Awareness of Antibiotic Use and Resistance in Jordanian Community

Background The public awareness toward the causes and consequences of antibiotic resistance (AR) is crucial to mitigate the inappropriate use of antibiotics (ABs), particularly in the low- and middle-income countries. There was no previous study that assessed the awareness, attitude, and knowledge about antibiotic use and AR among the Jordanian public in affluent and deprived areas. Objective This study aimed to assess the awareness, attitude, and knowledge about antibiotic use and AR in affluent and deprived areas in Jordan. Setting The survey was conducted in November 2019 in Amman, the capital of Jordan. Method A cross-sectional questionnaire was used to survey households in their areas in each of West Amman (affluent region) and East Amman (deprived region), Households were selected using proportionate random sampling method. Results A total of 620 householders (310 per area) completed the questionnaire. Pharmacists were perceived as strong influencers on householders’ decision, as 80.32% (n = 465/580) of those who used antibiotics in the last year follow pharmacists’ advice. Our results showed poor understanding of antibiotic usage among the Jordanian public, as only 14.2% (n = 44/310) of the sample in West Amman and 2.9% (n = 9/310) in East Amman disagreed with the statement “ Antibiotics work on most coughs and colds.” Householders in West Amman showed much better understanding of AR compared to those in East Amman; 82.3% (n = 255/310) of West Amman respondents agreed with the statement “ Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of the antibiotic.” compared to 31.9% (n = 99/310) of East Amman respondents on the same statement ( P < .05). Conclusion The Jordanian community generally had poor knowledge and awareness toward antibiotics use and AR. Socio-economic factors could influence the public’s attitude toward antibiotics use and AR.

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Understanding antimicrobial use in subsistence farmers in Chikwawa District Malawi, implications for public awareness campaigns

10.31235/osf.io/e7b6n ◽

2021 ◽

Author(s):

Eleanor MacPherson ◽

Joanna Reynolds ◽

Esnart Sanudi ◽

Alexander Nkaombe ◽

John Mankhomwa ◽

...

Keyword(s):

Low Income ◽

Public Awareness ◽

Antibiotic Use ◽

Subsistence Farming ◽

Formal Sector ◽

Middle Income ◽

The Public ◽

Middle Income Countries ◽

Awareness Campaigns ◽

The Right

Drug resistant infections are increasing across the world and urgent action is required to preserve current classes of antibiotics. Antibiotic use practices in low-and-middle-income countries have gained international attention, especially as antibiotics are often accessed beyond the formal health system. Public awareness campaigns have gained popularity, often conceptualising antimicrobial resistance (AMR) as a problem of excess, precipitated by irrational behaviour. Insufficient attention has been paid to people’s lived experiences of accessing medicines in low-income contexts. In Chikwawa District, Malawi, a place of extreme scarcity, our study aimed to understand the care and medicine use practices of households dependent on subsistence farming. Adopting an anthropological approach, we undertook medicine interviews (100), ethnographic fieldwork (six-month period) and key informant interviews (33) with a range of participants in two villages in rural Chikwawa. The most frequently used drugs were cotrimoxazole and amoxicillin, not considered to be of critical importance to human health. Participants recognised that keeping, sharing, and buying medicines informally was not the “right thing.” However, they described using antibiotics and other medicines in these ways due to conditions of extreme precarity, the costs and limitations of seeking formal care in the public sector, and the inevitability of future illness. Our findings emphasise the need in contexts of extreme scarcity to equip policy actors with interventions to address AMR through strengthening health systems, rather than public awareness campaigns that foreground overuse and the dangers of using antibiotics beyond the formal sector.

