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.

Determinants of knowledge, attitudes, and practices of front-line health workers during the first wave of COVID-19 in Africa: a multi-center online cross-sectional study

Background: During its first wave of COVID-19 infection in sub-Saharan Africa, there was insufficient understanding of the pandemic among front-line health care professionals that has led to a misidentification, and mistreatment of affected patients, with a potential risk of contracting and spreading the disease. This study was carried out to determine the Knowledge, attitude, and practices (KAP) of front-line health workers (HWs) towards COVID-19 in Africa and their related factors.Methods: This was a multi-centers online cross-sectional study conducted over a 3-months study-period using a google survey link among front lines HWs involved in the COVID-19 response in 26 African countries. Chi-square test & logistic regression were used in the bivariate and multivariate analysis respectively to assess determinants of KAP. Statistical analysis was done using STATA version 16; all tests were two-sided with 95% confidence interval. Results: Five hundred and seventeen (517, 96.3%) consented to participate in this study from 26 African countries; 289 (55.9%) were male and 228 (44.1%) female. Overall, most of HWs, 379 (73.3%) showed poor knowledge about COVID-19 infection and preventive measures. In contrast, majority of them showed good attitude (89%) and practice (90.3%) towards prevention of COVID-19 infections. Knowledge varied among countries; Uganda had the greatest number of HWs with good knowledge. (OR = 28.09, p <0.0001) followed by Ghana (OR=10.92, p=0.001) and DRC (OR: 4.59, p=0.015). The cadre of HWs also influenced knowledge; doctors were the most knowledgeable as compared to other cadres (OR: 3.4, p= 0.005). Additionally, knowledge increased with increasing HWs’ education level (p=0.011).Attitude and practice were both influenced by HWs country of workplace (p=0.05 & p< 0.0001 respectively) and their cadre (p = 0.025 & p < 0.0001 respectively).Conclusions: Majority of the front-line HWs in the African region had an overall good attitude and practice towards COVID-19 infection and practice measures despite relatively poor Knowledge. The KAP is influenced by HWs country of workplace, their cadre and level of education.

KNOWLEDGE, ATTITUDE AND PRACTICES IN CERVICAL CANCER SCREENING IN KAKAMEGA COUNTY, KENYA

Purpose: Early cervical cancer screening (CCS) and treatment is effective method of controlling the disease, however its uptake is poor. Women only screen for cervical cancer when they experience symptoms or when advised by healthcare workers. Main objective of the study was to assess knowledge, attitude and practices of cervical cancer screening among women in Kakamega County. Methodology: The target population was 208,905 women of reproductive age residing in Kakamega County. This was a quantitative research approach utilizing descriptive study design. An interviewer administered questionnaire was used to collect data. Multi-stage sampling was used to select 872 women aged 25-49 from 16 community units of Kakamega County. Participants were assured of confidentiality, voluntary participation and freedom to exit the study at any point. Descriptive statistics were used to analyze knowledge and attitude levels towards cervical cancer screening. Logistic regression along with odds ratios at 95% confidence intervals was used to analyze factors affecting uptake of screening. Findings: Majority (81%) of participants had heard of cervical cancer screening mainly from media and Health Care workers. Only 16 % and 13% had good knowledge about signs of and risk factors of cervical cancer respectively. More than 78% had positive attitude towards cervical cancer screening. Less than 22% of participants had been screened for cervical cancer previously. Uptake of cervical cancer screening was low, and there was poor knowledge on aspects of cervical cancer. Poor to average knowledge is not sufficient to enable women make decisive actions on CCS. Unique Contribution to Theory, Practice and Policy: Women should be encouraged to seek for more information about CCS through the various sources of media available to them. Healthcare providers need to be empowered further on delivering key information about CCS. The Ministry of Health should consider and strengthen alternative sources of information on CCS by use of Community Health Volunteers to complement health care providers. The government should further initiate a monitoring and evaluation program to track trends of factors barring uptake of CCS. A qualitative research need to be conducted to establish deeper factors associated with poor knowledge and uptake of CCS despite positive attitude.

