The Associations between Poor Antibiotic and Antimicrobial Resistance Knowledge and Inappropriate Antibiotic Use in the General Population Are Modified by Age

Objectives: Understanding factors influencing inappropriate antibiotic use can guide the design of interventions to improve antibiotic practices and reduce antimicrobial resistance (AMR). Methods: A nationally representative cross-sectional survey (N = 2004) was conducted between November 2020 and January 2021. Knowledge of antibiotic use and AMR using the World Health Organization’s Multi-Country AMR Survey questionnaire, and antibiotic practices were examined. Multivariable logistic regression was performed to identify factors associated with inappropriate antibiotic use and examine effect measure modifications. Results: After adjusting for potential confounding, poor knowledge of antibiotic use was associated with a 3× increased odds of inappropriate antibiotic use in adults aged ≥50 years (aOR 3.11, 95% CI [2.24–4.32]), 5x increased odds in those aged 35–49 years (aOR 4.88, 95% CI [3.32–7.16]), and 7× increased odds in those aged 21–34 years (aOR 6.58, 95% CI [4.19–10.33]). While there was no statistically significant association in adults aged ≥50 years, poor knowledge of AMR increased the odds of inappropriate antibiotic use by 4 times in adults aged 35–49 years (aOR 3.73, 95% CI [1.53–9.11]) and 5 times in those aged 21–34 years (aOR 4.90, 95% CI [1.84–13.02]). Conclusions: Targeted educational interventions for specific age groups are needed in conjunction with empowering the public with knowledge of antibiotic use and AMR.

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Evaluation of Antibiotic Supply Decisions by Community Pharmacists in Thailand: A Vignette Study

Antibiotics ◽

10.3390/antibiotics10020154 ◽

2021 ◽

Vol 10 (2) ◽

pp. 154

Author(s):

Sisira Donsamak ◽

Marjorie C. Weiss ◽

Dai N. John

Keyword(s):

Respiratory Infections ◽

Acute Diarrhoea ◽

Community Pharmacists ◽

Antibiotic Use ◽

Educational Interventions ◽

Community Pharmacies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Case Vignettes ◽

A Chain

In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported. The study aimed to evaluate the appropriateness of antibiotics selected by community pharmacists in Thailand in response to vignettes. A cross-sectional survey of community pharmacists across Thailand was conducted using a self-administered questionnaire including nine case vignettes with three conditions, namely upper respiratory infections (URIs), acute diarrhoea and simple wounds. A total of 208 questionnaires were completed and analysed (20.8% response rate). In response to vignettes relating to URIs, 50.8% of pharmacist recommendations were not in accordance with antibiotic guidelines. Inappropriate recommendations for diarrhoea and wound cases were 20.8% and 16.7%, respectively. A higher proportion of younger pharmacists, those with less experience, Pharm. D. graduate pharmacists, employee pharmacists and those pharmacists who worked in a chain pharmacy were more likely to recommend appropriate antibiotic treatment in response to the vignettes (p < 0.05). These findings will be useful to promote educational interventions for community pharmacists regarding common infectious disease management in order to improve appropriate antibiotic use.

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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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Knowledge, attitude and perception of Pakistanis towards COVID-19; a large cross-sectional survey

BMC Public Health ◽

10.1186/s12889-020-10083-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zoya Fatima Rizwan Ladiwala ◽

Rubaid Azhar Dhillon ◽

Ibrahim Zahid ◽

Omar Irfan ◽

Muhammad Sharjeel Khan ◽

...