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Public awareness regarding the use and resistance of antibiotics: A cross-sectional study among Nepalese adults in Kathmandu valley

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v6i3.19823 ◽

2018 ◽

Vol 6 (3) ◽

pp. 96-101

Author(s):

Satish Kumar Deo ◽

Sita Rijal ◽

Tulza K.C

Keyword(s):

Antibiotic Resistance ◽

Public Awareness ◽

Study Finding ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Public Health Issue ◽

Sectional Study ◽

Cross Sectional ◽

Interview Method ◽

Drug Classes

Background: Antibiotics are considered to be among the most commonly sold drug classes globally. Antibiotic resistance is a recognized public health issue at the local, national and global levels.Objectives: The aim of this study was to identify awareness of general public regarding the use and resistance of antibiotics.Methodology: A descriptive cross-sectional study was conducted in Kathmandu in November 2016 using a quantitative questionnaire among 120 adult people aged 20–60 years. Convenience sampling method was used and information on use of antibiotics and resistance was obtained using semi-structured questionnaire through interview method. Descriptive statistics was done to describe the respondent’s level of awareness regarding use of antibiotics and resistance.Results: Among the total respondents, majority had incorrect awareness as regards to action, reasons for using antibiotics, possible side effects of the antibiotic. Seventy one percent of the respondents had not heard about antibiotic resistance. The study finding showed that about 66.7% of the participants had inadequate awareness towards use and resistance of antibiotics.Conclusion: The findings demonstrate that the overall awareness on antibiotic use and resistance is poorly understood among our respondents. This information can be utilized in future educational and antibiotic resistance awareness raising campaigns.

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Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16245141 ◽

2019 ◽

Vol 16 (24) ◽

pp. 5141

Author(s):

Ashok J. Tamhankar ◽

Ramesh Nachimuthu ◽

Ravikant Singh ◽

Jyoti Harindran ◽

Gautam Kumar Meghwanshi ◽

...

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Use ◽

World Health ◽

Awareness Campaign ◽

Resource Limited Settings ◽

Middle Income ◽

Middle Income Countries ◽

Awareness Campaigns ◽

Resource Limited ◽

Low And Middle Income

Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries.

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Strategic Approach for Prioritising Local and Regional Sanitation Interventions for Reducing Global Antibiotic Resistance

Water ◽

10.3390/w11010027 ◽

2018 ◽

Vol 11 (1) ◽

pp. 27 ◽

Cited By ~ 8

Author(s):

David Graham ◽

Myra Giesen ◽

Joshua Bunce

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Use ◽

Middle Income ◽

Middle Income Countries ◽

National Priority ◽

Strategic Approach ◽

Starting Point ◽

Improved Sanitation ◽

Intervention Costs

Globally increasing antibiotic resistance (AR) will only be reversed through a suite of multidisciplinary actions (One Health), including more prudent antibiotic use and improved sanitation on international scales. Relative to sanitation, advanced technologies exist that reduce AR in waste releases, but such technologies are expensive, and a strategic approach is needed to prioritize more affordable mitigation options, especially for Low- and Middle-Income Countries (LMICs). Such an approach is proposed here, which overlays the incremental cost of different sanitation options and their relative benefit in reducing AR, ultimately suggesting the “next-most-economic” options for different locations. When considering AR gene fate versus intervention costs, reducing open defecation (OD) and increasing decentralized secondary wastewater treatment, with condominial sewers, will probably have the greatest impact on reducing AR, for the least expense. However, the best option for a given country depends on the existing sewerage infrastructure. Using Southeast Asia as a case study and World Bank/WHO/UNICEF data, the approach suggests that Cambodia and East Timor should target reducing OD as a national priority. In contrast, increasing decentralized secondary treatment is well suited to Thailand, Vietnam and rural Malaysia. Our approach provides a science-informed starting point for decision-makers, for prioritising AR mitigation interventions; an approach that will evolve and refine as more data become available.

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Use of WATCH antibiotics prior to presentation to the hospital in rural Burkina Faso

10.1101/2021.02.24.21252387 ◽

2021 ◽

Author(s):

Daniel Valia ◽

Brecht Ingelbeen ◽

Bérenger Kaboré ◽

Ibrahima Karama ◽

Marjan Peeters ◽

...

