Abstract
Self-medication with antimicrobial agents is a common form of self-care among patients globally with the prevalence and nature differing from country to country. Here we assessed the prevalence and predictors of antimicrobial self-medication in post-conflict northern Uganda. A cross-sectional study was carried out using structured interviews on 892 adult (≥18 years) participants. Information on drug name, prescriber, source, cost, quantity of drug obtained, and drug use was collected. Households were randomly selected using multistage cluster sampling method. One respondent who reported having an illness within three months in each household was recruited. In each household, information was obtained from only one adult individual. Data was analyzed using STATA at 95% level of significance. The study found that a high proportion (75.7%) of the respondents practiced antimicrobial self-medication. Fever, headache, lack of appetite and body weakness were the disease symptoms most treated through self-medication (30.3%). The commonly self-medicated antimicrobials were coartem (27.3%), amoxicillin (21.7%), metronidazole (12.3%), and cotrimoxazole (11.6%). Drug use among respondents was mainly initiated by self-prescription (46.5%) and drug shop attendants (57.6%). On average, participants obtained 13.9±8.8 (95%CI: 12.6–13.8) tablets/capsules of antimicrobial drugs from drug shops and drugs were used for an average of 3.7±2.8 days (95%CI: 3.3–3.5). Over half (68.2%) of the respondents would recommend self-medication to another sick person. A high proportion (76%) of respondents reported that antimicrobial self-medication had associated risks such as wastage of money (42.1%), drug resistance (33.2%), and masking symptoms of underlying disease (15.5%). Predictors of self-medication with antimicrobial agents included gender, drug knowledge, drug leaflets, advice from friends, previous experience, long waiting time, and distance to the health facility. Despite knowledge of associated risks, use of self-medication with antimicrobial drugs in management of disease symptoms is a common practice in post-conflict northern Uganda.
Highlights
Self-medication is a common practice in most parts of the world and it refers to the use of medicines to treat self-diagnosed disorders without a prescription and medical supervision [1]
The evidence of the benefits and risks of drugs used in selfmedication by patients is mostly obtained from past experiences with similar drugs. Medicines such as antibiotics which provide rapid relief of disease symptoms are preferred by most patients and are likely to be used without consulting a medical professional [5]
In this study we found a high prevalence of self-medication with antimicrobial agents, this is similar to reports from previous studies [17,18]
Summary
Self-medication is a common practice in most parts of the world and it refers to the use of medicines to treat self-diagnosed disorders without a prescription and medical supervision [1]. The evidence of the benefits and risks of drugs used in selfmedication by patients is mostly obtained from past experiences with similar drugs Medicines such as antibiotics which provide rapid relief of disease symptoms are preferred by most patients and are likely to be used without consulting a medical professional [5]. In using non-prescription drugs, patients take responsibility of, recognizing the appropriate indication, appropriate dosage regiment or seeking medical advice in cases where adverse events may occur or when the illness does not improve [7] This is a challenge especially to patients in developing countries where there are high illiteracy levels. The current study sought to establish the prevalence and factors predicting self-medication with antimicrobial agents in Northern Uganda especially that most former internally displaced people are resettling in their homes
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