Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study

Kagoya, Enid Kawala; Royen, Kathleen Van; Waako, Paul; Royen, Paul Van; Iramiot, Jacob Stanley; Obakiro, Samuel Baker; Kostyanev, Tomislav; Anthierens, Sibyl

doi:10.1016/j.jgar.2021.02.019

Cited by 13 publications

(14 citation statements)

References 21 publications

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“…Similar to our findings, the influence of pharmaceutical companies was mentioned in other studies conducted in countries such as Nigeria, India and Uganda [ 45 , 46 , 47 ]. Participants reported that to achieve their market goals, pharmaceutical companies may pay commissions to healthcare professionals in Sri Lanka.…”

Section: Discussionsupporting

confidence: 92%

“…Participants reported that to achieve their market goals, pharmaceutical companies may pay commissions to healthcare professionals in Sri Lanka. A study conducted in Uganda described pharmaceutical company representatives offering prescribers incentives such as watches, clothes and even money to encourage them to prescribe their antibiotic as a drug of choice [ 47 ]. In comparison to over- or inaccurate prescribing due to poor understanding, this highlights some professionals prescribing for personal gain.…”

Section: Discussionmentioning

confidence: 99%

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Exploring Barriers to One Health Antimicrobial Stewardship in Sri Lanka: A Qualitative Study among Healthcare Professionals

et al. 2022

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Antimicrobial resistance (AMR) is a global health threat, but little is known about the perceptions regarding antimicrobials and AMR among healthcare professionals in Sri Lanka. This research aimed to take a One Health approach to explore the knowledge, attitudes and perceptions of antibiotic stewardship and AMR among healthcare professionals in Sri Lanka. A qualitative study, using telephone interviews, allowing for an in-depth exploration of attitudes, beliefs and perspectives was conducted. Healthcare professionals from both the medical and veterinary sectors were included (n = 29). Interviews were conducted by an independent interviewer and were audio-recorded and transcribed. Conventional qualitative content analysis was undertaken. Four main categories were identified: (1) understanding of AMR and observing AMR, (2) barriers to antimicrobial stewardship, (3) personal factors in, and as a result of, inappropriate antibiotic usage and (4) how to tackle AMR. Healthcare professionals showed poor awareness regarding the spread of AMR and identified inappropriate prescribing behaviours by their inter- and intra-professional colleagues. Patient demands and the influence of pharmaceutical companies were factors contributing to poor prescribing behaviour. Suggestions for the future are stricter regulation of AMR control policy, effective government involvement, and awareness campaigns for healthcare professionals and the public.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Exploring Barriers to One Health Antimicrobial Stewardship in Sri Lanka: A Qualitative Study among Healthcare Professionals

et al. 2022

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“…The relatively high compliance to national guidelines in Tanzania and South Africa could partly be attributed to the implementation of antibiotic use policies and regulations, along with health care quality improvement initiatives [ 54 , 55 ]. A recent in-depth study of prescribers in Uganda found that stockouts of certain antibiotics, high patient load, prescriber’s years of experience, influence of pharmacies and pharmaceutical companies, patient demand, lack of ownership of the dangers of AMR and other factors contributed to poor prescribing practices [ 56 ]. Therefore, the Uganda Ministry of Health should strengthen and enforce policies to address the challenge of low compliance to guidelines in health facilities.…”

Section: Discussionmentioning

confidence: 99%

Point Prevalence Survey of Antibiotic Use across 13 Hospitals in Uganda

Kiggundu¹,

Wittenauer

Waswa³

et al. 2022

Antibiotics

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Standardized monitoring of antibiotic use underpins the effective implementation of antimicrobial stewardship interventions in combatting antimicrobial resistance (AMR). To date, few studies have assessed antibiotic use in hospitals in Uganda to identify gaps that require intervention. This study applied the World Health Organization’s standardized point prevalence survey methodology to assess antibiotic use in 13 public and private not-for-profit hospitals across the country. Data for 1077 patients and 1387 prescriptions were collected between December 2020 and April 2021 and analyzed to understand the characteristics of antibiotic use and the prevalence of the types of antibiotics to assess compliance with Uganda Clinical Guidelines; and classify antibiotics according to the WHO Access, Watch, and Reserve classification. This study found that 74% of patients were on one or more antibiotics. Compliance with Uganda Clinical Guidelines was low (30%); Watch-classified antibiotics were used to a high degree (44% of prescriptions), mainly driven by the wide use of ceftriaxone, which was the most frequently used antibiotic (37% of prescriptions). The results of this study identify key areas for the improvement of antimicrobial stewardship in Uganda and are important benchmarks for future evaluations.

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“…Other studies from LMICs, including Ethiopia, Egypt, Ghana and Uganda, highlight that although theoretical knowledge of ABR is good, context-related barriers in implementation of and adherence to IPC policies were very important to consider. 4 , 6 , 8–10 …”

Section: Discussionmentioning

confidence: 99%

“… 4 , 5 However, due to poor laboratory capacities in LMICs, many HCWs don’t rely on microbiology results for diagnosing and treating infections, and broad-spectrum antibiotics are commonly prescribed indiscriminately. 6 Additionally, the poor CML capacity leads to inadequate surveillance data, and consequently weak IPC, which is not based on local prevalence of infections. A number of studies worldwide, and in Africa in particular, highlight the lack of coordinated approach to ABR education for HCWs in LMICs.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic resistance in Sudan: assessing the knowledge and practices of healthcare workers in Khartoum

Osman,

Omer,

Elmubarak

et al. 2024

JAC-Antimicrobial Resistance

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Background Antibiotic resistance (ABR) is a major public health issue, associated with increased patient morbidity and mortality globally, with significantly higher rates in low- and middle-income countries (LMICs). Assessment of contextual factors, such as information, education, infrastructure and regulations are important for developing local solutions against ABR. Objectives To determine the knowledge and practices of healthcare workers (HCWs) towards ABR in hospitals in Sudan. Materials and methods A survey was conducted in three different hospitals in Khartoum, Sudan from February to December 2020. HCWs of different specialties and expertise were invited to participate. Data were descriptively analysed using Statistical Package for Social Sciences (SPSS). Results ABR was identified as a big challenge by 89% of 345 HCWs who participated. The results show that 79% of doctors don’t rely on the clinical microbiology laboratory (CML) results for antibiotic prescription or clinical decision-making. Sixty percent of HCWs agreed there are infection prevention and control (IPC) guidelines in their hospital, but 74% of them don’t have access to them, and infrequently receive relevant IPC training. Furthermore, HCWs obtain ABR information from other colleagues informally, not through local data or reports. Conclusions Despite adequate knowledge of ABR locally, there are significant contextual technical challenges facing HCWs in Sudan, such as availability of policies and accurate data from CMLs. The results indicate a poor link between HCWs and the CMLs for infection management and it is essential to improve communication between the different hospital departments with regard to ABR transmission, and ensure the effectiveness of local IPC policies based on locally available data.

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Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study

Cited by 13 publications

References 21 publications

Exploring Barriers to One Health Antimicrobial Stewardship in Sri Lanka: A Qualitative Study among Healthcare Professionals

Exploring Barriers to One Health Antimicrobial Stewardship in Sri Lanka: A Qualitative Study among Healthcare Professionals

Point Prevalence Survey of Antibiotic Use across 13 Hospitals in Uganda

Antibiotic resistance in Sudan: assessing the knowledge and practices of healthcare workers in Khartoum

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