Keyword(s):

Primary Care ◽

Burkina Faso ◽

Health Center ◽

Antibiotic Use ◽

Community Level ◽

Diagnostic Tools ◽

Middle Income ◽

Middle Income Countries ◽

Frequent Use ◽

Antibiotics Use

AbstractBackgroundIn low- and middle-income countries (LMIC), the prevalence of antimicrobial resistance (AMR) is increasing. WHO recommends monitoring antibiotic use, in particular Watch antibiotics, clinical important but at risk of becoming ineffective due to increasing AMR. We investigated antibiotic use at primary care or community-level in rural Burkina Faso.MethodsDuring 2016-2017, patients aged >3 months admitted with severe acute fever to the rural hospital of Nanoro Health District, Burkina Faso, reported antibiotic use in the two weeks prior to consultation or hospitalization, which we analysed using the WHO Access, Watch, Reserve (AWaRe) classification. Most Watch antibiotics, e.g. ceftriaxone, are not recommended at primary health center level, as is also the case for ciprofloxacin in children.ResultsOf 920 participants (63.0% ≤14 years), pre-admission antibiotic use was reported by 363 (39.5%) of whom 58 (16.0%) reported more than one antibiotic. Use was more frequent among health center referrals (231, 54.0%) than among self-referred patients (131, 26.7%, p<0.001). Of 424 antibiotics, 261 (61.6%) were Access and 159 (37.5%) Watch antibiotics. Watch antibiotics use was more frequent among >14 year olds (72, 51.1%) than 0-14 year olds (87, 30.7%) and among referrals (41, 28.1%) compared to self-referred patients (117, 42.2%). Most frequently used Watch antibiotics were ceftriaxone (114, 26.9%) and ciprofloxacin (32, 7.5%). Among antibiotics reported by referral patients, ceftriaxone and ciprofloxacin were respectively recorded 100 (36.1%) and 12 times (4.3%).ConclusionThe frequent use of Watch group antibiotics prior to presentation to the hospital in rural Burkina Faso highlights the need to address primary care, over-the-counter and informal community-level antibiotic use as part of antibiotic stewardship in LMIC, facilitating referral, access to qualified prescribers, or improving diagnostic tools in health centers.

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Self-Medication with Antibiotics among University Students in LMIC: A systematic review and meta-analysis

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11359 ◽

2019 ◽

Vol 13 (08) ◽

pp. 678-689 ◽

Cited By ~ 1

Author(s):

Rixiang Xu ◽

Tingyu Mu ◽

Guan Wang ◽

Jing Shi ◽

Xin Wang ◽

...

Keyword(s):

Systematic Review ◽

University Students ◽

Meta Analysis ◽

Antibiotic Use ◽

Self Medication ◽

Middle Income ◽

Inappropriate Use ◽

Middle Income Countries ◽

Effective Interventions ◽

Pooled Prevalence

Introduction: Self-medication with antibiotics (SMA) is common among university students in low and middle-income countries (LMICs). However, there has been no meta-analysis and systematic review in the population. Methodology: A literature search was conducted using PubMed, Embase and Web of Science for the period from January 2000 to July 2018. Only observational studies that had SMA among university students from LMICs were included. A random-effects model was applied to calculate the pooled effect size with 95% confidence interval (CI) due to the expected heterogeneity (I2 over 50%). Results: The pooled prevalence of SMA of overall included studies was 46.0% (95% CI: 40.3% to 51.8%). Africa had the highest pooled prevalence of SMA among university students (55.30%), whereas South America had the lowest prevalence (38.3%). Among individual LMICs, the prevalence of SMA among university students varied from as low as 11.1% in Brazil to 90.7% in Congo. Conclusions: The practice of SMA is a widespread phenomenon among university students in LMICs and is frequently associated with inappropriate use. Effective interventions such as medication education and stricter governmental regulation concerning antibiotic use and sale are required to be established in order to deal with SMA properly.

