Eugene Vernyuy Yeika1, Brecht Ingelbeen2, Ben-Lawrence Kemah3,4, Frankline Sevidzem Wirsiy5, Joseph Nkeangu Fomengia6,7, Marianne A B van der Sande2,8. 1. Ministry of Public Health, Yaoundé, Cameroon. 2. Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. 3. University Hospitals North Midlands, United Kingdom. 4. Health Education & Research Organization, Cameroon. 5. Médecins Sans Frontières, Kinshasa, Democratic Republic of Congo. 6. École de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium. 7. Sintieh Research Academy, Yaoundé, Cameroon. 8. Global Health, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands.
Abstract
OBJECTIVE: To evaluate and compare the prevalence, reasons, sources, and factors associated with self-medication with antibiotics (SMA) within Africa. METHODS: Systematic review and meta-analysis. An electronic search of PubMed and Google Scholar databases was performed for observational studies conducted between January 2005 and February 2020. Two reviewers independently screened abstracts and full texts using the PRISMA flowchart and performed quality assessment of eligible studies. Both quantitative and qualitative syntheses were carried out. RESULTS: 40 studies from 19 countries were eligible for qualitative synthesis. The prevalence of SMA in Africa ranged from 12.1% to 93.9% with a median prevalence of 55.7% (IQR 41%-75%). Western Africa was the sub-region with the highest reported prevalence of 70.1% (IQR 48.3%-82.1%), followed by Northern Africa with 48.1% (IQR 41.1-64.3%). We identified 27 antibiotics used for self-medication from 13 different antibiotic classes. Most frequently used antibiotics were penicillins (31 studies), tetracyclines (25 studies) and fluoroquinolones (23 studies). 41% of these antibiotics belong to the WHO Watch Group. The most frequent indications for SMA were upper respiratory tract infections (27 studies), gastro-intestinal tract symptoms (25 studies) and febrile illnesses (18 studies). Common sources of antibiotics used for self-medication were community pharmacies (31 studies), family/friends (20 studies), leftover antibiotics (19 studies), and patent medicine stores (18 studies). The most frequently reported factor associated with SMA was no education/ low educational status (9 studies). CONCLUSIONS: The prevalence of SMA is high in Africa and varies across sub-regions with the highest prevalence reported in Western Africa. Drivers of SMA are complex: comprising of socio-economic factors and insufficient access to healthcare coupled with poorly implemented policies regulating antibiotic sales. This article is protected by copyright. All rights reserved.
OBJECTIVE: To evaluate and compare the prevalence, reasons, sources, and factors associated with self-medication with antibiotics (SMA) within Africa. METHODS: Systematic review and meta-analysis. An electronic search of PubMed and Google Scholar databases was performed for observational studies conducted between January 2005 and February 2020. Two reviewers independently screened abstracts and full texts using the PRISMA flowchart and performed quality assessment of eligible studies. Both quantitative and qualitative syntheses were carried out. RESULTS: 40 studies from 19 countries were eligible for qualitative synthesis. The prevalence of SMA in Africa ranged from 12.1% to 93.9% with a median prevalence of 55.7% (IQR 41%-75%). Western Africa was the sub-region with the highest reported prevalence of 70.1% (IQR 48.3%-82.1%), followed by Northern Africa with 48.1% (IQR 41.1-64.3%). We identified 27 antibiotics used for self-medication from 13 different antibiotic classes. Most frequently used antibiotics were penicillins (31 studies), tetracyclines (25 studies) and fluoroquinolones (23 studies). 41% of these antibiotics belong to the WHO Watch Group. The most frequent indications for SMA were upper respiratory tract infections (27 studies), gastro-intestinal tract symptoms (25 studies) and febrile illnesses (18 studies). Common sources of antibiotics used for self-medication were community pharmacies (31 studies), family/friends (20 studies), leftover antibiotics (19 studies), and patent medicine stores (18 studies). The most frequently reported factor associated with SMA was no education/ low educational status (9 studies). CONCLUSIONS: The prevalence of SMA is high in Africa and varies across sub-regions with the highest prevalence reported in Western Africa. Drivers of SMA are complex: comprising of socio-economic factors and insufficient access to healthcare coupled with poorly implemented policies regulating antibiotic sales. This article is protected by copyright. All rights reserved.
Entities:
Keywords:
Africa; Associated Factors; Practices; Prevalence; Self-Medication with Antibiotics
Authors: Daniel Valia; Brecht Ingelbeen; Bérenger Kaboré; Ibrahima Karama; Marjan Peeters; Palpouguini Lompo; Erika Vlieghe; Annelies Post; Janneke Cox; Quirijn de Mast; Annie Robert; Marianne A B van der Sande; Hector Rodriguez Villalobos; Andre van der Ven; Halidou Tinto; Jan Jacobs Journal: Antimicrob Resist Infect Control Date: 2022-04-13 Impact factor: 4.887
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