Current rates of purchasing of antibiotics without a prescription across sub-Saharan Africa; rationale and potential programmes to reduce inappropriate dispensing and resistance

Expert Review of Anti-infective Therapy, Год журнала: 2023, Номер 21(10), С. 1025 - 1055

Опубликована: Сен. 23, 2023

ABSTRACTIntroduction Antimicrobial resistance (AMR) is a global concern. Currently, the greatest mortality due to AMR in Africa. A key driver continues be high levels of dispensing antibiotics without prescription.Areas covered need document current rates dispensing, their rationale and potential ways forward including antimicrobial stewardship programmes (ASPs). narrative review was undertaken. The highest antibiotic purchasing were Eritrea (up 89.2% dispensed), Ethiopia 87.9%), Nigeria 86.5%), Tanzania 92.3%) Zambia 100% pharmacies prescription). However, considerable variation seen with no minority countries situations. Key drivers self-purchasing included co-payment for physician consultations costs, travel convenience pharmacies, patient requests, limited knowledge weak enforcement. ASPs have been introduced some African along quality targets reduce inappropriate centering on educating pharmacists patients.Expert Opinion ASP activities accelerating among community alongside targets, greater monitoring pharmacists' dispensing. Such activities, patients healthcare professionals, should enhance appropriate AMR.KEYWORDS: Africaantibioticsantimicrobial resistanceantimicrobial programmesAWaRe classificationcommunity pharmaciesover-the-counter purchasingquality indicatorsutilization patterns Article highlights There still prescription across Africa, prescriptionHowever, vary considerably both within countries. It important address typically self-limiting conditions AMR, which major issue sub-Saharan Africa (currently continent prevalence rate globally) an part National Action Plan AMRHigh are exacerbated by issues affordability (cost medicines costs as well facilities) population possible loss earnings long waiting times see professional facilities. Community more convenientEducating can antibiotics. instigation indicators also helps dispensingWith publication AWaRe book, it increasingly likely that future will based its content. Alongside this, there increasing use information technology mobile telephones monitor against agreed indicatorsThe curricula universities professionals upgraded make sure they fully competent appropriately counsel optimal management infectious disease/those children post qualification, backed up continuous development activitiesDeclaration interestA Cook C Moore funded Welcome Trust (222051/Z/20/Z) ADILA project. E Yeika, SA. Opanga, ZU Mustafa, V Marković-Peković, Kurdi, BD Anand Paramadhas, Wesangula, Hango, N Schellack, S Mudenda, I Hoxha JC Meyer either worked national or regional government agenices advisers them surrounding NAPs. In addition, Opanga received grant from Kenya AIDS Vaccine Institute -Institute Clinical Research Institut Merieux tackling GM Rwegerera works Destiny Medical Solutions Proprietary Limited, Gaborone, Botswana. authors other relevant affiliations financial involvement any organization entity interest conflict subject matter materials discussed manuscript apart those disclosed.Reviewer disclosuresPeer reviewers this relationships disclose.Supplementary materialSupplemental data article accessed online at https://doi.org/10.1080/14787210.2023.2259106Additional informationFundingThis paper not funded.

Язык: Английский

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Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

Antibiotics, Год журнала: 2022, Номер 11(12), С. 1824 - 1824

Опубликована: Дек. 15, 2022

There are serious concerns with rising antimicrobial resistance (AMR) across countries increasing morbidity, mortality and costs. These have resulted in a plethora of initiatives globally nationally including national action plans (NAPs) to reduce AMR. Africa is no exception, especially the highest rates AMR globally. Key activities NAPs include gaining greater understanding current utilization patterns through point prevalence surveys (PPS) subsequently instigating stewardship programs (ASPs). Consequently, there need comprehensively document among hospitals coupled ASP studies. In total, 33 PPS studies ranging from single up 18 were documented narrative review typically over 50% in-patients prescribed antimicrobials, 97.6% Nigeria. The penicillins, ceftriaxone metronidazole, most antibiotics. Appreciable extended prescribing antibiotics 6 days or more post-operatively was seen prevent surgical site infections. At least 19 ASPs been instigated recent years improve future utilizing range indicators. various findings suggested that key stakeholders, governments healthcare professionals, should undertake short, medium long term Africa.