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Antibiotic Use and Antibiotic Resistance: Public Awareness Survey in the Republic of Cyprus

Antibiotics ◽

10.3390/antibiotics9110759 ◽

2020 ◽

Vol 9 (11) ◽

pp. 759

Author(s):

Mikaela Michaelidou ◽

Spyridon A. Karageorgos ◽

Constantinos Tsioutis

Keyword(s):

Antibiotic Resistance ◽

Viral Infections ◽

Public Awareness ◽

Antibiotic Use ◽

World Health ◽

Resistant Bacteria ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Awareness Campaigns ◽

Local Evidence

We aimed to assess the knowledge and understanding of antibiotic use and resistance in the general population of Cyprus, in order to inform future antibiotic awareness campaigns with local evidence. Cross-sectional survey following the methodology of the “Antibiotic resistance: Multi-country public awareness survey” of the World Health Organization, during December 2019–January 2020. A total of 614 respondents participated: 64.3% were female and most were aged 35–44 years (33.2%) or 25–34 years (31.8%). One-third had used antibiotics >1 year ago and 91.6% reported receiving advice on appropriate use from a medical professional. Despite high awareness on correct use of antibiotics, lack of knowledge was noted for specific indications, where approximately one-third believed that viral infections respond to antibiotics and 70.7% lack understanding of how antibiotic resistance develops. Higher education graduates exhibited significantly higher knowledge rates. As high as 72.3% were informed about “antibiotic resistant bacteria” from healthcare professionals or social media. Most agreed on the usefulness of most suggested actions to address antibiotic resistance, with higher proportions acknowledging the role of prescribers. Up to 47% could not identify their role in decreasing antibiotic resistance. Our study provides local evidence to inform future efforts in a country characterized by high antibiotic consumption rates.

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Assessment of Knowledge, Attitude, and Practice of Antibiotic Use among the Population of Boyolali, Indonesia: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168258 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8258

Author(s):

Hidayah Karuniawati ◽

Mohamed Azmi Ahmad Hassali ◽

Sri Suryawati ◽

Wan Ismahanisa Ismail ◽

Taufik Taufik ◽

...

Keyword(s):

Low Income ◽

Univariate Analysis ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Public ◽

Attitude And Practice ◽

Antibiotics Use ◽

Knowledge Attitude And Practice

Misuse and overuse of antibiotics are potential causes of the increasing prevalence of antibiotic resistance (ABR). Having information about the knowledge, attitude, and practices concerning antibiotics use by the public might help control ABR growth. Therefore, this cross-sectional study aimed to investigate the levels and associated factors of knowledge, attitude, and practice (KAP) of antibiotics use among the public. A questionnaire was designed and validated, which consisted of a total of 51 questions with four sections: demographics (6), knowledge (20), attitude (12), and practice (13) to measure KAP. Univariate analysis (using Mann–Whitney U and Kruskal–Wallis analysis) was applied to assess the differences in the mean scores of KAP. Linear regression analysis was performed to identify factors associated with KAP. Finally, using Spearman analysis we have examined the correlation between responses to the KAP. The sample size of this study was 575, with a 99.96% response rate. Regarding knowledge, 73.12% of respondents stated that antibiotics could be used to treat viral infections, and 63.35% of respondents answered that antibiotics could reduce fever. Concerning attitude, 50% of respondents had considered stopping taking antibiotics as soon as symptoms had disappeared. In analyzing practice, we found 40% of respondents obtained antibiotics from a pharmacy without a prescription from a physician, a nurse, or a midwife. Statistical analysis revealed that KAP about antibiotic use was significantly associated with gender, area of residence, level of education, and monthly income (p < 0.05). Our findings concluded that men, respondents with low income, those with low-level education, and those living in rural areas are more prone to excessive use of antibiotics without knowing the adverse effects of improper use and how it can contribute to high ABR. So it is urgently necessary to strengthen policies on antibiotics use, including drug provision, distribution, and sales. In addition, people with low KAP should be a priority consideration in education outreach initiatives.

