Factors affecting prevalence of self medication of antibiotics among adult population in Ishaka-Bushenyi municipality

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Kampala International University. School of Health Sciences
Introduction: The research deals with the factors affecting the prevalence of self-medication of antibiotics among adult population in Ishaka-Bushenyi Municipality. It was guided by the following objectives: to determine the prevalence of self-medication of antibiotics and other miscellaneous issues among the adult population in Ishaka-Bushenyi Municipality, to establish the socio-demographic characteristics of adult population engaged in self - medication of antibiotics in Ishaka-Bushenyi Municipality, and to establish the factors affecting self-medication of antibiotics among adult population in Ishaka-Bushenyi Municipality. Methodology: This was a cross-sectional study conducted in Ishaka-Bushenyi Municipality from April2018 to December, 2018. A pretested self-administered questionnaire was used to select 3 84 participants residing in the area, who reported to have felt sick in the last period of one year using simple random sampling method. The data obtained were entered into Microsoft Office Excel2010 and imported into STATA 13 for analysis. Both univariate and multivariate logistic regression analysis were carried out together with descriptive summary statistics using STAT A 13. Results: The prevalence of self-medication of antibiotics was high at f78.13%j. Friends (30.60%) and previous prescription (28.83%) were the source of information for the self-medication that was mostly reported. The most common indications that made respondents to use antibiotics were cough, cold and sore throat (31.67%) followed by headache, fever and malaria (23.13%). Metronidazole (19.57%), Amoxicillin (12.81 %), Doxycline (12.10%), Ciprofloxacin (11.03%) and Sepuin (11.03%) were the most self-medicated antibiotics. Quick relief (27.76%) and no need to visit a doctor for minor illness (26.33%) were the main reasons in favor of this practice. In the univariate analysis with respect to the relationship between self-medication and sociodemographics, only age (P=<0.0001), place of residence (P=0.0103), marital status (P=0.0016), educational level (P=0.0001) and occupation of participants (P=<0.0001) were statistically related to self-medication, and the likelihood of self-medication was statistically higher among those with tertiary education [COR=26.62, P=0.002, 95%CI (3.406- 240.5)], secondary education [COR=20.30, P=0.006, 95%CI (2.398- 171 .9)] and primary education [COR=11.81, P=0.024, 95%CI (1.389- 100.4)] respectively than reference group without formal education [COR=1] as well as among the students [COR=6.937, P= <0.0001, 95%CI (3.150 to 15.28)] and those with modem occupation [COR=2.417, P= 0.001, 95%CI(l.435 to 4.071)], than the reference group on traditional occupation [COR=1]. Similarly, in the multivariate analysis, all the variables including age, sex, residence, marital status, educational level, occupation, religion, and monthly income were statistically related to self-medication (P=<0.0001) respectively. The likelihood of self-medication was however, statistically higher among the age group age 25-29 years [AOR=2.316, P=0.042, 95%CI (1.031 to 5.202)] than the reference age 18-24 years [AOR=1], those with secondary education [AOR=9.20, P=0.041,95%CI (1.098 to 87.81)] than the reference group who had no formal education [AOR=1], and the students and apprentice [AOR=5.026, P=<0001, 95% CI (2.124 to 11.89)] than the reference group in the traditional occupation [AOR=1] respectively. In the context of factors affecting self-medication in the univariate level, long distance to the health facility (P=<0.0001), lack of access to healthcare facility (P=<0.0001), nonaffordability of healthcare services (P=0.003), non-availability of healthcare facility (P=0.0002), lack of drugs in healthcare facility (HCF) (P=0.002), lack ofhealthcare workers (HCWs) in HCF (P=0.014), lack of health insurance policy among the participants (P=0.004), and lack of enforcement of antibiotic policies (P=0.001) respectively, significantly affected self-medication of antibiotics. In the multivariate analysis, long distance to the health care facility (HCF), lack of access to healthcare facility, non-affordability of healthcare services, non-availability of health care facility, lack of drugs in the healthcare facility, lack of HCWs, the attitude of the HCWs, lack of health insurance policy, and lack of enforcement of antibiotic policies statistically affected self-medication (P=<0.0001) respectively. Conclusion: The prevalence of self-medication is high (73.18%). It is more prevalent in: younger population 25-30 years followed by 18-24 years than the old population, single participants than the married and divorced, educated than the non-educated, male than the female, those residing in the urban than the rural population and students than any other occupation. Metronidazole and amoxicillin were the most self-medicated antibiotics. Recommendations: Proper education on the dangers of self-medication without prescription through media and provision of affordable, available, accessible health care services together with provision of health insurance and introduction of strict antibiotic policies might help to reduce the practice.
A Research Dissertation Submitted to the School of Pharmacy in Partial Fulfillment of the Requirements for the Award of Degree of Bachelor of Pharmacy of Kampala International University Uganda
Self medication, Antibiotics, Adult population, Ishaka-Bushenyi municipality