National Antibiotic Consumption for Human Use in Sierra Leone (2017–2019): A Cross-Sectional Study

Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access, 31% were Watch, and no Reserve antibiotics were reported. The top ten oral antibiotics represented 97% of total oral antibiotics consumed, with metronidazole (35%) and ciprofloxacin (15%) together constituting half of the total. Of parenteral antibiotics consumed, procaine penicillin (32%) and ceftriaxone (19%) together comprised half of the total. Policy recommendations at global and national levels have been made to improve monitoring of antibiotic consumption and antibiotic stewardship.

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Annual consumption of parenteral antibiotics in a tertiary hospital of Nepal, 2017–2019: a cross-sectional study

Public Health Action ◽

10.5588/pha.21.0043 ◽

2021 ◽

Vol 11 (1) ◽

pp. 52-57

Author(s):

P. Baral ◽

K. Hann ◽

B. Pokhrel ◽

T. Koirala ◽

R. Thapa ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Antibiotic Consumption ◽

Cross Sectional Study ◽

Defined Daily Dose ◽

Care Hospital ◽

Sectional Study ◽

Beta Lactam ◽

Cross Sectional ◽

Increasing Trend

SETTING: Patan Hospital, a tertiary care hospital in Lalitpur District, Nepal.OBJECTIVES: To describe the annual parenteral antibiotic consumption in 1) defined daily dose (DDD) and DDD per 100 admissions; 2) calculate DDD per 100 admissions and proportions by pharmacological subgroup, chemical subgroup and AWaRe categories; and 3) describe patient expenditure on parenteral antibiotics as a proportion of the total patient expenditure on drugs and consumables between 2017 and 2019.DESIGN: This was a cross-sectional study.RESULTS: Total DDD of parenteral antibiotics increased by 23% from 39,639.7 in 2017 to 48,947.7 in 2019. DDD per 100 admissions increased by 10% from 172.1 in 2017 to 190.2 in 2019. Other beta-lactam antibacterials comprised the most frequently consumed pharmacological subgroup. The chemical substance most often consumed was ceftriaxone, with an increasing trend in the consumption of vancomycin and meropenem. Parenteral antibiotics in ‘Watch’ category were the most consumed over the study period, with a decreasing trend in ’Access’ and increasing trend in ‘Reserve’ categories.CONCLUSION: We aimed to understand the consumption of parenteral antibiotics at a tertiary care hospital and found that Watch antibiotics comprised the bulk of antibiotic consumption. Overconsumption of antibiotics from the ‘Watch’ and ‘Reserve’ categories can promote antimicrobial resistance; recommendations were therefore made for their rational use.

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

10.21203/rs.2.19809/v1 ◽

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.

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An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-020-8279-7 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 6

Author(s):

Peter Bai James ◽

Jonathan Wardle ◽

Amie Steel ◽

Jon Adams

Keyword(s):

Sierra Leone ◽

Healthcare Utilisation ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Related Stigma

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Early clinical sequelae of Ebola virus disease in Sierra Leone: a cross-sectional study

The Lancet Infectious Diseases ◽

10.1016/s1473-3099(15)00489-2 ◽

2016 ◽

Vol 16 (3) ◽

pp. 331-338 ◽

Cited By ~ 96

Author(s):

John G Mattia ◽

Mathew J Vandy ◽

Joyce C Chang ◽

Devin E Platt ◽

Kerry Dierberg ◽

...

Keyword(s):

Sierra Leone ◽

Ebola Virus ◽

Virus Disease ◽

Cross Sectional Study ◽

Ebola Virus Disease ◽

Sectional Study ◽

Cross Sectional

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Patients satisfaction with free healthcare pharmaceutical services in Sierra Leone: a national cross-sectional study

International Journal of Clinical Pharmacy ◽

10.1007/s11096-020-01163-5 ◽

2020 ◽

Author(s):

John Alimamy Kabba ◽

Abdulai Jawo Bah ◽

Peter Bai James ◽

Jie Chang ◽

Chenai Kitchen ◽

...

Keyword(s):

Sierra Leone ◽

Cross Sectional Study ◽

Pharmaceutical Services ◽

Sectional Study ◽

Cross Sectional ◽

Patients Satisfaction ◽

Free Healthcare

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Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone

BMC Public Health ◽

10.1186/s12889-020-08985-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sanni Yaya ◽

Komlan Kota ◽

Amos Buh ◽

Ghose Bishwajit

Keyword(s):

Sierra Leone ◽

Tetanus Toxoid ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

In Pregnancy

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Prevalence of hypertension in the Gambia and Sierra Leone, western Africa : a cross-sectional study : cardiovascular topic

CardioVascular Journal of Africa ◽

10.5830/cvja-2014-058 ◽

2014 ◽

Vol 25 (6) ◽

pp. 269-278 ◽

Cited By ~ 10

Author(s):

Morcos Awad ◽

Andrea Ruzza ◽

James Mirocha ◽

Saman Setareh-Shenas ◽

J. Robert Pixton ◽

...