Keyword(s):

Age Groups ◽

Female Gender ◽

Educational Status ◽

Educational Interventions ◽

Public Understanding ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Adequate Knowledge ◽

Wide Range

Abstract Background The Novel Coronavirus Disease (COVID-19) has created havoc globally as countries worldwide struggle to combat this pandemic. Since prevention and social isolation are known to be the only ways to prevent the spread of COVID-19, this has created challenges among the lower-middle income countries (LMIC) including Pakistan, as it battles between an under-resourced healthcare, an economic shutdown, and widespread myths and misconceptions. Therefore, a study was conducted to evaluate the knowledge, attitude and perceptions regarding COVID-19 as public understanding is vital to help facilitate the control of this outbreak. Methods A pre-validated online questionnaire was distributed among the general population of Pakistan from 1st to 12th June 2020. Descriptive statistics were analyzed using SPSS v25. Adequate knowledge was assigned as a score of > 4 (range: 0–8) and good perception as a score of > 3 (range: 0–5). Chi-square test was used to determine the significance of difference in knowledge and perception of COVID-19 with socio-demographic characteristics. Logistic regression analysis was run to identify factors associated with adequate knowledge and perception. P < 0.05 was considered as significant. Results A total of 1200 respondents participated in this study with a wide range of age groups and education. Majority of the respondents had adequate knowledge (93.3%) with a mean score of 6.59 ± 1.35, and good perception (85.6%) with a mean score of 4.29 ± 0.82. Significant differences in knowledge and perception were observed among genders, age groups, education and between students and employees in the healthcare and non-healthcare department. A multivariate analysis revealed a higher educational status and female gender to be significant predictors of adequate knowledge and perception. Conclusions Albeit the surge of COVID-19 cases in Pakistan, the participants demonstrated an overall adequate knowledge and good perception towards COVID-19. There is a need to follow the preventive protocols and dissemination of correct information through conducting educational interventions that target safe health practices and provide appropriate information on this infection.

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Carrier prevalence and risk factors for colonisation of multiresistant bacteria in Danish emergency departments: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2019-029000 ◽

2019 ◽

Vol 9 (6) ◽

pp. e029000 ◽

Cited By ~ 2

Author(s):

Helene Skjøt-Arkil ◽

Christian Backer Mogensen ◽

Annmarie Touborg Lassen ◽

Isik S Johansen ◽

Ming Chen ◽

...

Keyword(s):

Risk Factors ◽

Emergency Departments ◽

Respiratory Infections ◽

Age Groups ◽

Antibiotic Use ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Extended Spectrum Beta Lactamase ◽

Multiresistant Bacteria ◽

Significant Difference

ObjectivesThe aim of this study was to describe the carrier prevalence and demographic variation of four different multiresistant bacteria (MRB) among acute patients in Danish emergency departments (EDs): methicillin-resistantStaphylococcus aureus(MRSA), carbapenemase-producing enterobacteria (CPE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL) and vancomycin-resistant enterococci (VRE), and to analyse the association of MRB carriage to a range of potential risk factors.DesignMulticentre descriptive and analytic cross-sectional survey.SettingEight EDs and four clinical microbiology departments in Denmark.ParticipantsAdults visiting the ED.Main outcome measuresSwabs from nose, throat and rectum were collected and analysed for MRSA, ESBL, VRE and CPE. The primary outcome was the prevalence of MRB carriage, and secondary outcomes relation to risk factors among ED patients.ResultsWe included 5117 patients in the study. Median age was 68 years (54–77) and gender was equally distributed. In total, 266 (5.2%, 95% CI 4.6 to 5.8) were colonised with at least one MRB. No significant difference was observed between male and female patients, between age groups and between university and regional hospitals. Only 5 of the 266 patients with MRB were colonised with two of the included bacteria and none with more than two. CPE prevalence was 0.1% (95% CI 0.0 to 0.2), MRSA prevalence was 0.3% (95% CI 0.2 to 0.5), VRE prevalence was 0.4% (95% CI 0.3 to 0.6) and ESBL prevalence was 4.5% (95% CI 3.9 to 5.1). Risk factors for MRB carriage were previous antibiotic treatment, previous hospital stay, having chronic respiratory infections, use of urinary catheter and travel to Asia, Oceania or Africa.ConclusionEvery 20th patient arriving to a Danish ED brings MRB to the hospital. ESBL is the most common MRB in the ED. The main risk factors for MRB carriage are recent antibiotic use and travel abroad.Trial registration numberNCT03352167;Post-results.

