healthcare Services ◽

Pediatric Dentistry ◽

Cross Sectional Survey ◽

Self Medication ◽

Chi Square ◽

Cross Sectional ◽

Attitudes And Practices ◽

Chi Square Test ◽

Knowledge Attitudes And Practices

Abstract Background Self-medication refers to taking medicine without consultation with a doctor or dentist, and it is an important health issue, especially during the COVID-19 pandemic. There are no data about parents’ SM practices for their children’s dental problems during the COVID-19 pandemic. The present study aims to evaluate parents’ knowledge, attitudes, and practices regarding self-medication for their children’s dental problems during the COVID-19 pandemic in Northern Turkey. Methods A cross-sectional survey was carried out in the pediatric dental clinic at Ondokuz Mayis University, Faculty of Dentistry, Department of Pediatric Dentistry, immediately after the COVID-19 lockdown ended. A total of 389 parents who agreed to participate in the study completed the questionnaire from July 1 to October 1. A questionnaire with 18 items was designed to collect information on the parents’ knowledge and attitudes regarding when, why, and how to use drugs and on their practices on medicating their children. The collected data were analyzed using descriptive and analytical statistics (chi-square test). Results The majority of parents (n = 273; 70.2%) practiced self-medication for their children's dental problems. Self-medication with a previously prescribed medications was usually preferred by parents (n = 179; 62.2%). Analgesics (98%) were the most commonly used medicines by parents in their self-medication for their children's dental problems. Conclusion Prevalence of self-medication practices for children's dental problems is high in Turkey during the COVID-19 pandemic. Therefore, new healthcare services, such as teledentistry, may be useful to overcome problems related to the self-medication of children during times when the ability to reach healthcare providers is limited, such as during pandemics.

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Parental Knowledge, Attitudes, and Practices Regarding Antibiotic Use: A Cross-Sectional Study in Bangladesh

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.954 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s342-s342

Author(s):

Golam Dostogir Harun ◽

Romel Haider ◽

Imdadul Haque ◽

Alauddin Chowdhury ◽

Saiful Islam

Keyword(s):

Low Income ◽

Parental Attitudes ◽

Parental Knowledge ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Attitudes And Practices ◽

Awareness Campaigns ◽

Knowledge Attitudes And Practices

Background: Antibiotics play a vital role in reducing the morbidity and mortality associated with common infectious among children aged <5 years. Objective: We assessed the parental knowledge, attitudes, and practices regarding antibiotic use among a low-income urban population in Bangladesh. Methods: A cross-sectional study was conducted among the parents of 516 low-income urban children aged <5 years in Bangladesh from February 2018 to April 2019. A semi-structured questionnaire was developed and administrated to explore parental knowledge, attitudes, and practice regarding antibiotic use. A logistic regression analysis and Spearman rank-order correlation was used to compare and evaluate possible associations regarding parental KAP on antibiotic use. Results: The mean age of the participants was 26.65 years (SD, 6.38) and average monthly income was US$195.00. Most respondents (437 of 516) were women. One-third of the participants had no formal education, and 64% had only 5 years of education. We categorized the knowledge, attitudes, and practice regarding antibiotic use into 3 categories: poor, moderate, and good. More than half (52%) of these parents had poor knowledge of antibiotic use, and 32% had moderate knowledge of antibiotic use. Overall, 55% of parental attitudes were moderate and 70% of antibiotic practices were moderate. However, only 16% respondents had good knowledge, 14% had good attitudes, and 14% had good practices regarding antibiotic use for their children. The study revealed that 41% of parents thought that their child could be treated with antibiotics without advice from a qualified doctor, and 71% of parents thought that a child with flu-like symptoms got better faster if antibiotics were used. Also, 54% thought that the antibiotics could be stopped as soon as the symptoms disappeared. In this study, only 40% of parents completed the full dose of antibiotics. Monthly family income (P = .005), father’s profession (P = .003), and parents’ education were significantly associated with antibiotic use to treat the child. Conclusions: Most participants’ knowledge, attitude, and practices regarding rational antibiotic usage was very poor. Awareness campaigns and implementation of education on how to purchase, use, and sell antibiotics is crucial to optimum the use of antibiotics in Bangladesh.Funding: NoneDisclosures: None

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Antimicrobial Resistance: KAP of Healthcare Professionals at a Tertiary-Level Hospital in Nepal

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910062 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10062

Author(s):

Mee-Lang Cheoun ◽

Jongho Heo ◽

Woong-Han Kim

Keyword(s):

Antimicrobial Resistance ◽

Work Experience ◽

Practical Knowledge ◽

Healthcare Providers ◽

Nonparametric Tests ◽

Medical Department ◽

Cross Sectional ◽

Middle Income ◽

Surgical Department ◽

Attitudes And Practices

Although increasing antimicrobial resistance (AMR) is a substantial threat worldwide, low- and middle-income countries, including Nepal, are especially vulnerable. It is also known that healthcare providers (HCPs) are the major determinants of antimicrobial misuse. A cross-sectional, self-administered survey was conducted among 160 HCPs to assess the knowledge, attitudes, and practices (KAP) of Nepali HCPs regarding AMR and its use. Descriptive statistics and nonparametric tests were performed to evaluate KAP dimensions and investigate subgroup differences. HCPs scored higher on theoretical than practical knowledge. Regarding practical knowledge, men scored higher than women (p < 0.01), and physicians scored higher than nurses (p < 0.001). Participants aged < 25 years scored lower on practical knowledge than older participants (p < 0.001), while those with <3 years work experience scored lower than those with >6 years (p < 0.05). Participants from the medical department scored higher on practical knowledge than those from the surgical department (p < 0.01). AMR control was more accepted in the medical than in the surgical department (p < 0.001). Regarding practices, women and nurses scored higher than men (p < 0.001) and physicians (p < 0.01), respectively. An educational intervention that is tailored to the sociodemographic and professional characteristics of HCPs is necessary to reduce the gap between theoretical and practical knowledge and improve their attitudes and practices.