A Study to Evaluate the Effectiveness of Information Booklet on Knowledge regarding Coronary Angiography among 3rd Year G.N.M. students in selected Nursing School at Vijayapur, Karnataka

Background: Coronary heart disease contributes much to the burden morbidity and mortality from chronic diseases globally and more than 80% of CVD-related deaths worldwide now occur in low and middle income countries. In India about 30 million adults suffer from cardiovascular disease. Objectives: To assess the knowledge of 3rd year G.N.M. students regarding coronary angiography and evaluate the effectiveness of informational booklet on knowledge regarding coronary angiography. Method: Pre-experimental research design was used for the study. Information booklet is dependent variable and knowledge of student nurses regarding coronary angiography is dependent variable. The setting of the study is at selected Schools of nursing at Vijayapur, Karnataka. Simple random sampling technique is used to select the subjects. The sample size is of 60 students. Result: In pre-test majority of subjects 30 (50%) had an average knowledge; 18 (30%) had poor knowledge and 12 (20%) had good knowledge, where as in post-test 51 (85%) of them had good knowledge and 09 (15%) had poor knowledge. Study also reveals that there is no association between pre-test knowledge and selected Socio demographic variables. Study also reveals that calculated paired‘t’ value (t= 26.48) is greater than tabulated value (t= 1.960). Hence H1 is accepted. This indicates that the gain in knowledge score is statistically significant at P< 0.05 levels. Conclusion: The findings of the study conclude that there is a need for educating the student nurses regarding coronary angiography. It implies that a nursing administrator should take part in developing protocols, standing orders related to design of the educational programmes and strategies for GNM Students regarding Coronary angiography.

Teledentistry—Knowledge, Practice, and Attitudes of Dental Practitioners in Saudi Arabia: A Nationwide Web-Based Survey

The present survey assessed the knowledge, attitudes, and practice of teledentistry (TD) among dental practitioners in Saudi Arabia. This questionnaire-based cross-sectional study was conducted with dental interns and practicing dentists in Saudi Arabia. An online questionnaire was sent to all potential respondents. Questions related to knowledge, practice, attitudes, and training regarding TD were presented. A total of 603 (227 dental interns, 376 practicing dentists) completed the questionnaire. Generally, the participants revealed poor knowledge and practice of TD, with only 38% having heard about TD and only one-quarter of the sample (23.2%) reporting practicing TD at their current workplace. However, most of the participants expressed positive attitudes and a willingness to practice TD in the future. Specialists and those in practice for >5 years showed significantly better knowledge and practice of TD than general dentists and those with lesser clinical experience (p < 0.01). While only one-fifth of the participants (20.2%) reported having attended a workshop/lecture about TD, the majority (69.7%) felt that they needed training on TD. The results revealed poor knowledge, practice, and training with regard to TD among practicing dentists in Saudi Arabia. However, the positive attitude expressed by most of the participants towards practicing TD in the future is an encouraging sign for dental educators and planners of oral health care. Continuous education through periodic workshops and training courses on TD is crucial to improve dentists’ knowledge, practice, and attitudes towards TD. Integration of TD topics into undergraduate/postgraduate curricula is highly recommended. Special attention should be directed to training general dental practitioners and junior dentists.

Knowledge, attitude, and associated factors towards mental illness among residents of Dessie town, northeast, Ethiopia, a cross-sectional study

Background Knowledge and attitude towards mental illness are poor and neglected as compared to medical illness. However, there is an increasing burden of mental illness in the community. As per the knowledge of the investigators, studies are scarce and not done in the study area about knowledge and attitudes of mental illness. Therefore, this study aimed to assess the knowledge, attitude, and associated factors towards mental illness among, Dessie town residents. Methods A community-based cross-sectional study was conducted in Dessie town, Northeast, Ethiopia from October 27 to November 29/2020. A multi-stage sampling technique was employed. The data were collected from 477 study participants using a standard structured questionnaire, which were Mental Health Knowledge Schedule (MAKS) and Community Attitude to Mental Illness Inventory (CAMI) respectively. Data were entered using Epi-data version 3.1 and, then exported to SPSS version 26 for analyses. Bivariable and Multivariable logistic regression analyses was employed. Results From 477 study participants the prevalence of poor knowledge and unfavorable attitude towards mental illness were 55.3% (95% CI: 50.9, 60.0) and 45.1% (95% CI: 40.7,49.5) respectively. Being female [AOR = 1.62 (95% CI:1.06,2.47)], could not read and write [AOR = 6.28 (95% CI: 2.56, 15.39)], lack of information about mental illness [AOR = 5.82 (95% CI: 3.78,8.94)] and unfavorable attitude [AOR =1.73 (95% CI: 1.12,2.66)] were variables found statistical significant with poor knowledge. Whereas, income < 2166 [AOR = 1.64, (95% CI: 1.12, 2.41)], poor social support [AOR = 2.04, (95% CI: 1.13, 3.68)], moderate social support [AOR = 2.44, (95% CI: 1.45, 3.97)] and poor knowledge [AOR = 1.66, (95% CI: 1.13,2.43)] were variables significantly associated with unfavorable attitude toward mental illness. Conclusion In this study about half of the community have poor knowledge, and less than half of the participants have an unfavorable attitude to wards mental illness. There are many factors associated with poor knowledge and unfavorable attitudes. This having poor knowledge and unfavorable attitude may cause certain problems like a decrease in health care of a person with mental illness. Therefore, we recommend practice-based awareness in the community regarding mental health problems needs to be addressed.

