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

Author(s):  
Mee-Lang Cheoun ◽  
Jongho Heo ◽  
Woong-Han Kim

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.

2020 ◽  
Vol 20 (1) ◽  
pp. 29
Author(s):  
Samir Shah ◽  
Ali Elgalib ◽  
Adil Al-Wahaibi ◽  
Maha Al-Fori ◽  
Prasanna Raju ◽  
...  

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.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028224 ◽  
Author(s):  
Marco J Haenssgen ◽  
Nutcha Charoenboon ◽  
Giacomo Zanello ◽  
Mayfong Mayxay ◽  
Felix Reed-Tsochas ◽  
...  

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.


Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 878
Author(s):  
Mohamed A. Baraka ◽  
Amany Alboghdadly ◽  
Samar Alshawwa ◽  
Asim Ahmed Elnour ◽  
Hassan Alsultan ◽  
...  

Factors reported in the literature associated with inappropriate prescribing of antimicrobials include physicians with less experience, uncertain diagnosis, and patient caregiver influences on physicians’ decisions. Monitoring antimicrobial resistance is critical for identifying emerging resistance patterns, developing, and assessing the effectiveness of mitigation strategies. Improvement in prescribing antimicrobials would minimize the risk of resistance and, consequently, improve patients’ clinical and health outcomes. The purpose of the study is to delineate factors associated with antimicrobial resistance, describe the factors influencing prescriber’s choice during prescribing of antimicrobial, and examine factors related to consequences of inappropriate prescribing of antimicrobial. A cross-sectional study was conducted among healthcare providers (190) in six tertiary hospitals in the Eastern province of Saudi Arabia. The research panel has developed, validated, and piloted survey specific with closed-ended questions. A value of p < 0.05 was considered to be statistically significant. All data analysis was performed using the Statistical Package for Social Sciences (IBM SPSS version 23.0). 72.7% of the respondents have agreed that poor skills and knowledge are key factors that contribute to the inappropriate prescribing of antimicrobials. All of the respondents acknowledged effectiveness, previous experience with the antimicrobial, and reading scientific materials (such as books, articles, and the internet) as being key factors influencing physicians’ choice during antimicrobial prescribing. The current study has identified comprehensive education and training needs for healthcare providers about antimicrobial resistance. Using antimicrobials unnecessarily, insufficient duration of antimicrobial use, and using broad spectrum antimicrobials were reported to be common practices. Furthermore, poor skills and knowledge were a key factor that contributed to the inappropriate use and overuse of antimicrobials, and the use of antimicrobials without a physician’s prescription (i.e., self-medication) represent key factors which contribute to AMR from participants’ perspectives. Furthermore, internal policy and guidelines are needed to ensure that the antimicrobials are prescribed in accordance with standard protocols and clinical guidelines.


2021 ◽  
Vol 2 (1) ◽  
pp. 72-80
Author(s):  
Md. Sahidur Rahman ◽  
Nazifa Rafa

Abstract The perceived risk of antimicrobial-resistant pathogens creates the necessity for understanding the role of the prescriber groups. Hence, we conducted a cross-sectional survey among veterinary practitioners to assess their understanding regarding antimicrobial prescribing and the issue of antimicrobial resistance (AMR) in livestock. We collected responses from 100 veterinarians engaged in the large animal, poultry, and pet animal care practices. Proportions were calculated for categorical variables and the results were visualized. We revealed two key barriers: a lack of enough information and of training on the proper prescription of antimicrobials. Prescribing a wide variety of antimicrobials and doing incomplete courses of antimicrobial treatments were two very important causes pointed out by the respondents for the development of antimicrobial resistance. A number of highest-priority critically important antimicrobials (HP-CIAs) of human health were found to be used by veterinary practitioners. In addition to clinical features like types of organisms and severity of the disease, the availability of drugs in the local market and the economic conditions of farmers have the potential to influence the decisions of veterinarians in prescribing antimicrobials. The professional development of veterinarians and the maintenance of strong coordination are crucial to ensure the proper engagement of veterinarians as the front-line fighters for tackling the AMR issue.


2019 ◽  
Vol 58 (6) ◽  
pp. 730-736 ◽  
Author(s):  
J Hubber ◽  
A Person ◽  
L Jecha ◽  
D Flodin-Hursh ◽  
J Stiffler ◽  
...  

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 &lt;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.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Belayneh Ayanaw Kassie ◽  
Aynishet Adane ◽  
Eskeziaw Abebe Kassahun ◽  
Amare Simegn Ayele ◽  
Aysheshim Kassahun Belew

Background. The novel coronavirus disease (COVID-19) pandemic outbreak affects the global social, economic, and political context and becomes a significant threat to healthcare providers who are among the exposed groups to acquire and transmit the disease while caring and treating patients. It is crucial to comply with prevention recommendations so as to stay safe and protected. Therefore, this study aimed to assess COVID-19 preventive practice and associated factors among healthcare workers in Northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted among 630 healthcare workers in Northwest Ethiopia from March to April 2020. A multistage sampling technique was used to select study participants. A pretested and structured self-administered questionnaire was used to collect data. The data were entered using Epi Info 7 and analyzed using STATA 16 statistical software. Both bivariate and multivariable logistic regression analyses were employed to identify associated factors. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine independent predictors of COVID-19 preventive practice. In multivariable analysis, a variable with a P value of less than 0.05 was considered as statically significant. Result. Among 630 healthcare workers participated in the study, the overall good preventive practice towards COVID-19 was found to be 38.73% (95% CI: 34.8, 42.5). Being a male healthcare provider (AOR = 1.48; 95% CI: 1.02, 2.10), having work experience of 6–10 years (AOR = 2.22; 95% CI: 1.23, 4.00), and having poor attitude towards COVID-19 (AOR = 2.22; 95% CI: 1.03, 2.22) were found to be significantly associated with poor COVID-19 preventive practice among healthcare workers. Conclusion. Overall compliance towards COVID-19 preventive practice among healthcare workers was found to be low. Multiple education and training platforms with focus on COVID-19 preventive measures and adequate personal protective equipment and supplies should be provided for healthcare providers.


