scholarly journals Prevalence, Pattern and Impact of Self Medication of Anti-infective Agents During COVID-19 Outbreak in Dhaka City

Author(s):  
Nasir M ◽  
Mannan M ◽  
Chowdhury ASM ◽  
Zahan T ◽  
Perveen RA

Background: The outbreak of coronavirus disease-2019 is putting a massive strain on the vulnerable healthcare systems in low and middle-income countries like Bangladesh. Inequitable access to healthcare is further widened by the socio-economic gap and sense of insecurity during this pandemic. Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines to treat self-recognized symptoms by the people. During the outbreak of COVID-19 in Dhaka city, the tendency of taking medicines by own decision was increased alarmingly due to unusual distress, caused by high self-awareness of their health and buying capacity of medication. Objectives: To observe the prevalence, pattern, sources, and impact of self-medication practice among the respondents with high socio-economic standings and education. Setting: Citizens living in Dhaka city, Bangladesh, during the COVID-19 outbreak from April 2020 to May 2020. Method: Cross-sectional online survey conducted on 626 citizens without having a background of medical knowledge or related to any healthcare services (doctors, nurses, pharmacists, medical students) by structured questionnaires during the COVID-19 outbreak. Outcome measures: Frequency of self-medication, commonly used antimicrobial agents, symptoms causing self-medication, sources of inspiration, relation with COVID-19 test results, economic burden involved in self-medication during the outbreak.

2020 ◽  
Author(s):  
Morshed Nasir ◽  
Khandaker Abu Talha ◽  
ASM Salauddin Chowdhury ◽  
Tahmina Zahan ◽  
Rawshan Ara Perveen

Abstract Background: The outbreak of coronavirus disease-2019 is putting a massive strain on vulnerable healthcare system in low and middle-income countries like Bangladesh. Inequitable access to healthcare is further widened by the socio-economic gap and sense of insecurity during this pandemic. Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines to treat self-recognized symptoms by the people. During the outbreak of COVID-19 in Dhaka city, the tendency of taking medicines by own decision was thought to be increased alarmingly due to unusual distress, caused by high self-awareness of their health and buying capacity of medication. Objectives: To observe the prevalence, pattern, sources and impact of self-medication practice among the respondents with high socio-economic standings and education. Setting: Citizens living in Dhaka city, Bangladesh during COVID-19 outbreak from April 2020 to May 2020. Method: Cross sectional online survey conducted on 626 citizens without having background of medical knowledge or related to any healthcare services (doctors, nurses, pharmacist, medical students) by structured questionnaires during COVID-19 outbreak. Outcome measures: Frequency of self-medication, commonly used antimicrobial agents, symptoms causing self-medication, sources of inspiration, relation with COVID-19 test results, economic burden involved in self-medication during outbreak. Results: The prevalence of self-medication amid the outbreak of COVID-19 was 88.33% and only 179 (28.59%) took medication with doctors’ advice and remaining 447 (71.40%) respondents took the drugs as “self-medication” by other sources. The most frequently used anti-infective drugs during the outbreak were ivermectine (77.15%), azithromycin (54.15%), doxycycline (40.25%). The common symptoms were fever, throat pain, dry-cough and total 105 (16.77%) respondents took medications without having any symptoms. Almost 355 (85.33%) had taken medication without doing any test for COVID-19. The causes of self-medication as news of spread, effects and remedies in media channels, internet; mental stress of lockdown and isolation, insecurity and panic about scarcity of drug and healthcare support. Conclusion: High risks of developing antibiotic resistance, adverse drug reactions and financial loss was predictable with absence of strict regulatory enforcement to protect people and proper utilization resources during COVID-19 outbreak in Dhaka city.