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Is there a syndrome of bullying?

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh.2012.013 ◽

2012 ◽

Vol 24 (1) ◽

Cited By ~ 2

Author(s):

Jorge Srabstein ◽

Thomas Piazza

Keyword(s):

Health And Safety ◽

Physical Symptoms ◽

World Health ◽

Emotional Symptoms ◽

Cross Sectional Survey ◽

Psychosomatic Disorder ◽

Cross Sectional ◽

The Usa ◽

Nationally Representative ◽

Health Organization

Abstract Objective: We investigated the existence of a psychosomatic disorder associated with bullying by delineating its health and safety and correlates, and defining the demographic characteristics of the USA adolescents affected by this condition. Methods: This study was based on an analysis of USA data from the 1996 World Health Organization Health Behavior in School-aged Children survey. The survey provides nationally-representative, cross-sectional survey information on 9938 USA students in Grades 6–10. We examined those students who were involved in bullying as a victim and/or as a bully, with or without a self-reported cluster of depression, “bad mood”, “feeling low”, “feeling nervous” and sleeping difficulties, and one or more physical symptoms (headaches, stomach aches, back aches, dizziness). Results: A cluster of physical and emotional symptoms linked to their participation in bullying as bullies and/or victims was reported by 9.5% of adolescents, with a higher frequency of 8th Grade students and a predominance of females. These students were 8.14 times more likely to hurt themselves on purpose and 4.20 times more likely to hurt others purposely than their peers who were not involved in bullying and did not suffer from a cluster of physical and emotional symptoms. Conclusions: This study may elicit further examination and debate about the existence of a nosological entity linked to bullying. Pending further research, the present results should support the need to ascertain participation in bullying, as a bully and/or as a victim, in all pediatric visits. Furthermore, there is a need to enquire about symptoms and risks related to this form of abuse.

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Management of Common Infections in German Primary Care: A Cross-Sectional Survey of Knowledge and Confidence among General Practitioners and Outpatient Pediatricians

Antibiotics ◽

10.3390/antibiotics10091131 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1131

Author(s):

Peter Konstantin Kurotschka ◽

Elena Tiedemann ◽

Dominik Wolf ◽

Nicola Thier ◽

Johannes Forster ◽

...

Keyword(s):

Primary Care ◽

General Practitioners ◽

Primary Care Physicians ◽

Antibiotic Use ◽

Educational Interventions ◽

Treatment Decisions ◽

Antimicrobial Treatment ◽

Antibiotic Prescribing ◽

Cross Sectional Survey ◽

Cross Sectional

Outpatient antibiotic use is closely related to antimicrobial resistance and in Germany, almost 70% of antibiotic prescriptions in human health are issued by primary care physicians (PCPs). The aim of this study was to explore PCPs, namely General Practitioners’ (GPs) and outpatient pediatricians’ (PDs) knowledge of guideline recommendations on rational antimicrobial treatment, the determinants of confidence in treatment decisions and the perceived need for training in this topic in a large sample of PCPs from southern Germany. Out of 3753 reachable PCPs, 1311 completed the survey (overall response rate = 34.9%). Knowledge of guideline recommendations and perceived confidence in making treatment decisions were high in both GPs and PDs. The two highest rated influencing factors on prescribing decisions were reported to be guideline recommendations and own clinical experiences, hence patients’ demands and expectations were judged as not influencing treatment decisions. The majority of physicians declared to have attended at least one specific training course on antibiotic use, yet almost all the participating PCPs declared to need more training on this topic. More studies are needed to explore how consultation-related and context-specific factors could influence antibiotic prescriptions in general and pediatric primary care in Germany beyond knowledge. Moreover, efforts should be undertaken to explore the training needs of PCPs in Germany, as this would serve the development of evidence-based educational interventions targeted to the improvement of antibiotic prescribing decisions rather than being focused solely on knowledge of guidelines.