Язык: Английский

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COVID-19 Vaccine Uptake and Associated Factors in Sub-Saharan Africa: Evidence from a Community-Based Survey in Tanzania

Vaccines, Год журнала: 2023, Номер 11(2), С. 465 - 465

Опубликована: Фев. 17, 2023

COVID-19 is a major public health threat associated with the increased global burden of infectious diseases, mortality, and enormous economic loss to countries communities. Safe efficacious vaccines are crucial in halting pandemic. We assessed vaccine uptake factors among community members from eight regions Tanzania. The interviewer-administered questionnaire collected data. Multiple logistic regression models determined uptake. median age 3470 respondents was 37 years (interquartile range 29-50 years) 66% them were females. Only 18% had received vaccine, ranging 8% Dar es Salaam 37% Simiyu regions. A third (34%) those vaccinated people did not know which they given. Significantly higher rates aged 30+ years, males, history infection. Unfavorable perceptions about safety efficacy lowered Setting-specific interventions innovations critical improving uptake, given observed differences between Efforts needed increase women younger less than 30 years. Knowledge-based should enhance understanding available vaccines, benefits, target groups, availability.

Язык: Английский

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Determinants of the Empiric Use of Antibiotics by General Practitioners in South Africa: Observational, Analytic, Cross-Sectional Study

Antibiotics, Год журнала: 2022, Номер 11(10), С. 1423 - 1423

Опубликована: Окт. 17, 2022

The overuse of antibiotics is the main driver antimicrobial resistance (AMR). However, there has been limited surveillance data on AMR and antibiotic prescribing at a primary healthcare level in South Africa. An observational, analytic, cross-sectional study was undertaken to assess key factors associated with empiric among private sector general practitioners (GPs) eThekwini district Africa, particularly for patients acute respiratory infections (ARIs). A semi-structured web-based questionnaire used between November 2020−March 2021. One hundred sixteen (55.5%) responding GPs prescribed empirically ARIs more than 70% time, primarily symptom relief prevention complications. ages 35−44 years (OR: 3.38; 95%CI: 1.15−9.88), >55 4.75; 95% CI 1.08−21) practice < 15 2.20; 1.08−4.51) were significantly likely prescribe empirically. Three factors—workload/time pressures; diagnostic uncertainty, use formulary, prescribing. experience working alone slightly less These findings indicate that combination environmental are important underlying contributors development AMR. As result, guide appropriate interventions using health system approach, which includes pertinent indicators targets.

Язык: Английский

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Evaluation of Healthcare Students’ Knowledge on Antibiotic Use, Antimicrobial Resistance and Antimicrobial Stewardship Programs and Associated Factors in a Tertiary University in Ghana: Findings and Implications

Antibiotics, Год журнала: 2022, Номер 11(12), С. 1679 - 1679

Опубликована: Ноя. 22, 2022

Antimicrobial resistance (AMR) is a major public health problem globally, and Ghana no exception. Good knowledge regarding antibiotic use, AMR, the concept of antimicrobial stewardship (AMS) critical among healthcare students to curb rising AMR rates in future. Consequently, need ascertain this. A cross-sectional survey was undertaken fifth-year pharmacy, medical fourth (final)-year nursing physician assistantship at University Health Allied Sciences assess their on AMS using web-based self-administered structured questionnaire. Descriptive statistics, Fishers’ exact test, multiple logistic regression analyses were performed. total 160 interviewed, which 56.3% (n = 90) male 58.8% 94) year study. associated with study course (p 0.001) number years < 0.001). Overall, there differences level antibiotics different Efforts must now be made enhance curricula ensure an improved uniform transfer antibiotics, sustain fight against given growing concerns.

Язык: Английский

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COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Lusaka, Zambia; Findings and Implications for the Future

Vaccines, Год журнала: 2023, Номер 11(8), С. 1350 - 1350

Опубликована: Авг. 9, 2023

The uptake of COVID-19 vaccines is critical to address the severe consequences disease. Previous studies have suggested that many healthcare workers (HCWs) are hesitant receive vaccine, further enhancing hesitancy rates within countries. vaccine acceptance and levels currently unknown among HCWs in Zambia, which a concern given burden infectious diseases country. Consequently, this study assessed Lusaka, Zambia. A cross-sectional was conducted 240 between August September 2022, using semi-structured questionnaire. Multivariable analysis used determine key factors associated with HCWs. Of who participated, 54.2% were females. total 72.1% would accept being vaccinated, while 27.9% hesitant. Moreover, 93.3% had positive attitudes towards vaccines, medical doctors having highest mean attitude score (82%). Encouragingly, reduced odds (AOR = 0.02, 95% CI: 0.01-0.11,

Язык: Английский

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Knowledge of Community Pharmacists in Saudi Arabia Regarding Human Monkeypox, Its Management, Prevention, and Vaccination: Findings and Implications