Author(s):  
Morshed Nasir ◽  
A. S. M. Salauddin Chowdhury ◽  
Tahmina Zahan

Background: Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines treat self-recognized symptoms by the people.Methods: A cross sectional online survey was conducted on 626 citizens by structured questionnaires during COVID-19 outbreak from April to May 2020 in Dhaka city, to observe the prevalence, pattern and sources of self-medication among the respondents with high socio-economic standings and education.Results: The prevalence of self-medication amid the outbreak of COVID-19 was 88.33% and only 179 (28.59%) took medication with doctors’ advice and remaining 447 (71.40%) respondents took the drugs as “self-medication” by other sources. The most frequently used prescription-only drug during the outbreak were ivermectin (77.15%), azithromycin (54.15%), doxycycline (40.25%). The common symptoms for which the respondent took self-medications were fever, throat pain, dry-cough and total 105 (16.77%) respondents took medications without having any symptoms. Almost 355 (85.33%) had taken medication without doing any test for COVID-19. This could be due to unusual distress, caused by high self-awareness of their health and buying capacity of medication.Conclusions: The study revealed the causes of self-medication as news of spread, effects and remedies in media channels, internet; mental stress of lockdown and isolation, insecurity and panic about scarcity of drug and healthcare support. High risks of developing antibiotic resistance, adverse drug reactions and financial loss was predictable with absence of strict regulatory enforcement to protect people and proper utilization resources during COVID-19 outbreak in Dhaka city.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajad Vahedi ◽  
Amin Torabipour ◽  
Amirhossein Takian ◽  
Saeed Mohammadpur ◽  
Alireza Olyaeemanesh ◽  
...  

Abstract Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons. Results About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN. Conclusion It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.


2021 ◽  
Vol 7 ◽  
pp. 237796082110290
Author(s):  
Jing Xu ◽  
Kristen Hicks-Roof ◽  
Chloe E. Bailey ◽  
Hanadi Y. Hamadi

Introduction Delivery of healthcare services makes up a complex system and it requires providers to be competent and to be able to integrate each of the institute of medicine’s (IOM) 5 core competencies into practice. However, healthcare providers are challenged with the task to be able to understand and apply the IOM core competencies into practice. Objective The purpose of the study was to examine the factors that influence health professional’s likelihood of accomplishing the IOM core competencies. Methods A cross-sectional study design was used to administer a validated online survey to health providers. This survey was distributed to physicians, nursing professionals, specialists, and allied healthcare professionals. The final sample included 3,940 participants who completed the survey. Results The study findings show that younger health professionals more consistently practice daily competencies than their older counterparts, especially in the use of evidence-based practice, informatics, and working in interdisciplinary teams. Less experienced health professionals more consistently applied quality improvement methods but less consistently used evidence-based practice compared to their more experienced counterparts. Conclusion There is a need to understand how health professionals’ age and experience impact their engagement with IOM’s core competencies. This study highlights the need for educational resources on the competencies to be tailored to health providers’ age and experience.


2021 ◽  
Vol 50 (5) ◽  
pp. 1357-1365
Author(s):  
Aniza Ismail ◽  
Nur Farahani Anas ◽  
Shun Qin Neo ◽  
Najwa Hayati Ab Ghani ◽  
Muhammad Amir Ridzwan Mahadi ◽  
...  

A cross-sectional study was conducted among mothers visiting antenatal clinic in UKMMC from 1st to 19th August 2016 to acquire opinions on unassisted childbirth and the determinant factors among mothers at a teaching hospital. Structured questionnaires were used in assessing their opinions on unassisted childbirth. A total of 259 respondents were recruited, 229 of them who met the inclusion criteria were included for analysis. Majority (87.3%) was Malay and 98.7% of respondents were more than 25 years old. The prevalence for mothers who agreed with unassisted childbirth was 6.6%. Bivariate analysis showed Malay (p=0.013) and non-working mothers (p=0.000) are the significant factors. There was no significant association between opinions on unassisted childbirth and quality of government healthcare services. Multivariate analysis showed middle income and non-working mothers were the significant factors contributing to opinions on unassisted childbirth. The outcome showed minority of mothers agreed with unassisted childbirth, middle income group and non-working mothers agreed on unassisted childbirth. Dissatisfaction to the quality of care at government healthcare services was not found to be the reason for unassisted childbirth. However, there could be other factors contributing to opinions on unassisted childbirth delivery which were not studied. Community-based study should be conducted to determine the other factors.


2021 ◽  
Vol 8 ◽  
Author(s):  
Juan Pablo Villanueva-Cabezas ◽  
Karma Rinzin ◽  
Sithar Dorjee ◽  
Pema Tshewang ◽  
Ugyen Namgyel ◽  
...  

