DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20220826

Prevalence and possible causes of antibiotic self-medication among rural dwellers and volunteer health workers in Nattalin Township, Bago region, Myanmar

Thein Hlaing, Tun W. Lat, Zaw M. Myint

Abstract


Background: In Myanmar, the emergence of antibiotic-resistant strains is increased, but its exact causes remain unrecognized. This cross-sectional study examined the prevalence and possible causes of antibiotic self-medication (ASM) among rural dwellers and volunteer health workers (VHWs).

Methods: 445 adult rural dwellers from 24 villages and all the 133 registered VHWs within Nattalin Township were examined for illnesses, types and sources of antibiotics, knowledge, perception and possible causes for ASM practices within the last six months. The significant causes of ASM were determined by 95% CI resulting from bivariate and multivariate analysis.

Results: The ASM proportions of rural dwellers and VHWs were 14.2% and 84.2%. The top three most frequent illnesses for ASM were sore throat-(28.6%), respiratory symptoms-(15.8%) and diarrhoea-(17.9%) among rural dwellers and the common cold-(30.4%), sore throat-(25.0%) and respiratory symptoms-(20.6%) among VHWs. In ASM of rural dwellers and VHWs, amoxicillin-(46.0% and 67.9%) was used for the most frequency followed by cefixime-(33.3% and 29.5%), ampicillin-(22.2% and 8.9%) and penicillin-V-(6.3% and 10.7%). For ASM practice, convenience-(54.0% and 65.2%), their prior experiences-(60.3% and 49.1%) and cost reduction advantages-(31.7% and 25.0%), and for the availability of antibiotics, community pharmacies-(88.9% and 78.6%) were mentioned among rural dwellers and VHWs respectively. Among rural dwellers and VHWs, ASM was significantly associated with knowledge-(AOR: 0.5, 95% CI-0.2, 0.9, AOR: 0.2, 95% CI-0.05, 0.8) and keeping antibiotics-(AOR: 64, 95% CI-14, 292, AOR: 45, 95% CI-5.1, 395).

Conclusions: Through multisectoral approaches, it is necessary to promote awareness of the consequences of irrational antibiotic use, enforce national drug laws, and regular inspections on community pharmacies, and provide easy access to public health infrastructures.

 


Keywords


Antibiotic self-medication, Prevalence, Possible causes, Rural dwellers, Volunteer health workers

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References


World Health Organization (WHO). Antibiotics Resistance. 2018. Available at: https://www. who.int/news-room/fact-sheets/detail/antibiotic-resistance. Accessed on 14 December 2019.

SCENIHR (Scientific Committee on Emerging and Newly Identified Health Risks). Assessment of the Antibiotic Resistance Effects of Biocides. 2009. Available at: https://ec.europa.eu/health/ph_risk/ committees/04_scenihr/docs/scenihr_o_021.pdf. Accessed on 21 December 2019.

Emeka PM, Al-Omar M, Khan TM. Public attitude and justification to purchase antibiotics in the Eastern region Al Ahsa of Saudi Arabia. Saud Pharm J. 2014;22:550-4.

Alhomoud F, Aljamea Z, Almahasnah R, Alkhalifah K, Basalelah L, Alhomoud FK. Self-medication and self-prescription with antibiotics in the Middle East—Do they really happen? A systematic review of the prevalence, possible reasons, and outcomes. Int J Infect Dis. 2017;57:3-12.

Kardas P, Pechere JC, Hughes DA, Cornaglia G. A global survey of antibiotic leftovers in the outpatient setting'. Int J Antimicrob Agents. 2007;30:530-6.

Grigoryan L, Haaijer-Ruskamp EM, Burgerhof JGM, Mechtler R, Deschepper R, Tambic-Andrasevic A. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006;12:452-9.

Togoobaatar G., Ikeda N, Ali M, Sonomjamts M, Dashdemberel S, Mori R, et al. Survey of non-prescribed use of antibiotics for children in an urban community in Mongolia. Bull. World Health Organiz. 2010;88:930-6.

Zoorob R, Grigoryan L, Nash S, Trautner BW. Nonprescription Antimicrobial Use in a Primary Care Population in the United States'. Antimicrob Agents Chemotherap. 2016;60:5527-32.

Isturiz RE, Carbon C. Antibiotics use in developing countries, Infect Control Hospital Epidemiol. 2000;21:394-7.

Nepal G, Bhatta S. Self-medication with antibiotics in WHO Southeast Asian Region: a systematic review'. Cureus J Med Sci. 2018;10(4):e2428.

Tshokey T, Adhikari D, Tshering T, Wangmo S, Wangdi K. Assessing the knowledge, attitudes, and practices on antibiotics among the general public attending the outpatient pharmacy units of hospitals in Bhutan: a cross-sectional survey. Asia Pacif J Public Health. 2017;29:580-8.

Biswas M, Roy MN, Manik MIN, Hossain MS, Tapu SMTA, Moniruzzaman M, et al. Self-medicated antibiotics in Bangladesh: a cross-sectional health survey conducted in the Rajshahi City. BMC Public Health. 2014;14:847.

Ganesan N, Subramanian S, Jaikumar, Rawat H, Kumar S. Self-medication and indiscriminate use of antibiotics without prescription in Chennai, India: a major public health problem. J Club Pharm Sci. 2014;1:131-41.