Vaccines, Год журнала: 2023, Номер 11(4), С. 878 - 878

Опубликована: Апрель 21, 2023

Many cases of monkeypox have recently been reported in countries where this disease is not endemic, raising a global health concern. Consequently, healthcare professionals (HCPs), including pharmacists, need to be aware the disease, its prevention, role vaccines, and management reduce transmission. A cross-sectional, questionnaire-based study was conducted among conveniently sampled community pharmacists Qassim region Saudi Arabia. total 189 participated study, giving response rate 72.97%. From these, 86.77% were male, 51.32% ≤30 years old, 36.51% aged between 31-40 years, 43.39% had 1-5 experience as pharmacists. Their overall knowledge 17.72 ± 5.56 out maximum 28. The correct answers for statements 63.29%, with 52.4% answering ≥50-<75% questions correctly 31.2% ≥75% correctly. subdomain related diagnosis clinical characteristics recorded highest score, relating causative pathogens epidemiology recording lower score. Overall, moderate management, which concern future. tailored, flexible, timely educational interventions are needed ensure that HCPs, fully equipped latest evidence-based regarding viral transmission improve care.

Язык: Английский

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Knowledge, Attitude and Practices of Self-Medication Including Antibiotics among Health Care Professionals during the COVID-19 Pandemic in Pakistan: Findings and Implications

Antibiotics, Год журнала: 2023, Номер 12(3), С. 481 - 481

Опубликована: Фев. 28, 2023

Since the emergence of COVID-19, several different medicines including antimicrobials have been administered to patients treat COVID-19. This is despite limited evidence effectiveness many these, fueled by misinformation. These utilization patterns resulted in concerns for patients’ safety and a rise antimicrobial resistance (AMR). Healthcare workers (HCWs) were required serve high-risk areas throughout pandemic. Consequently, they may be inclined towards self-medication. However, responsibility ensure any recommended or prescribed management with COVID-19 are evidence-based. this not always case. A descriptive cross-sectional study was conducted among HCWs six districts Punjab assess their knowledge, attitude practices self-medication during ongoing included working range public sector hospitals Province. total 1173 final analysis. The majority possessed good knowledge regarding attitudes. 60% practicing amid most frequent consumed under antipyretics (100%), antibiotics (80.4%) vitamins (59.9%). Azithromycin commonly purchase antibiotic (35.1%). In conclusion, possess of, regarding, purchased. there that high rates purchasing antibiotics, especially “Watch” enhance AMR. needs addressing.

Язык: Английский

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Talking about the Vaccine after the Pandemic: A Cross-Sectional Study among Youth in Turkey and Ethical Issues

Vaccines, Год журнала: 2023, Номер 11(1), С. 104 - 104

Опубликована: Янв. 1, 2023

Examining the factors that affect vaccination rate among young people in an ethical frame can support promotion. Therefore, this study will elaborate, through lens, on people's hesitation about and decisions regarding getting vaccinated. The cross-sectional was conducted with 2428 aged 15-30 Turkey June 2022. questionnaire included following subtitles: psycho-social situation, health services policies, COVID-19 vaccine, predictions life after pandemic. average age 22.9 years. In sample, 80% were vaccinated, while 20% not. Vaccinated participants acted more cautiously to protect their health. Receiving accurate sufficient information proposed vaccines affects status. primary reason for vaccinated "to health, families, relatives", not "not trusting vaccine content or country where produced". Specifically, those felt relaxed physically, psychologically, socially. addition, expectations future of significantly higher. Accurate adequate is essential reducing hesitancy. promoting prosocial behaviors highlighting related values vaccination.

Язык: Английский

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Antimicrobial Management of Skin and Soft Tissue Infections among Surgical Wards in South Africa: Findings and Implications

Antibiotics, Год журнала: 2023, Номер 12(2), С. 275 - 275

Опубликована: Янв. 31, 2023

Skin and soft tissue infections (SSTIs) are one of the most common infectious diseases requiring antibiotics. However, complications SSTIs may lead to overprescribing antibiotics subsequent antibiotic resistance. Consequently, monitoring prescribing alignment with current recommendations from South African Standard Treatment Guidelines (STG) is necessary in order improve future care. This study involved reviewing pertinent patients who were prescribed antimicrobials surgical ward a leading tertiary public hospital April June 2021 using an adapted data collection tool. Sixty-seven patient files reviewed. Among SSTIs, hypertension chronic osteomyelitis frequent co-morbidities at 22.4% 13.4%, respectively. The diagnosed site (35.1%), wound (23%), major abscesses (16.2%). Blood cultures performed on 40.3% patients, Staphylococcus aureus (32.7%) Enterococcus spp. (21.2%) being cultured pathogens. Cefazolin was empirically for 46.3% their SSTIs. In addition, treated gentamycin, ciprofloxacin, rifampicin 17.5%, 11.3%, 8.8%, respectively, treatment fully complying STG 55.2% cases. Overall, cause aureus, empiric recommended as initial management. Subsequently, culture sensitivities should be enhance adherence STGs

Язык: Английский

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