The veterinary prescription of antibiotics in low- and middle-income countries (LMIC) remains largely undocumented. In Bhutan, however, the national veterinary service keeps records of their activities and prescriptions, which offer an opportunity to establish a benchmark to assess the use of these agents in this and other LMIC. A cross-sectional retrospective study was designed and 2,266 handwritten veterinary records from 2017 were sampled from 23 animal health premises (AHPs) to estimate individual and an overall proportion of consultations that resulted in an antibiotic prescription. The frequency of antibiotic prescription per species, type of AHP, and according to WHO's AWaRe index and OIE list of priority antimicrobials were also explored. It was estimated that 31% (95% confidence interval: 29–33%; intracluster correlation: 0.03) of the veterinary consultations resulted in an antibiotic prescription. The incidence of antibiotic prescription was highest in consultations of poultry across AHP. Across species, diarrhea and wounds were frequently treated with broad-spectrum antibiotics including sulfonamides, tetracyclines, trimethoprim + sulfa, and penicillin. Between 45% and 70% antibiotics prescribed correspond to AWaRe's access group and up to 25% to AWaRe's watch group. Over 70% of antibiotics dispensed in veterinary consultations for any species correspond to the OIE's veterinary critically important antimicrobial agents. Overall, the study demonstrated positive features of veterinary antimicrobial stewardship in Bhutan, given the conservative proportion of consultation that results in this type of prescription and the type of antibiotic prescribed. Although the veterinary service closely follows the Bhutanese Standard Treatment Guidelines, the prescription of antibiotics to key species should be closely monitored. Our study suggests that further improvements of antibiotic stewardship can be achieved through standardisation of antibiotic prescription to some species, a revision of the guidelines toward reducing the prescription of antibiotics of high relevance for human medicine, and by including details of clinical investigation, use of tests, and treatment outcomes in veterinary consultation records.


2020 ◽  
pp. tobaccocontrol-2020-055969
Author(s):  
Tarana Ferdous ◽  
Kamran Siddiqi ◽  
Sean Semple ◽  
Caroline Fairhurst ◽  
Ruaraidh Dobson ◽  
...  

IntroductionExposure to secondhand smoke (SHS) is a health risk to non-smokers. Indoor particulate matter (PM2.5) is associated with SHS exposure and is used as a proxy measure. However, PM2.5 is non-specific and influenced by a number of environmental factors, which are subject to geographical variation. The nature of association between SHS exposure and indoor PM2.5—studied primarily in high-income countries (HICs) context—may not be globally applicable. We set out to explore this association in a low/middle-income country setting, Dhaka, Bangladesh.MethodsA cross-sectional study was conducted among households with at least one resident smoker. We inquired whether smoking was permitted inside the home (smoking-permitted homes, SPH) or not (smoke-free homes, SFH), and measured indoor PM2.5 concentrations using a low-cost instrument (Dylos DC1700) for at least 22 hours. We describe and compare SPH and SFH and use multiple linear regression to evaluate which variables are associated with PM2.5 level among all households.ResultsWe surveyed 1746 households between April and August 2018; 967 (55%) were SPH and 779 (45%) were SFH. The difference between PM2.5 values for SFH (median 27 µg/m3, IQR 25) and SPH (median 32 µg/m3, IQR 31) was 5 µg/m3 (p<0.001). Lead participant’s education level, being a non-smoker, having outdoor space and smoke-free rule at home and not using kerosene oil for cooking were significantly associated with lower PM2.5.ConclusionsWe found a small but significant difference between PM2.5 concentrations in SPH compared with SFH in Dhaka, Bangladesh—a value much lower than observed in HICs.


2019 ◽  
Vol 3 ◽  
pp. 239920261984684 ◽  
Author(s):  
Garba Mohammed Khalid ◽  
Abubakar Ibrahim Jatau ◽  
Umar Idris Ibrahim ◽  
Fatima Mustapha Dungus ◽  
Zayyanu Shitu ◽  
...  

Introduction: The burden of antibiotic self-medication (ASM) is increasing and becoming a global health threat due to antibiotics resistance. However, little is known about ASM among undergraduate pharmacy students who are the future custodians of medicines including antibiotics. Therefore, this study aims to develop, validate and utilize an online survey tool to investigate the prevalence of ASM among undergraduate pharmacy students in Northern Nigeria. Methods: A cross-sectional online survey form was developed, validated by face validity, content validity, and pilot study. The hyperlink to the online survey form was shared with undergraduate pharmacy students in northern Nigeria via WhatsApp, Facebook, and Twitter. Data were collected from eligible participants and analyzed using descriptive statistic. Results: A total of 217 students responded to the online survey, with a completion rate of 100%. Of the total number of respondents, 200 (92.2%) reported practicing ASM at least once in their lifetime. The major reasons for ASM were previous knowledge (40.4%) and having no time to see a doctor or pharmacist (27.5%). Amoxicillin (32.6%), Amoxicillin/Clavulanic acid (32.1%), Ampicillin/Cloxacillin (21.7%) and Ciprofloxacin (22.6%) were the most commonly implicated antibiotics in ASM. Cough, diarrhea, typhoid, and wound were the most frequently involved conditions. Patent medicine vendors (75.4%) and community pharmacies (29.4%) were the common source of antibiotics subjected to ASM. Conclusion: A research tool to assess ASM among undergraduate pharmacy students has been developed, validated and utilized. The prevalence of ASM is high among undergraduate pharmacy students in Northern Nigeria. Interventions to improve knowledge and awareness on ASM are needed among undergraduate pharmacy students to ensure antibiotic stewardship.