Kurniawan K, Posangi J, Rampengan N. Association between public knowledge regarding antibiotics and self-medication with antibiotics in Teling Atas Community Health Center, East Indonesia. Med J Indonesia. 2017;26:62-9.

Kim SS, Moon S, Kim EJ. Public knowledge and attitudes regarding antibiotic use in South Korea. J Korean Acad Nurs. 2011;41:742-9.

Sirijoti K, Hongsranagon P, Havanond P, Pannoi W. Assessment of knowledge attitudes and practices regarding antibiotic use in Trang province, Thailand. J Health Res. 2014;28:299-307.

Thamlikitkul V, Rattanaumpawan P, Boonyasiri A, Pumsuwan V, Judaeng T, Tiengrim S, et al. Thailand antimicrobial resistance containment and prevention program. J Global Antimicrob Resistance. 2015;3:290-4.

World Health Organization (WHO) Global Report on Surveillance: Antimicrobial Resistance. 2014. Available at: www.who.int/iris/bitstream/10665/ 112642/ 1/9789241564748_eng.pdf. Accessed on 12 December 2019.

National Health Laboratory (NHL). Instruction for laboratory aspects of infection prevention and control (IPC). Yangon, Myanmar: Ministry of Health and Sports. 2016.

National Professional Officer. National Professional Officer (Antimicrobial Resistance)-(1904762). Yangon, Myanmar: SE-MMR MR Office. 2019.

Daniel WW. Biostatistics: A foundation for analysis in the health sciences. 7th Edition. New York: John Wiley & Sons. 1999.

Sein TT, Myint P, Tun N, Win H. 'The Republic of the Union of Myanmar Health System Review'. Health System in Transition. 2014;4(3):1-206.

Lwin MM, Sudhinaraset M, San AK, Aung T. Improving malaria knowledge and practices in rural Myanmar through a village health worker intervention: a cross-sectional study. Malaria J. 2014;13(5).

Lin KS, Hlaing T, Maung ET, Lat TW. Prevalence and reasons for practicing self-medication among basic health staff: case of Monywa District, Myanmar: a cross-sectional study. Int J Community Med Public Health. 2022;9.

Hedenrud T, Sundell KA, Martinsson J, Hakonsen H. Attitudes towards sales and use of over-the-counter drugs in Sweden in a reregulated pharmacy market: a population-based study. Int J Pharm Pract. 2019;27(1):17-24.

Myint A. Self-medication among Myanmar villagers. Mahidol University. 1999.

Thuzar M, Aung PL. Prevalence of self-medication and its influence in the labor force in rural Hlaing Tharyar, Yangon, Myanmar. Open Public Health J. 2019;12(1).

Aslam A, Zin CS, Ab Rahman NS, Gajdács M, Ahmed SI, Jamshed S. Self-Medication Practices with Antibiotics and Associated Factors among the Public of Malaysia: A Cross-Sectional Study. Drug Healthc Patient Saf. 2021;13:171-81.

Guinovart MC, Figueras A, Llop JC, Llor C. Obtaining antibiotics without prescription in Spain in 2014: even easier now than 6 years ago. J Antimicrob Chemother. 2015;70(4):1270-1.

Ahmad A, Patel I, Mohanta G, Balkrishnan R. Evaluation of self-medication practices in a rural area of town sahaswan at northern India. Ann Med Health Sci Res. 2014;4(2):73-8.

Bilal M, Haseeb A, Khan MH, Arshad MH, Ladak AA, Niazi SK, et al. Self-Medication with Antibiotics among People Dwelling in Rural Areas of Sindh. J Clin Diagn Res. 2016;10(5):OC08-13.

Yousif M, Abubaker I. Prevalence, determinants and practices of self-medication with antibiotics–a population-based survey in Taif, Kingdom of Saudi Arabia KSA. Age. 2015;172:57.

Abdulraheem I, Adegboye A, Fatiregun A. Self-medication with antibiotics: Empirical evidence from a Nigerian rural population. Br J Pharm Res. 2016;11:1-13.

Widayati A, Suryawati S, de Crespigny C, Hiller JE. Self-medication with antibiotics in Yogyakarta City Indonesia: a cross sectional population-based survey. BMC Res Notes. 2011;4:491.

Gajdács M, Paulik E, Szabó AJAPH. Public knowledge, attitude and practices towards antibiotics and antibiotic resistance: a cross-sectional study in Szeged District, Hungary. Antibiotics (Basel). 2020;90(1):5-14.

Sihavong A, Lundborg CS, Syhakhang L, Akkhavong K, Tomson G, Wahlstrom R. Antimicrobial self-medication for reproductive tract infections in two provinces in Lao People's Democratic Republic. Sexually Transmitted Infect. 2006;82(2).

Skliros E, Merkouris P, Papazafiropoulou A, Gikas A, Matzouranis G, Papafragos C, et al. Self-medication with antibiotics in rural population in Greece: a cross-sectional multicenter study. BMC Fam Pract. 2010;11(58).

Nazir S, Azim M. Assessment of antibiotic self-medication practice among public in the northwestern region of Pakistan. Eur J Hosp Pharm. 2017;24(4):200-3.

Awad AI, Aboud EA. Knowledge, attitude and practice towards antibiotic use among the public in Kuwait. PLoS One. 2015;10(2):e0117910.

Centers for Disease Prevention and Control. Antibiotics Prescribing and Use. 2022. Available at: https://www.cdc.gov/antibiotic-use/colds.html. Accessed on 26 January 2022.