Awareness of Risk factor and Warning symptoms of Stroke among patients with hypertension at Tertiary care hospital of South India

Introduction: High blood pressure, also termed as hypertension is a condition that afflicts almost 1 billion people worldwide and is a leading cause of mortality and morbidity. Therefore, this disease is often referred as a “Silent Killer.” In most of the instances, this disease remains asymptomatic until severe to express as one of the following outcomes: stroke, myocardial infarction, renal dysfunction, visual problems and others. Thus, hypertension is affirmed as the major risk factor for stroke, coronary artery disease and myocardial infarction. High blood pressure is one of the most common causes of stroke as it strains blood vessel walls causing them to thicken and deteriorate. Aim: To Assess the awareness of risk factors, symptoms of stroke among hypertensive patients and associate the awareness of risk factors and symptoms stroke with selected variables. Methods: a non-experimental descriptive research design was used in this study. the study was conducted among 300 samples of all the hypertensive patients admitted in Sri Ramachandra hospital and the patients who come for OPD during the study period. Purposive sampling technique is used for the study. The instrument used for this study has 3 components demographic data, self structured questionnaire on risk factors of stroke and self structured questionnaire on symptoms of stroke. Data were collected and analyzed using descriptive and inferential statistics. Findings: With related symptoms severity reveals that majority of the sample 220(73.3%) had poor knowledge and 58(19.3%) had moderate knowledge and 4(1.3%) had good knowledge risk factors Reveals that majority of the sample 156 (52.0%) had poor knowledge and 109(36.3%) had poor knowledge 109 (36.3%) had moderate knowledge and 10(3.3%) had good knowledge. The mean and standard deviation of awareness of risk factors and symptoms of stroke among patient with hypertension was and there was no significant association between any patient with hypertension and selected demographic variables. Conclusion: The study concluded that majority of the samples had poor knowledge on risk factors and symptoms of stoke among hypertensive patients. Here the health care team members need create awareness among public in order reduce the morbidity and mortality rate of stroke.

Delay of TB patients in diagnosis in a conflict setting of Mogadishu, Somalia - a cross-sectional study

BBackground. The TB case detection rate in Somalia is 42%, which is much lower than the WHO target of detecting 70% of new TB cases. Understanding the factors contributing to the delay of TB patients in the diagnosis, and reducing the time between the onset of TB symptoms to diagnosis, is a prerequisite to increase the case detection rate and to ultimately bring the TB epidemic in Somalia under control. The aim of this study is to examine the duration of delay, and factors associated with the delay among patients in TB management centers in Mogadishu, Somalia. Methods. An institution-based, cross-sectional study was conducted in TB management clinics providing directly observed treatments (DOTS) programs in Mogadishu. A total of 276 patients were interviewed using a structured questionnaire from June-October 2018. We analyzed data using descriptive statistics and different logistic regression models. Results. Approximately 78% of study participants were male. Nearly a third (36.5%) came from a household of nine individuals or more, while 73% were unemployed. The median patient and provider delays were 50 days and one day, respectively. The median total delay was 55 days, with an inter-quartile range of 119 days. Patients who had a poor knowledge of the symptoms of TB had 3.16 times higher odds of delay over 50 days than their counterparts. Furthermore, a poor knowledge of the symptoms of TB (aOR 4.22, CI 2.13-8.40), not making ones own decisions in seeking TB treatment (aOR 2.43, CI 1.22-4.86) and a poor understanding of the fact that TB can be treated with biomedical treatment, as opposed to traditional treatment (aOR 2.07, CI 1.02-4.16), were predictors of a patient delay over 120 days. Conclusions. The duration in the delay of TB patients under diagnosis in Mogadishu is one of the highest reported in developing countries, exceeding two years in some patients. Training local community health workers to detect suspected TB cases, and referring the cases of prolonged cough over three weeks for TB care centers for diagnosis, is imperative to help break the transmission and reduce the infectious pool in the population of Mogadishu. This may not only increase the community awareness of TB disease, but it may also facilitate the early referral of TB patients to diagnostic and treatment care centers.