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Cross-sectional study of dengue-related knowledge, attitudes and practices in Villa El Salvador, Lima, Peru

BMJ Open ◽

10.1136/bmjopen-2020-037408 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037408

Author(s):

William H Elson ◽

Emma Ortega ◽

Michelle Kreutzberg-Martinez ◽

Frederique Jacquerioz ◽

Lilia N Cabrera ◽

...

Keyword(s):

El Salvador ◽

Mosquito Control ◽

Cross Sectional Study ◽

Community Action ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Attitudes And Practices ◽

Dengue Transmission ◽

Knowledge Attitudes And Practices

ObjectivesTo describe and quantify the dengue-related knowledge, attitudes and practices of residents in an urban shantytown in Lima, Peru.Design/settingA cross-sectional survey of adults between 18 and 80 years living in approximately 120 blocks in Oasis, an urban shantytown situated in the low-to-middle income district of Villa El Salvador in Southern Lima. The survey was adapted from an existing survey previously used in Iquitos, Peru, and included questions relating to knowledge of dengue symptoms, transmission, prevention and current mosquito control practices.ParticipantsA total of 240 surveys were completed with 80% of respondents being female and approximately 50% of all respondents describing themselves as housewives.ResultsAlthough 97.9% of respondents had heard of dengue, only 6.2% of people knew someone who had experienced the disease. Approximately half (54.2%) of the respondents knew dengue was transmitted by mosquitoes and 51.7% were able to identify fever and one other correct symptom of dengue. Female sex was significantly associated with greater symptom knowledge (OR 2.22, 95% CI 1.08 to 4.72) and prevention knowledge (OR 2.12, 95% CI 1.06 to 4.21). Past or current higher education attendance was significantly associated with symptom knowledge (OR 2.56, 95% CI 1.25 to 5.44) and transmission knowledge (OR 3.46, 95% CI 1.69 to 7.57). Knowledge of dengue was not significantly associated with carrying out practices to control mosquitoes (OR 1.76, 95% CI 0.87 to 3.54).ConclusionsThis population demonstrated baseline dengue knowledge. However, this was incomplete and substantially less when compared with endemic areas. Given the sporadic nature of dengue transmission in Lima, it is not surprising that knowledge of the disease was not associated with carrying out practices to reduce mosquitoes. However, as dengue transmission in Lima is likely to increase, understanding how best to improve public knowledge of the disease and how to translate this into appropriate community action will be a key public health consideration.

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Assessment of knowledge, attitudes, and practices towards Zika virus among healthcare workers in St. Kitts

BMC Infectious Diseases ◽

10.1186/s12879-021-05932-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Donya L. Francis ◽

Utoomporn Wongsin ◽

Shuo-Chen Chien ◽

Yi-Hsin ( Elsa) Hsu ◽

Franziska Michaela Lohmeyer ◽

...

Keyword(s):

Low Income ◽

Zika Virus ◽

Healthcare Workers ◽

Cross Sectional Study ◽

Good Knowledge ◽

Cross Sectional ◽

Logistic Regression Models ◽

Attitudes And Practices ◽

Formal Degree ◽

Knowledge Attitudes And Practices

Abstract Background Healthcare workers are usually the first responders during outbreaks and are instrumental in educating the populace about the prevention of different diseases and illnesses. The aim of this study was to assess the association between healthcare workers’ characteristics and knowledge, attitudes and practices toward Zika virus. Methods This was a cross-sectional study that collected data from healthcare workers at 3 medical facilities using a validated self-administered questionnaire between July 2017 – September 2017. Logistic regression models were used to examine the association between sociodemographic and knowledge, attitudes, and practices. Results A total of 190 healthcare workers were analyzed. Of these, 60, 72.6 and 64.7% had good knowledge, positive attitudes, and good practices toward Zika virus, respectively. Healthcare workers without a formal degree were less likely to have good knowledge of Zika virus (adjusted odds ratio (AOR) = 0:49; 95% confidence interval (CI) = 0.24–0.99) compared to those with a formal degree. Reduced odds for positive attitude towards Zika virus were observed in healthcare workers with low income as compared to those with high income (AOR = 0.31; 95% CI =0.13–0.75). Being younger than 40 years old was associated with poor Zika virus practices (AOR = 0:34; 95% CI = 0.15–0.79). Conclusions Significant association between healthcare workers’ sociodemographic characteristics and Zika virus knowledge, attitudes and practices were observed. Public health interventions that seek to increase Zika virus awareness should aim to train healthcare workers who are younger, without formal degree and those earning low income.

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