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Published on: July 19, 2024
Knowledge, attitude, and practices regarding antibiotic use and antimicrobial resistance among urban slum dwellers in
Regina Ndagire1,2, Ekwaro A Obuku3,4,5, Ivan Segawa6
1Africa Center for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala, Uganda. ndaginar@gmail.com.
Background:
Antimicrobial resistance (AMR) remains a public health threat especially in low-and-middle-income countries (LMICs). Urban slum dwellers are at higher risk of developing AMR than the general population. The aim of this study was to assess the knowledge, attitude and practices (KAP) regarding antibiotic use and AMR and the associated socio-demographic determinants among urban slum dwellers in Uganda.
Methods:
A cross sectional study was conducted among 371 adults of Bwaise slum in Uganda selected through multi-stage cluster sampling techniques. An interviewer administered questionnaire was used to collect data on participants' socio-demographics, KAP regarding antibiotic use and AMR. The responses to the KAP were aggregated into scores for each participant which were later dichotomized by the mean to form the predictors variables. Analysis was done in STATA 17.0. A modified Poisson regression model was used to determine predictors of each of KAP, while considering a 5% significance level.
Results:
The study enrolled 371 participants of which 238(64.2%) were females. The median (IQR) age of the participants was 31 [24, 40] years. Over half of the respondents, 205(55.3%) were married and 157(42.3%) had primary level education. Of all participants, 177 (47.7%), 184 (49.6%) and 205 (55.3%) had good knowledge, a positive attitude and good practices regarding antibiotic use and AMR respectively. Being single (aPR = 0.75, p-value = 0.040) was negatively associated with good knowledge of antibiotic use and resistance, while having acquired tertiary education level (aPR = 1.88, p-value < 0.001) and self-employed (aPR = 1.36, p = 0.017) were associated with good knowledge of antibiotic use and resistance. Male gender (aPR = 1.25, p-value = 0.036) and monthly income < 300,000 UGX (aPR = 1.42, p-value = 0.003) were associated with a positive attitude towards antibiotic use and resistance. Likewise tertiary level of education (aPR = 0.64, p-value = 0.033) was negatively associated with good practices of antibiotic use and resistance.
Conclusion And Recommendations:
Residents of urban slums have limited knowledge of antibiotic use and AMR with minimal understanding of AMR concepts. Education level, gender, occupational status are key players in people's understanding and practices of antibiotic use and AMR. There's need for context specific health education programs. Health promotion messaging should emphasize AMR concepts and dangers of drug misuse. Antimicrobial stewardship initiatives should trickle down to the local citizen.
Insights
Urban slum dwellers in Uganda exhibit limited knowledge and understanding of antimicrobial resistance (AMR). Education level, gender, and occupation significantly influence antibiotic use knowledge and practices, highlighting the need for targeted health education.
Area of Science:
- Public Health
- Infectious Diseases
- Health Education
Background:
- Antimicrobial resistance (AMR) poses a significant global health threat, particularly in low- and middle-income countries (LMICs).
- Urban slum populations face elevated risks of AMR due to various socio-environmental factors.
- This study investigated the knowledge, attitudes, and practices (KAP) concerning antibiotic use and AMR among urban slum dwellers in Uganda.
Purpose of the Study:
- To assess the current levels of knowledge, attitude, and practices (KAP) regarding antibiotic use and AMR in an urban slum setting in Uganda.
- To identify socio-demographic factors associated with KAP related to antibiotic use and AMR among this vulnerable population.
Main Methods:
- A cross-sectional study was conducted involving 371 adults in Bwaise slum, Uganda, using multi-stage cluster sampling.
- Data were collected via interviewer-administered questionnaires assessing socio-demographics and KAP regarding antibiotic use and AMR.
- Modified Poisson regression analysis was employed to identify predictors of KAP, with a 5% significance level.
Main Results:
- Nearly half of the participants demonstrated good knowledge (47.7%), positive attitudes (49.6%), and good practices (55.3%) regarding antibiotic use and AMR.
- Being single was associated with lower knowledge, while tertiary education and self-employment correlated with better knowledge.
- Male gender and lower monthly income were linked to more positive attitudes, whereas higher education showed a negative association with good practices.
Conclusions:
- Urban slum residents in Uganda possess limited understanding of antibiotic use and AMR concepts.
- Educational attainment, gender, and occupation are crucial determinants of knowledge and practices related to antibiotic use and AMR.
- Context-specific health education programs emphasizing AMR and safe antibiotic use are essential, alongside community-level antimicrobial stewardship initiatives.
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