Keyword(s):

Sierra Leone ◽

Cross Sectional Study ◽

The Gambia ◽

Sectional Study ◽

Cross Sectional ◽

Western Africa

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Observational Study of Antibiotic Usage at the Children’s Clinical University Hospital in Riga, Latvia

Medicina ◽

10.3390/medicina54050074 ◽

2018 ◽

Vol 54 (5) ◽

pp. 74 ◽

Cited By ~ 2

Author(s):

Inese Sviestina ◽

Dzintars Mozgis

Keyword(s):

Pediatric Patients ◽

Antibiotic Consumption ◽

University Hospital ◽

Antibiotic Prescribing ◽

Defined Daily Dose ◽

Total Consumption ◽

Prevalence Survey ◽

Cross Sectional ◽

Study Results ◽

Antibiotic Drug

Background and objectives: Many pediatric patients have been treated with antibiotics during their hospitalization. There is a need to improve antibiotic prescribing for pediatric patients because many of these prescriptions are inappropriate. Antibiotic consumption analysis was conducted at the Children’s Clinical University Hospital to identify targets for quality improvement. Materials and Methods: A one day cross-sectional point prevalence survey (PPS) was conducted in May and November 2011–2013 using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antibiotic treatment on the day of survey. Total consumption of systemic antibiotics belonging to the ATC J01 class (except amphenicols (J01B) and a combination of antibacterials (J01R)) was also analyzed by using a defined daily dose (DDD) approach and antibiotic drug utilization (90%DU) for the period 2006–2015. Results were compared with results in 2017 using the DDD and 90%DU methodology. Results: The most commonly used antibiotic group in all PPS, except in May and November 2011, was other β-lactam antibiotics (J01D): 42 (40%) prescriptions in May 2013 and 66 (42%) and November 2011. In 2006–2015 and also in 2017, the most commonly used antibiotic groups were penicillins (J01C) and other β-lactam antibiotics (J01D)—76% (90%DU) of the total antibiotic consumption registered in 2006, 73% in 2015 and 70% in 2017. Starting in 2008, amoxicillin was the most commonly used antibiotic at the hospital. The usage of ceftriaxone increased from 3% in 2006 to 13% in 2015, but decreased in 2017 (7%). Conclusions: Study results from 2006–2015 showed that there was a need to establish a stronger antibiotic prescribing policy in the hospital reducing the use of broad-spectrum antibiotics (especially 3rd generation cephalosporins) and increasing the use of narrower spectrum antibiotics. It was partly achieved in 2017 with some reduction in ceftriaxone use.

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Global, regional, and national consumption of controlled opioids: a cross-sectional study of 214 countries and non-metropolitan territories

British Journal of Pain ◽

10.1177/20494637211013052 ◽

2021 ◽

pp. 204946372110130

Author(s):

Georgia C Richards ◽

Jeffrey K Aronson ◽

Kamal R Mahtani ◽

Carl Heneghan

Keyword(s):

The United States ◽

Cross Sectional Study ◽

Opioid Consumption ◽

Sectional Study ◽

Total Consumption ◽

Cross Sectional ◽

The World ◽

Narcotics Control ◽

Using Data ◽

National Consumption

Introduction: The consumption of opioids has increased globally since the 1990s. Previous studies of global opioid consumption have concentrated on morphine alone or a subset of opioids, with a focus on cancer pain and palliative care. In this study, we have determined the global, regional, and national consumption of all controlled opioids, including anaesthetics, analgesics, antidiarrheals, opioid substitution therapies, and cough suppressants. Methods: We conducted a cross-sectional study using data from the International Narcotics Control Board (INCB). We calculated mean opioid consumption (mg/person) globally, regionally, and nationally for 2015–2017, where consumption refers to the total amount of controlled opioids distributed for medical purposes and excludes recreational use. We ranked countries by total consumption and quantified the types of opioids consumed globally. Results: Between 2015 and 2017, 90% of the world’s population consumed only 11% of controlled opioids. An average of 32 mg/person was consumed annually, but this was not equally distributed across the world. Consumption was the highest in Germany (480 mg/person), followed by Iceland (428 mg/person), the United States (398 mg/person) and Canada (333 mg/person). Oxycodone (35%) was the most heavily consumed controlled opioid globally, followed by morphine (15.9%), methadone (15.8%) and tilidine (14%). Conclusion: Large disparities persist in most of the world in accessing essential opioid medicines. Consumption patterns should continue to be monitored, and collaborative strategies should be developed to promote access and the appropriate prescribing of opioids in all countries and non-metropolitan territories.

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