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GENDERED LEISURE ACTIVITY BEHAVIOR AMONG NORWEGIAN ADOLESCENTS ACROSS DIFFERENT SOCIO-ECONOMIC STATUS GROUPS

International Journal of Child Youth and Family Studies ◽

10.18357/ijcyfs34201211482 ◽

2012 ◽

Vol 3 (4) ◽

pp. 355 ◽

Cited By ~ 10

Author(s):

Ingrid Leversen ◽

Torbjorn Torsheim ◽

Oddrun Samdal

Keyword(s):

Propensity Scores ◽

Economic Status ◽

Leisure Activities ◽

Leisure Activity ◽

World Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Socio Economic Status ◽

Activity Behavior ◽

Nationally Representative

The present paper explores gendered behavior based on participation patterns of leisure activities among adolescents across socio-economic status (SES) groups, aiming to increase knowledge and understanding of how gender socialization processes are expressed through boys’ and girls’ participation in leisure activities. Furthermore, the aim is to investigate whether such gendered behavior is associated with general levels of participation, and if there may be differences between low, middle, and high SES groups. The study used Norwegian nationally representative data of 15- and 16-year-olds from the World Health Organization's cross-sectional survey, <em>Health Behaviour in School-aged Children 2005/06</em> (<em>n</em> = 3,273). Logistic regression analysis and propensity scores showed that adolescent boys and girls had clear gendered behavior patterns based on leisure activity participation in 27 different activities, and that boys and girls had about equal distributions on what was classified as typical (“boyish” or “girlish”), atypical, and neutral gender behavior. Furthermore, gendered behavior was correlated with higher levels of participation for both sexes, and it was more or less similar for boys and girls and for different socio-economic status groups. However, when investigating differences in distributions between SES groups, high SES girls were found to have a significantly higher prevalence of both “boyish” and “girlish” activity behavior, but less “gender-neutral” compared with girls in medium and low SES groups. There were no such differences for boys.

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Prevalence and Predictors of Smoking among Gambian Men: A Cross-Sectional National WHO STEP Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16234719 ◽

2019 ◽

Vol 16 (23) ◽

pp. 4719 ◽

Cited By ~ 2

Author(s):

Cham ◽

Scholes ◽

Groce ◽

Mindell

Keyword(s):

Smoking Status ◽

Survey Methods ◽

World Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

The World ◽

Nationally Representative ◽

Health Organization ◽

Low Prevalence

Background: Tobacco use is the leading cause of preventable death in the world, with a higher burden in low- and middle-income countries. The aim of this study was to quantify the prevalence and predictors of smoking among Gambian men using nationally representative data. Methods: Data was collected in 2010 from a random, nationally representative sample of 4111 adults aged 25–64 years (78% response rate) using the World Health Organization (WHO) STEPwise cross-sectional survey methods. Our analyses focused on men with valid information on smoking status (n = 1766) because of the low prevalence of smoking among women (1%). Results: The prevalence of current smoking among men was 31.4% (95% CI: 27.2–35.9). The median age of starting smoking was 19 years; 25% started before the age of 18 years and 10% started aged 8–10 years. Rural residence, underweight, and hypertension were significantly associated with smoking. Conclusion: The study reveals a high prevalence of smoking among Gambian men. It is evident that cigarettes are obtained by minors in The Gambia, as a high proportion of current smokers started at a young age. Advice and support to quit smoking should be extended to all smokers regardless of their age and whether or not they have any underlying health conditions.