Effectiveness of planned teaching programme on knowledge regarding poly cystic ovarian disease among adolescent girls of Sursinghdhar, New Tehri, Uttarkhand, India

Background: An experimental study was conducted to evaluate the effectiveness of planned teaching programme on knowledge regarding polycystic ovarian disease (PCOD) among adolescent girls.Methods: The research design adopted for the study was one group pre – test post – test design and approach was educative and evaluative approach. This study was undertaken in village of Sursinghdhar, New Tehri, Uttarakhand, India. The data were collected through the questionnaire method with sample size 60 adolescent girls.Results: Findings related to the assessment of pre-test knowledge regarding PCOD depicted that 48.4% of the respondents had average knowledge while 43.3% had poor knowledge. Only 8.3% had good knowledge regarding PCOD. The pretest mean and Sd was 10.1±4.0. Post-test knowledge regarding PCOD depicted that 81.7% of respondents had good knowledge whereas 16.7% and 1.6% reported average and poor knowledge. The post test mean and SD was 19.0±2.8. Effectiveness of PTP on knowledge regarding PCOD among adolescent girls was calculated by paired t- test; and value was 24.1 with p value of 0.001 (S) at ≤0.05 level of significance. It was highly significant. Chi square test revealed that there was significant association between pre-test knowledge score with age (p value 0.02) and previous knowledge socio-demographic variable p value 0.05 at ≤0.05 level of significanceConclusions: The overall findings of the study clearly shows that the pretest knowledge was very less related to PCOD and there is the statistically enhancement in post-test knowledge after PTP. It reveals that, if the adolescent girls are provided regular awareness programme on PCOD will definitely brief up their knowledge, which in turn to improve the total quality of one’s reproductive health.

Relations of Knowledge with Perceptions of Eligible Men About Vasectomy in Angsau Primary Health Care, Tanah Laut, South Kalimantan

Background: Indonesia’s Maternal Mortality Rate (MMR) in 2015 was still high around 305 over 100.000 population. South Kalimantan MMR’s in 2018 increase to 108 over 100.000 population. If not handled properly the increasing of MMR, it will not achieve the SDG's by 2030. The high MMR is caused by the large number of pregnancies and deliveries in Indonesia. One of the ways to prevent it, is by reducing the number of pregnancies and one of the most effective way is through the Family Planning (FP) program. Vasectomy is a method of operative contraception in men. Public perception of vasectomy is a complicated operation, so vasectomy is not an option. Aim: Knowing the relations between knowledge and perceptions of eligible men on vasectomy Method: This research is an analytical survey with a cross sectional approach. The number of subjects used as many as 80 respondents who meet the feasibility of being included in this study. The chi-square test with a significance level of p<0.05 was used for statistical analysis. Knowledge is considered good if it has a total score of more than 76 percent, and it is considered poor if it is less than equal to 76 percent. Positive perception if the respondent's mean score is less than the T score, and to be negative perception if the respondent's mean score is more than the T score. Results: A total of 108 respondents were included in this study. There are 89 respondents or 82% who have good knowledge and 19 respondents or 18% who have bad knowledge about vasectomy. Negative perceptions were owned by 81 respondents or 75% while positive perceptions were only found in 27 respondents or 25%. Chi-square analysis showed that there was a significant relation between poor knowledge and negative perceptions with p<0.05. Conclusion: Poor knowledge of vasectomy is associated with negative perceptions. This study shows lack of public knowledge about vasectomy, causing a negative stigma about vasectomy.