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Coronavirus disease 2019 (COVID-19) is a respiratory tract infection that emerged from China in December 2019 and is caused by severe acute respiratory syndrome coronavirus 2. Due to the airborne nature of its transmission, COVID-19 spread to the rest of the world rapidly. Thus, the World Health Organization declared COVID-19 a pandemic. This paper evaluated the factors that lead to self-medication in people suffering from respiratory tract infections such as COVID-19, and the consequences of practicing self-medication using antimicrobial agents. Most of the signs and symptoms of COVID-19 are also seen in infections such as malaria, flu, and the common cold. For this reason, and also due to poor healthcare-seeking behaviour, most people tend to self-medicate using medicines that are known to be effective against malaria, common cold, and COVID-19. Among the commonly used medicines in the practice of self-medication include antibacterials, antimalarials, and antivirals. Some vitamins such as vitamin C boost the immune system enabling it to provide effective defence mechanisms against microbes. However, self-medication may pose consequences such as the emergence of antimicrobial-resistant microorganisms, hypersensitivity reactions as well as dose-dependent toxicities viz dermatoxicity, cardiotoxicity, and hepatoxicity. Infectious diseases caused by antimicrobial-resistant microbes are difficult and, in some instances, impossible to treat thereby leading to increased morbidity and mortality among infected people. Consequently, antimicrobial resistance poses another global public health problem and requires a multisectoral approach to curb. It is our recommendation that all governments ensure that there are adequate medicines and efficient human resources in healthcare facilities as well as sufficient public awareness to prevent people from seeking self-medication.

Antibiotic resistance is among the major threats to global health. Due to limited information on the subject matter in Zambia, we assessed the knowledge, attitude, and practices of community pharmacists on antibiotic resistance and antimicrobial stewardship. We conducted a descriptive cross-sectional study among 144 randomly selected community pharmacists through a structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22 at 95% confidence level. A response rate of 91% (n=144) was achieved. The majority (63%) of the community pharmacists were male and were aged between 30 and 39 years. Interestingly, 93.8% had good knowledge while 67% had positive attitudes. Conversely, 75% of the community pharmacists demonstrated poor practices towards antibiotic resistance and antimicrobial stewardship. Even though community pharmacists had good knowledge and positive attitudes, they demonstrated poor practices that require quick educational interventions. There is a need to promote antimicrobial stewardship sensitization programmes among community pharmacists. Keywords: Antibiotic resistance, antimicrobial stewardship, attitude, community pharmacists, knowledge, practices, Zambia

Background: The novel coronavirus disease (COVID-19) is a serious global health problem that has negatively impacted the mental health of students.Methods: We conducted an online descriptive cross-sectional study among 273 undergraduate pharmacy students at the University of Zambia from August to September 2020. A partial proportional odds regression model was used to determine the predictors of anxiety. All statistical tests were set at 95% confidence level (p<0.05).Results: A response rate of 70% was obtained with the majority of the students being female 51.6%. Of the 273 respondents, 23.8% did not experience anxiety, 34.4% experienced mild anxiety, 24.9% experienced moderate anxiety while 16.9% experienced severe anxiety about COVID-19. It was also found that 61.2% of students reported that their attention to mental health increased during the COVID-19 pandemic whereas 44.3% reported an increased resting time with a significant reduction in relaxation 51.3% and physical activity 45.4% time. Factors that affected mental health included; reduced family care (OR: 2.27; 95% CI: 1.09-4.74), not changing attention to mental health (OR: 0.33; 95% CI: 0.18-0.62), being in the final year of study (OR: 0.33; 95% CI: 0.13-0.84), reduced time of resting (OR: 2.10; 95% CI: 1.26-3.50) and feeling helpless (OR: 0.42; 95% CI:0.23-0.75).Conclusions: COVID-19 negatively impacted the mental health and physical activity of pharmacy students at the University of Zambia. This can have negative health and academic outcomes for students going forward. Higher learning institutions and key stakeholders should implement measures to aid students to recover from the impact of COVID-19 on their mental health and physical activity.

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Background: Antimicrobial/Antibiotic Resistance (AMR) is among the major threats to global health. Due to limited information on the subject matter in Zambia, we assessed the knowledge, attitude, and practices of community pharmacists on AMR and Antimicrobial Stewardship (AMS). Materials and Methods: We conducted a descriptive cross-sectional study among 144 randomly selected community pharmacists through a structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22 at a 95% confidence level. The Fisher’s exact test was used to determine the relationship between sociodemographic factors of community pharmacists and their knowledge, attitude, and practices on antibiotic resistance and antimicrobial stewardship. Results: A response rate of 91% (n = 144) was achieved. Interestingly, 93.8% had good knowledge while 67% had positive attitudes regarding AMR and AMS. Conversely, 75% of the community pharmacists demonstrated poor practices towards AMR and AMS. The majority of the CPs 69.4% agreed that antibiotic resistance is a public health problem. The majority of the CPs 57.6% agreed that the appropriate use of antibiotics improves patient care and outcome. Of concern, (32.6%) of CPs rarely collaborated with other healthcare workers in activities that promote infection control and AMS. Also, the majority of the CPs did not take part in antibiotic awareness campaigns nor educate the public on antibiotic use and over 80% of CPs regularly issued antibiotics without a prescription. Conclusions: Even though community pharmacists had good knowledge and positive attitudes, they demonstrated poor practices that require quick educational interventions. As most CPs issue antibiotics without a prescription, this should be highlighted as a major policy issue on AMR and should be addressed by the Government. There is a need to promote AMS sensitization programmes among community pharmacists.

Currently, there is no availability of any proven specific treatment or prevention strategy to fight against COVID-19. Convalescent plasma (CP) therapy is expected to increase survival rates in COVID-19 as in the case of emerging viral infection (SARS-CoV and MERS-CoV). To collect all the studies relevant to CP therapy in critically ill or severe COVID-19 patients and summarize the findings. The systematic review was conducted according to the PRISMA consensus statement. A systematic search was performed in PubMed, Scopus, Web of Science, and Cochrane databases on April 25, 2020. A total of six studies (28 patients) relevant to CP therapy in severe or critical COVID-19 are considered for inclusion. Two authors extracted the data about study characteristics, demographics, symptoms, co-morbidities, clinical classification of COVID-19, drug therapies, oxygen therapy, laboratory results, chest CT, neutralizing antibody titer, SARS-CoV-2 RNA load, aal outcome. The review findings revealed that CP therapy increases lymphocyte count, reduced s serum inflammatory markers (CRP, IL-6, Procalcitonin) and liver enzyme levels (AST or ALT). There was a rise in serum neutralizing antibody titers in 10 of 14 patients after CP transfusion. In 4 of 14 patients, the titer levels remain unchanged after CP transfusion. All 28 cases (100%) achieved negative to the SARS-CoV-2 RNA after CP transfusion. The convalescent plasma transfusion can improve neutralizing antibody titers and reduces the viral load in severe/critical COVID-19 patients. The review recommends a well-controlled trial design is required to give a definite statement on the safety and efficacy of convalescent plasma therapy in severe/critical COVID-19.

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