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Knowledge of Antimicrobial Resistance among Veterinary Students and Their Personal Antibiotic Use Practices: A National Cross-Sectional Survey

Antibiotics ◽

10.3390/antibiotics8040243 ◽

2019 ◽

Vol 8 (4) ◽

pp. 243 ◽

Cited By ~ 6

Author(s):

Ismail A. Odetokun ◽

Uduak Akpabio ◽

Nma B. Alhaji ◽

Khalid T. Biobaku ◽

Nurudeen O. Oloso ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Antimicrobial Stewardship ◽

Antibiotic Use ◽

Antibiotic Usage ◽

Descriptive Statistics ◽

Antimicrobial Use ◽

Cross Sectional Survey ◽

Veterinary Students ◽

Cross Sectional ◽

Contributory Factors

The challenge of antimicrobial resistance (AMR) is grave in developing countries. Antimicrobials are misused yet stakeholders’ contribution to antimicrobial stewardship is low. Veterinary students are future prescribers and their knowledge could influence progress in combating AMR; hence, there is a need to assess their knowledge, attitude, and awareness of AMR. A multi-institutional questionnaire was administered to undergraduates in Nigerian veterinary schools. It comprised demographics, own personal antibiotic usage, and knowledge, attitude, and awareness of AMR in humans and animals. Descriptive statistics and logistic regression were used for analyses. Of the 426 respondents, 39.2% reported personal antimicrobial use in the previous six months. Over 60% received knowledge scores lower than average and >87% requested more education on clinical use and prescriptions pre-graduation, monitored dispensing of antimicrobials, conducting AMR research, and confirmed link among human, animal, and environmental health. Less than 25% of respondents were aware of antimicrobial stewardship and global efforts/organizations for AMR. Final year students have 9-fold and 14-fold more satisfactory knowledge on antimicrobials in humans and animals compared with other students, respectively (p = 0.001). Final year students also have more knowledge (13×) and awareness of contributory factors (3×) on AMR (p = 0.001) than other students. Unsatisfactory knowledge on AMR issues exists among veterinary students yet willingness to improve was observed. Identified knowledge, attitude, and gaps in AMR awareness should be targeted by veterinary schools in Nigeria.

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Is neighbourhood walkability related to body mass index among different age groups? A cross-sectional study of Canadian urban areas

BMJ Open ◽

10.1136/bmjopen-2019-032475 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032475 ◽

Cited By ~ 1

Author(s):

Justin Thielman ◽

Ray Copes ◽

Laura C Rosella ◽

Maria Chiu ◽

Heather Manson

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Rural Areas ◽

Urban Areas ◽

Age Groups ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Neighbourhood Walkability ◽

Nationally Representative ◽

Objectively Measured

BackgroundStudies of neighbourhood walkability and body mass index (BMI) have shown mixed results, possibly due to biases from self-reported outcomes or differential effects across age groups. Our objective was to examine relationships between walkability and objectively measured BMI in various age groups, in a nationally representative population.MethodsThe study population came from the 2007–2011 Canadian Health Measures Survey, a cross-sectional survey of a nationally representative Canadian population. In our covariate-adjusted analyses, we included survey respondents aged 6–79 who were not pregnant, did not live in rural areas, were not missing data and were not thin/underweight. We used objectively measured height and weight to calculate BMI among adults aged 18–79 and zBMI among children aged 6–17. We categorised respondents into walkability quintiles based on their residential Street Smart Walk Score values. We performed linear regression to estimate differences between walkability quintiles in BMI and zBMI. We analysed adults and children overall; age subgroups 6–11, 12–17, 18–29, 30–44, 45–64 and 65–79; and sex subgroups.ResultsThe covariate-adjusted models included 9265 respondents overall. After adjustment, differences between walkability quintiles in BMI and zBMI were small and not statistically significant, except for males aged 6–17 in the second-highest walkability quintile who had significantly lower zBMIs than those in the lowest quintile.ConclusionAfter accounting for confounding factors, we did not find evidence of a relationship between walkability and BMI in children or adults overall, or in any age subgroup with sexes combined. However, post hoc analysis by sex suggested males aged 6–17 in more walkable areas may have lower zBMIs.

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