Determinants of Antimicrobial Use for Covid-19 Related Symptoms among Nigerians

Antimicrobial use plays a key role in development and spread of antimicrobial resistance. Following the global coronavirus disease 2019 (COVID-19) pandemic and the report of the first confirmed case in Nigeria, several states embarked on either a full or partial lockdown as a measure to prevent or curtail the spread of the virus with its attendant challenges. This survey was designed to provide a snapshot of public antimicrobial use and common perception related to antimicrobial use for COVID-19 related symptoms among Nigerian populace.

We developed and tested a 29-question electronic questionnaire with Google forms asking respondents about their antimicrobial use and perceptions regarding appropriate antimicrobial use for real or perceived symptoms during the outbreak period. Respondents aged 18 years and above were recruited through crowd sourcing and they received the link to the survey tool through emails and social media including WhatsApp, Twitter, Facebook, LinkedIn, and Instagram. All data analysis was performed using SPSS version 26.0.

A total of 410 responses were received from the six geopolitical zones in Nigeria comprising 200 (48.8%) females and 210 (51.2%) males. Majority (62.9%) of the respondents had taken antimicrobials in the 3 months period preceding the survey, while less than half (46.8%) received prescription for it. Previous intake of antimicrobial for similar illness was a predictor of antimicrobial intake (OR: 0.55, 95%CI: 0.30-1.01). The most consumed antimicrobial was antimalarial drugs, specifically Artemisinin-based combination therapy (43.4%), followed by antibiotics [Ciprofloxacin (20.2%)].

There was high levels of antimicrobial use for COVID-19 related symptoms by the Nigerian public. This is likely to escalate the already high prevalence of antimicrobial use previously reported and may further fuel the emergence of antimicrobial resistance.