2019 ◽  
Vol 5 (1) ◽  
pp. 22-25
Author(s):  
Michel Ekono ◽  
◽  
Henri Essome ◽  
JGS Bwemba ◽  
Pierre Marie Tebeu ◽  
...  

Introduction: The female condom is a polyurethane sheath that fits into the vagina before the sexual act, protecting the woman against both sexually transmitted infections, including HIV, and unwanted pregnancies. Objectives. We assessed the attitudes and practices of the female condom among female students in three faculties at the University of Douala. Methods: We conducted a prospective, cross-sectional and analytical study of female students aged at least 21 years old and willing to participate in the study. We excluded those who were not sexually active, as well as those whose cards were poorly completed. A pre-tested and questionnaire was used to collect socio-demographic characteristics, attitudes and practical knowledge of female condom students. The rating tables have been established. Data was analyzed using SPSS version 2.0 software. Results: A total of 320 students were enrolled in the study. The average age was 23.6 ± 4 years old. The majority of participants were single. 74.4% were poorly knowledgeable, 17.5% had average knowledge, and 0.3% had good knowledge of female students. The attitude regarding the female condom was unfavorable at 83.3% and indeterminate at 16.2%. The female condom use rate was 8.4% with a user satisfaction rate of 7.4%. Conclusion: Students in these 3 faculties have poor knowledge of the female condom. Their attitude is unfavorable, and its use infrequent and unsatisfactory


Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1697
Author(s):  
Ashokkumar Thirunavukkarasu ◽  
Abdulmohsen Khaled Almulhim ◽  
Faisal Ahmed Albalawi ◽  
Ziyad Muharib Alruwaili ◽  
Ola Ali Almajed ◽  
...  

Primary care physicians play a vital role in preventing the progression of diabetic retinopathy (DR) from the initial stages to the late stages. This questionnaire-based analytical cross-sectional study was carried out to assess the knowledge, attitude, practices, and their correlation among 274 randomly selected primary care physicians in Saudi Arabia. Among the studied population, high knowledge, attitudes, and practice scores were observed in 21.5%, 15%, and 29.2% of the physicians, respectively. The mean knowledge score was significantly higher among the age group of less than 30 years (p = 0.031) and the female gender (p = 0.012). The attitude scores were significantly higher among the Saudi physicians (p = 0.027) and those with PHC work experience of less than five years (p < 0.001). Regarding the practices, a significant association was found among the age group of less than 30 years (p = 0.019) and Saudi physicians (p = 0.003). There was a significant positive correlation between knowledge (correlation coefficient (r) = 0.739, p < 0.001) and attitude (r = 0.479, p = 0.007) with the practice scores. It is recommended that targeted continuous medical education, workshops, and seminars are conducted on the prevention and care of DR among primary care physicians. Furthermore, an exploratory multicenter study that involves primary care physicians belonging to all ministries and private sectors is warranted.


2020 ◽  
Author(s):  
Gamil Ghaleb Alrubaiee ◽  
Talal Ali Hussein Al-Qalah ◽  
Mohammed Sadeg A. Al-Aawar

Abstract Background: The growing incidence of coronavirus (COVID-19) continues to cause fear, anxiety, and panic amongst the community, especially for healthcare providers (HCPs), as the most vulnerable group at risk of contracting this new SARS-CoV-2 infection. To protect and enhance the ability of HCPs to perform their role in responding to COVID-19, healthcare authorities must help to alleviate the level of stress and anxiety amongst HCPs and the community. This will improve the knowledge, attitude and practice towards COVID-19, especially for HCPs. In addition, authorities need to comply in treating this virus by implementing control measures and other precautions. This study explores the knowledge, attitude, anxiety, and preventive behaviours among Yemeni HCPs towards COVID-19. Methods: A descriptive, web-based-cross-sectional study was conducted among 1,231 Yemeni HCPs. The COVID-19 related questionnaire was designed using Google forms where the responses were coded and analysed using the Statistical Package for the Social Sciences software package (IBM SPSS), version 22.0. Descriptive statistics and Pearson’s correlation coefficient test were also employed in this study. A p-value of < 0.05 with a 95% confidence interval was considered as statistically significant. The data collection phase commenced on 22nd April 2020, at 6 pm and finished on 26th April 2020 at 11 am. Results: The results indicated that from the 1,231 HCPs participating in this study, 61.6% were male, and 67% were aged between 20 and 30 years with a mean age of 29.29 ±6.75. Most (86%) held a bachelor’s degree or above having at least 10 years of work experience or less (88.1%). However, while 57.1% of the respondents obtained their information via social networks and news media, a further 60.0% had never attended lectures/discussions about COVID-19. The results further revealed that the majority of respondents had adequate knowledge, optimistic attitude, moderate level of anxiety, and high-performance in preventive behaviours, 69.8%, 85.10%, 51.0 and 87.70%, respectively, towards COVID-19. Conclusion: Although the Yemeni HCPs exhibited an adequate level of knowledge, optimism, attitude, moderate level of anxiety, and high-performance in preventive behaviours toward COVID-19, the results highlighted gaps, particularly in their knowledge and attitude towards COVID-19.


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