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Knowledge, attitudes and practices related to self-medication with antimicrobials in Lilongwe, Malawi
Cecilia S Sambakunsi1,2, Lars Småbrekke3, Christine A Varga2
1Pharmacy Medicines and Poisons Board, Lilongwe 3, Malawi.
Background:
The use of antimicrobials is associated with the emergence of antimicrobial resistance (AMR), and self-medication increases the risk of the inappropriate use of antimicrobials. This study aims to describe the knowledge, attitudes, and practices (KAP) regarding self-medication with antimicrobials among residents in Lilongwe, Malawi.
Methodology:
This study has a cross-sectional, mixed-methods design. We conducted two focus group discussions (n=15) to describe community attitudes towards self-medication with antimicrobials and used a structured questionnaire to collect data on individual KAP regarding self-medication from 105 respondents.
Results:
Self-medication was common, and the sources of these medicines were market vendors, pharmacies, drugs shared with friends and family and those leftover from previous treatments. The lack of medical supplies, long distances to health facilities, poor attitudes of medical professionals towards patients, and past experience with the disease and treatment are the main factors that influence self-medication. KAP respondents had little knowledge of antimicrobials, their use, or any awareness of AMR. Seventy-four per cent (n=78) were unable to differentiate antimicrobials from other categories of medicines, and 92.4% wrongly responded that antimicrobials could be used to stop a fever. Concerning attitudes towards self-medication, over 54% wrongly believe that antimicrobials are effective in treating common colds. In regard to practice, 53% reported that they would use antimicrobials to treat upper respiratory infections, and 41% agreed that they must complete antibiotic therapy even if they are improving. Logistic regression analysis found that stocking antimicrobials at home for future use significantly promotes self-medication whereas an awareness of AMR would reduce self-medication.
Conclusion:
Self-medication is a public health risk that needs to be addressed urgently. Findings from this study point to the need for multifaceted interventions.
Insights
Self-medication with antimicrobials is prevalent in Malawi due to poor knowledge and accessibility issues. Increased awareness of antimicrobial resistance (AMR) could help reduce this public health risk.
Area of Science:
- Public Health
- Infectious Diseases
- Pharmacology
Background:
- Antimicrobial use is linked to antimicrobial resistance (AMR).
- Self-medication with antimicrobials poses a significant risk for inappropriate use and the development of AMR.
- Understanding knowledge, attitudes, and practices (KAP) is crucial for addressing this issue.
Purpose of the Study:
- To describe the knowledge, attitudes, and practices (KAP) regarding self-medication with antimicrobials among residents in Lilongwe, Malawi.
- To identify factors influencing self-medication with antimicrobials.
Main Methods:
- Cross-sectional, mixed-methods study design.
- Two focus group discussions (n=15) to explore community attitudes.
- Structured questionnaire administered to 105 respondents for KAP data collection.
Main Results:
- Self-medication with antimicrobials is common, sourced from vendors, pharmacies, and leftover medications.
- Key drivers include lack of medical supplies, distance to facilities, and poor healthcare provider attitudes.
- Respondents demonstrated poor knowledge of antimicrobials, mistaking them for fever reducers and believing they treat common colds. Stocking antimicrobials at home correlated with increased self-medication, while AMR awareness correlated with reduced self-medication.
Conclusions:
- Self-medication with antimicrobials represents a critical public health risk in Malawi.
- Multifaceted interventions are urgently needed to address the identified knowledge gaps and practice behaviors.
- Raising awareness about antimicrobial resistance (AMR) is a key strategy to mitigate self-medication practices.
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