Effect of an educational intervention on knowledge and attitude of antimicrobial resistance among school children in Nay Pyi Taw union territory: a quasi-experimental study

Phyu Cin Ne Myo; Aye Sandar Mon; Swe Mar Myint Lwin; Ab

doi:10.18203/2394-6040.ijcmph20261011

Authors

Phyu Cin Ne Myo Union Minister's Office, Ministry of Health, Nay Pyi Taw, Myanmar
Aye Sandar Mon University of Public Health, Ministry of Health, Yangon, Myanmar
Swe Mar Myint Lwin University of Public Health, Ministry of Health, Yangon, Myanmar
Ab University of Public Health, Ministry of Health, Yangon, Myanmar

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20261011

Keywords:

Antimicrobial resistance, Antibiotics, Attitude, e-Bug, Knowledge

Abstract

Background: Antimicrobial resistance (AMR) is a global threat to health and human development by interrupting the efforts and investments of countries to effectively combat the infectious diseases. The overuse and misuse of antimicrobial agents has been recognized as the main cause of AMR. Children of today are antibiotic consumers and prescribers of tomorrow. Building foundational knowledge early shapes their future decisions regarding antibiotic use. Therefore, educational intervention programs targeting them can be effective and have a long-term impact.

Methods: A quasi-experimental study was conducted among grade-10 students attending public schools during the academic year 2025-26 in Nay Pyi Taw Union Territory, Myanmar. This study consisted of a baseline assessment, the educational intervention using Power point slides, discussion, game and group activities and post-intervention assessment among students in the intervention group compared to a control group using the validated knowledge and attitude questionnaires adapted from the questionnaires of lesson plans, worksheets and activities of e-Bug.

Results: A total of 300 students participated in the study. There was statistically significant change in students’ knowledge and attitude. The mean knowledge and attitude scores were increased in the intervention group compared to the control group. The mean difference in knowledge scores was 2.7 (95% CI=2.3 to 3.2) and the mean difference in attitude scores was 1.2 (95% CI=0.7 to 1.7).

Conclusions: Educational intervention on knowledge and attitude of antimicrobial resistance among school children is an effective strategy to enhance our younger generation's responsible antibiotic use.

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References

WHO. Consumption and Rational Use of Antimicrobials in South-East Asia Region. 2024. Available at:https://iris.who.int/bitstream/handle. Accessed on 21 August 2025.

Hayes C, Eley C, Brown C, Syeda R, Verlander NQ, Hann M. Improving educator’s knowledge and confidence to teach infection prevention and antimicrobial resistance. Health Edu J. 2021;80(2):131-44. DOI: https://doi.org/10.1177/0017896920949597

NICE. Antimicrobial Stewardship: Changing Risk-Related Behaviours in the General Population. 2017. Available at: https://www.nice.org.uk/guidance. Accessed on 21 October 2025

IHME. Global Bacterial Antimicrobial Resistance Burden Estimates. 2019. Available at: https://ghdx.healthdata.org/record/ihme-data/global-bacterial-antimicrobial-resistance-burden-estimates. Accessed on 21 October 2025.

WHO. Antimicrobial resistance fact sheets. Avaiable at: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance. Accessed on 24 September 2024.

Tang KW, Millar BC, Moore JE. Antimicrobial resistance (AMR). British J Biomed Sci. 2023;80:11387. DOI: https://doi.org/10.3389/bjbs.2023.11387

Lecky DM, McNulty CAM. Current initiatives to improve prudent antibiotic use amongst school-aged children. J Antimicrob Chemother. 2013;68(11):2428-30. DOI: https://doi.org/10.1093/jac/dkt361

UNICEF. The urgent threat of drug-resistant infections protecting children worldwide A UNICEF Guidance Note on Antimicrobial Resistance. Available at: https://www.unicef.org/media. Accessed on 21 August 2025.

Lecky DM, McNulty CAM, Touboul P. Evaluation of e-Bug, an educational pack, teaching about prudent antibiotic use and hygiene, in the Czech Republic, France and England. J Antimicrob Chemother. 2010;65(12):2674-84. DOI: https://doi.org/10.1093/jac/dkq356

Eley CV, Young VL, Hayes CV. A mixed methods pilot of Beat the Bugs: A community education course on hygiene, self-care and antibiotics. J Infect Prev. 2018;19(6):278-86. DOI: https://doi.org/10.1177/1757177418780990

Balachandran P, Venkitachalam R, James A. Effectiveness of an educational intervention in promoting antibiotic awareness among 8th to 10th grade students in Kerala, India. Cumhur Dent J. 2023;26:173-9. DOI: https://doi.org/10.7126/cumudj.1233563

Vicki L. Young, Amy Cole1, Donna M. Lecky. A mixed-method evaluation of peer-education workshops for school-aged children to teach about antibiotics, microbes and hygiene. Avaiable at: https://pmc.ncbi.nlm.nih.go. Accessed on 21 August 2025.