2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Munirah Al Omar ◽  
Mahmoud Salam ◽  
Khaled Al-Surimi

Abstract Background Workplace bullying (WPB) is a physical or emotional harm that may negatively affect healthcare services. The aim of this study was to determine to what extent healthcare practitioners in Saudi Arabia worry about WPB and whether it affects the quality of care and patient safety from their perception. Methods A cross-sectional study was conducted in 2018. An online survey was distributed among all practitioners at a multi-regional healthcare facility. A previously validated tool was sourced from an integrative literature review by Houck and Colbert. Responses to 15 themes were rated on a 5-point Likert scale, converted to percentage mean scores (PMS) and compared across participants’ characteristics using bivariate and regression analyses. Results A total of 1074/1350 (79.5%) completed the questionnaire. The overall median [interquartile range] score of worrying about WPB was 81.7 [35.0]. Participants were mainly worried about the effect of WPB on their stress, work performance, and communication between staff members. A significant negative relationship developed between the quality of care and worrying about WPB, P < 0.001. More educated practitioners were 1.7 times more likely to be worried about WPB compared with their counter group, adj.P = 0.034. Junior practitioners were 1.6 times more likely to be worried about WPB, adj.P = 0.017. The group who has not been trained in handling WPB (1.7 times), and those who had been exposed to WPB (2.2 times) were both more likely to be worried about WPB compared with their counter groups, adj.P = 0.026 and adj.P < 0.001 respectively. Conclusions Most healthcare practitioners worry about WPB, especially its negative impact on the quality of care and patient safety. A greater proportion of practitioners with higher levels of education and their less experienced counterparts were more worried about WPB. Previous exposure to a WPB incident amplifies the practitioners’ worry, but being trained on how to counteract bullying incidents makes them less likely to be worried.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chelsea L. Kracht ◽  
Peter T. Katzmarzyk ◽  
Amanda E. Staiano

Abstract Background The home environment is an important facilitator of young child movement behaviors, including physical activity (PA), sleep, and screen-time. Household chaos, characterized by crowding, noise, and disorder in the home, may hinder efforts to obtain adequate amounts of movement behaviors. The COVID-19 outbreak impacted many families, and social distancing during this time may create conditions for more household chaos. Family routines can help establish order in the home and encourage an appropriate balance of movement behaviors, such as less screen-time and more sleep. The purpose of this study was to evaluate the association between household chaos and young child movement behaviors during the COVID-19 outbreak in the United States, and the role of family routines in this relationship. Methods A national online survey including 1836 mothers of preschoolers (3.0–5.9 years) was conducted during May 2020. Mothers reported demographic characteristics, household chaos, family routines, and the preschooler’s movement behaviors during the outbreak. Mothers completed a household chaos questionnaire and were grouped into chaos categories (low, moderate/low, moderate/high, and high) for analysis. Linear regression was used to assess the association between chaos category, family routines, and movement behaviors with adjustment for covariates. Results Mothers were 35.9 ± 4.1 years of age, middle income (47.8%), and preschoolers were 3.8 ± 0.8 years of age. Most mothers reported their preschooler was less physically active (38.9%), slept the same amount of time (52.1%), and increased their screen-time (74.0%) after the COVID-19 outbreak. Preschoolers in the high chaos households performed less total PA (β = − 0.36 days/week, 95% CI:-0.62 to − 0.09, p = 0.008), slept less (β = − 0.42 h, 95% CI:-0.59 to − 0.25, p = 0.001) and had more screen-time (β = 0.69 h, 95% CI:0.45 to 0.92, p = 0.001) compared to those in low chaos households. In most chaos categories, having a bed-time ritual was related to more child sleep, and mothers who viewed routines as “less/not important” reported more preschooler screen-time compared to mothers who viewed routines as “very important”. Conclusion Promoting bed-time rituals and prioritizing routines, even somewhat, may be related to an improved balance of child movement behaviors. Innovative measures are needed to support families during periods of disruption such as that experienced in the COVID-19 pandemic.


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