A qualitative study on community use of antibiotics in Kinshasa, Democratic Republic of Congo.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2022
2022
Historique:
received:
06
01
2021
accepted:
11
04
2022
entrez:
27
4
2022
pubmed:
28
4
2022
medline:
30
4
2022
Statut:
epublish
Résumé
Resistance to antibiotics is an increasing and major threat to global health. While the large majority of antimicrobial use occurs in the community where antibiotics are available without prescription, we did not find any studies investigating community-level factors influencing the inappropriate use of antibiotics in the Democratic Republic of Congo (DRC), where non-prescription antibiotic use is prevalent. This qualitative study was conducted from April 1st 2019 to May 5th 2019 and consisting of in-depth semi-structured interviews, utilizing purposive and snowball sampling schemes to recruit adult heads of households in the Pakadjuma slum, in Kinshasa, DRC. Participants with differing medical and educational backgrounds were selected. We employed a thematic analysis approach to explore community knowledge and use of antibiotics in the sampled population. A total of 18 participants with a median age of 35 years were interviewed. The majority was female (77.7%), had at least a secondary education (83.4%), and unemployed (61.1%). We found that participants were familiar with the term "antibiotics", but had limited knowledge of the indications and risks of antibiotics, including the risk of antibiotic resistance. Inappropriate use of antibiotics was common and there was frequent self-medication of non-prescribed medicines for a range of non-indicated conditions such as menstruation. Having limited income was the most commonly reported reason for not visiting a health facility for appropriate health care. Inappropriate use of antibiotics is a widespread practice and is influenced by lack of adequate knowledge of antibiotic use, indications and risks, prevalent self-medication, and financial barriers to accessing appropriate health care. There is need for both community education as well as structural interventions addressing poverty in order to reduce the inappropriate use of antibiotics in the Pakadjuma slum in Kinshasa.
Sections du résumé
BACKGROUND
Resistance to antibiotics is an increasing and major threat to global health. While the large majority of antimicrobial use occurs in the community where antibiotics are available without prescription, we did not find any studies investigating community-level factors influencing the inappropriate use of antibiotics in the Democratic Republic of Congo (DRC), where non-prescription antibiotic use is prevalent.
METHODS
This qualitative study was conducted from April 1st 2019 to May 5th 2019 and consisting of in-depth semi-structured interviews, utilizing purposive and snowball sampling schemes to recruit adult heads of households in the Pakadjuma slum, in Kinshasa, DRC. Participants with differing medical and educational backgrounds were selected. We employed a thematic analysis approach to explore community knowledge and use of antibiotics in the sampled population.
RESULTS
A total of 18 participants with a median age of 35 years were interviewed. The majority was female (77.7%), had at least a secondary education (83.4%), and unemployed (61.1%). We found that participants were familiar with the term "antibiotics", but had limited knowledge of the indications and risks of antibiotics, including the risk of antibiotic resistance. Inappropriate use of antibiotics was common and there was frequent self-medication of non-prescribed medicines for a range of non-indicated conditions such as menstruation. Having limited income was the most commonly reported reason for not visiting a health facility for appropriate health care.
CONCLUSION
Inappropriate use of antibiotics is a widespread practice and is influenced by lack of adequate knowledge of antibiotic use, indications and risks, prevalent self-medication, and financial barriers to accessing appropriate health care. There is need for both community education as well as structural interventions addressing poverty in order to reduce the inappropriate use of antibiotics in the Pakadjuma slum in Kinshasa.
Identifiants
pubmed: 35476752
doi: 10.1371/journal.pone.0267544
pii: PONE-D-21-00434
pmc: PMC9045656
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0267544Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
BMC Public Health. 2020 Jul 29;20(1):1183
pubmed: 32727445
Infect Drug Resist. 2009;2:1-11
pubmed: 21694883
Int J Infect Dis. 2017 Jul;60:83-87
pubmed: 28546075
Am J Infect Control. 2006 Oct;34(8):495-502
pubmed: 17015154
Ann Pharmacother. 2007 Jul;41(7):1249-55
pubmed: 17565044
Bioethics. 2019 Sep;33(7):756-765
pubmed: 31264232
Lancet. 2005 Feb 12-18;365(9459):579-87
pubmed: 15708101
Trans R Soc Trop Med Hyg. 2019 Apr 1;113(4):183-188
pubmed: 30597114
Am J Trop Med Hyg. 2019 Jun;100(6):1378-1390
pubmed: 30994091
PLoS One. 2014 Mar 21;9(3):e92323
pubmed: 24658124
BMJ. 2010 May 18;340:c2096
pubmed: 20483949
Am J Infect Control. 2017 Apr 1;45(4):384-388
pubmed: 28087169
Bull World Health Organ. 2010 Dec 1;88(12):930-6
pubmed: 21124718
PLoS One. 2018 Nov 21;13(11):e0207465
pubmed: 30462700
PLoS One. 2015 Feb 12;10(2):e0117910
pubmed: 25675405
PLoS One. 2013 Dec 23;8(12):e84177
pubmed: 24376793
Lancet Infect Dis. 2011 Sep;11(9):692-701
pubmed: 21659004
Sante Publique. 2013 Mar-Apr;25(2):233-40
pubmed: 23964549
BMC Public Health. 2020 Jul 14;20(1):1103
pubmed: 32664902
Antimicrob Resist Infect Control. 2015 Jan 28;4:1
pubmed: 25717374
BMC Pharmacol Toxicol. 2014 Feb 20;15:6
pubmed: 24555709
J Pharm Policy Pract. 2018 Dec 14;11:30
pubmed: 30564369
Am J Med. 2006 Jun;119(6 Suppl 1):S3-10; discussion S62-70
pubmed: 16735149
Med Mal Infect. 2010 Jun;40(6):333-40
pubmed: 19951830
Res Social Adm Pharm. 2009 Mar;5(1):76-81
pubmed: 19285292
Int J Environ Res Public Health. 2012 Oct 05;9(10):3519-29
pubmed: 23202760
Nurs Econ. 2015 Jul-Aug;33(4):236-9
pubmed: 26477123
J Am Board Fam Med. 2007 Nov-Dec;20(6):533-9
pubmed: 17954860
Front Public Health. 2020 Mar 24;8:90
pubmed: 32266200
Nat Med. 1998 May;4(5):545-6
pubmed: 9585218
J Clin Pharm Ther. 2018 Feb;43(1):59-64
pubmed: 28833324
BMC Infect Dis. 2014 Feb 27;14:112
pubmed: 24576064