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Characteristics Of Street Children In Cameroon: A Situational Analysis Of Demographic, Socio-Economic And Behavioural Profiles And Challenges

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v8i1.1076 ◽

2016 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Samuel N. Cumber ◽

Joyce M. Tsoka-Gwegweni

Keyword(s):

Cultural History ◽

Street Children ◽

Situational Analysis ◽

Sufficient Information ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

The Public ◽

Middle Income Countries ◽

Risky Behaviours

Introduction: The issue of street children is one of the global social problems rising in low- and middle-income countries. These children are vulnerable, but because of a lack of sufficient information, it is very difficult for stakeholders to address their plight in Cameroon.Aim: To examine the situation and characteristics of street children in three Cameroonian cities.Objectives: To describe the demographic, socio-economic and behavioural profiles of street children. To identify challenges of street children and to compare the results from the three cities on account of their different settings, cultural history and challenges.Materials and methods: The study was an analytical cross-sectional survey conducted through researcher-administered questionnaires to 399 street children (homeless for at least a month), in three Cameroonian cities from 1 January 2015 to 30 March 2015.Results: The majority of the participants were boys, more than 70% were homeless for less than 12 months and poverty was found to be the most common reason for being on the street. Most of the participants earned less than 500CFA francs (USD 0.85), with many of them resorting to begging, drug abuse, sex work and other risky behaviours. Only two of the respondents (0.5%) regarded the public attitude towards them as supportive.Conclusion: As children roam the streets in search of shelter, food and other basic needs, their future hangs in the balance. Understanding the plight of street children highlights the need for immediate design and implementation of intervention strategies to prevent children from living in the streets and assist those who have become street children.

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Public knowledge, attitudes and practices related to antibiotic use and resistance in Singapore: a cross-sectional population survey

BMJ Open ◽

10.1136/bmjopen-2020-048157 ◽

2021 ◽

Vol 11 (9) ◽

pp. e048157

Author(s):

Jane M Lim ◽

Minh Cam Duong ◽

Alex R Cook ◽

Li Yang Hsu ◽

Clarence C Tam

Keyword(s):

Antibiotic Resistance ◽

Public Awareness ◽

Action Plan ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Primary Care Doctor ◽

Public Knowledge ◽

Cross Sectional ◽

Attitudes And Practices ◽

Knowledge Attitudes And Practices

ObjectivesThe WHO’s Global Action Plan on Antimicrobial Resistance (AMR) includes increasing overall public awareness of appropriate antibiotic use and resistance as a key priority area. We aimed to measure public knowledge, attitudes and practices of antibiotics and antibiotic resistance in Singapore, as well as their healthcare-seeking behaviours relating to respiratory illnesses, providing baseline data against which to measure the progress of future interventions.DesignA cross-sectional study.SettingThe general population in Singapore.ParticipantsBetween May and June 2019, we conducted a survey via an online panel in Singapore with 706 respondents.ResultsOur findings indicated common misconceptions surrounding antibiotic effectiveness and mechanisms of antibiotic resistance—most participants thought that resistance occurs when our bodies become resistant to antibiotics (62.5%) or when antibiotics become less powerful (48.5%). In multivariable analyses, better knowledge scores were associated with more favourable antibiotic attitudes (β=0.29; 95% CI 0.20 to 0.37). In addition, more favourable attitude scores were associated with lower odds of both expecting (OR: 0.84, 95% CI 0.72 to 0.99) and being prescribed antibiotics by a primary care doctor (OR: 0.76, 95% CI 0.63 to 0.90).ConclusionsThis study presents important information about population perceptions towards antibiotics and antibiotic resistance in Singapore. Results from this study emphasise the importance of effective public communication strategies to promote responsible antibiotic use locally and should be used to inform future implementation of programmes and activities as laid out in Singapore’s National Strategic Action Plan on AMR.

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