L'automédication chez des patients reçus aux urgences médicales des Cliniques Universitaires de Kinshasa

Mbutiwi, Fiston Ikwa Ndol; Bompeka, François Lepira; Dramaix-Wilmet, Michèle; Meert, Philippe; Malengreau, Myriam; Mangani, Nazaire Nseka; Tsobo, Flory Muanda; Koné, Dramane

doi:10.3917/spub.132.0233

Cited by 15 publications

(4 citation statements)

References 23 publications

(28 reference statements)

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“…Most methods used were medicinal. In the DRC and other developing countries, regulations on the sale and use of pharmaceutical products are scarcely observed, and the practices of self-medication and diversification of remedies are commonplace; they constitute the therapeutic choices of the majority of persons before they resort to a sanitary structure [21–23].…”

Section: Discussionmentioning

confidence: 99%

Extent of induced abortions and occurrence of complications in Kinshasa, Democratic Republic of the Congo

et al. 2019

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Background Due to a lack of relevant data on induced abortions in the Democratic Republic of the Congo (DRC) as well as the persistence of maternal deaths in the country, this study aims to analyse the extent of induced abortions and occurrence of complications in Kinshasa. Methodology This cross-sectional study was conducted with a sample of 460 women who were interviewed about their experiences as females, and provided information of 1444 women of childbearing age living in Kinshasa. Respondents’ households were selected to represent the five types of residential quarters in Kinshasa, differentiated by cultural, socioeconomic, and infrastructural characteristics. Information was collected using a survey form and analyzed. Results Among all confidantes included in the study, 5.5% (95% CI: 4.4–6.8%) had induced abortions during 2015, a rate of 55.0 abortions per 1000 women of childbearing age. This practice was significantly performed amongst single/separated/divorced women; those without formal education, or primary-school education, and women who consumed excessive alcohol. Most abortions were induced by the administration of high doses of medication, by the women themselves or by health workers. A percentage of 51.9% (95%CI: 40.4–63.3%) of induced abortions led to complications, which were predominantly haemorrhagic. Moreover, 39% of patients had a complication for which they sought care, and of whom 12.5% had genital trauma or uterine perforation/intestinal necrosis. Conclusion Induced abortion is a public health problem in Kinshasa due to its frequency of practice, the complications that occur, and the absence of major surgeries in the health care package offered by the health centres or dispensaries that also provide the treatment of some serious complications. Thus, there is a need to focus on the enhancement of the health care package offered by health centres to include appropriate measures in favour of maternal health.

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Section: Discussionmentioning

confidence: 99%

Extent of induced abortions and occurrence of complications in Kinshasa, Democratic Republic of the Congo

et al. 2019

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“…More worrying would be continuing to recommend a molecule with a sensitivity reduction of over 50%, and which, moreover, is intended for the treatment of severe malaria only. This decrease in sensitivity may be due to self-medication which could favor the selection of resistant strains of plasmodia [27][28][29]. For MQ, the reduction in isolate susceptibility was 30.8% in Kinshasa and 52.5% in Kongo Central.…”

Section: Discussionmentioning

confidence: 99%

National guidelines for malaria treatment in Democratic Republic of the Congo: A critical appraisal

Nkoli

Moke²,

Kisita

et al. 2023

Preprint

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CONTEXT AND OBJECTIVES The fight against malaria is threatened by the emergence and expansion of Plasmodium falciparum resistance to antimalarial drugs, to the point of questioning treatment patterns drawn by control programs. The objective of this work was to do a critical appraisal of the national guidelines for the treatment of malaria in the Democratic Republic of the Congo. METHODS To estimate the selective pressure that leads to the emergence of P. falciparum resistance to antimalarials, a cross-sectional survey was conducted on antimalarials in circulation in pharmacies in Kinshasa. An ex vivo evaluation of the P. falciparum resistance to antimalarial drugs and the analysis of molecular markers of Sulfadoxine-pyrimethamine resistance were conducted in the provinces of Kinshasa and Kongo Central during 2014 and 2015. RESULTS. The following antimalarial drugs were found in 404 pharmacies: Artemisinin-based combination therapies 88.1%, quinine 80.9%, Sulfadoxine-Pyrimethamine 56.4%, oral artemisinin-based monotherapies 23.0% and traditional medicine 30.2%. Artemether-lumefantrine combinations were the most frequently dispensed drugs (93% of pharmacies). The decrease in the susceptibility of P. falciparum isolates to antimalarials was as follows: chloroquine 65.7%, quinine 52.6%, monodesethylamodiaquine 25%, mefloquine ~ 45%, dihydroartemisinin 1.3%, piperaquine 1.6%, and doxycycline 4.3%. No isolates were found to be lumefantrine-resistant. The prevalence of mutations was high in pfdhfr (N51I: 98.5%, C59R: 88.2%, and S108N: 99.4%) and pfdhps (A437G: 97.8%). The pfdhps A581G, pfdhps K540E, pfdhfr I164L, and pfdhps A613S mutations were 14%, 17.5%, 0.1%, and 0.6%, respectively. CONCLUSION These findings show a high ex vivo resistance of P. falciparum to quinine, the antimalarial that plays an important role in the fight against malaria in the DRC. The present work highlights the complexity of the inappropriate antimalarials distribution. This shows the lack of regulation in the distribution system, potentially affecting the dynamics of resistance.

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“…Le diclofénac était l'AINS le plus consommé dans notre étude (76,28%) comme dans des études réalisées en RDC (Ndol & al, 2013) Phalke & al, 2006). Dans les pays en voie de développement, la vente à la sauvette des médicaments dans les abords des rues, dans les marchés, les cars de transports sont courants avec un risque d'usage de médicaments contrefaits, périmés ou mal conservés.…”

Section: Au Plan Thérapeutiqueunclassified

“…et pouvait s'expliquer par le faible niveau d'accès aux soins ; d'où le recours facile à l'automédication(Ndol & al, 2013 ; Angbo-Effi & al, 2011 ; Sallam & al, 2009 ; Ngo & al, 2010 ; Al-Ghamdi & al, 2020 ; Dean & al, 2018). La relative jeunesse de la population dans notre étude (52+/-16 ans) était observée ailleurs en Afrique et en Asie (33 ans et 42,4 ans), contrairement à l'Occident où la population est vieillissante (Ndol & al, 2013 ; Sallam & al, 2009 ;Gobir & al, 2017 ; Makita-ikouaya & al, 2020 ; Shafie & al, 2018 ; Divya & al, 2016 ; Michele Dion & al, 2015 ;UNFPA, 2016).…”

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Facteurs Associés à la Consommation des AINS en Automédication chez les Patients vus en Rhumatologie à Abidjan

Kollo,

Bamba,

Condé

et al. 2024

ESJ

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Objectif: Identifier les facteurs associés à la consommation des AINS en automédication par les patients vus en rhumatologie à Abidjan. Méthodologie: Etude transversale et analytique menée au sein du service de rhumatologie du CHU de Cocody (Abidjan) du 1er Février 2023 au 31 Juillet 2023, portant sur 388 patients présentant des douleurs ostéoarticulaires venus en consultation de rhumatologie et ayant pratiqué une automédication aux AINS quel que soit la voie d’administration, la durée de consommation et l’ancienneté. Nous avons recherché une corrélation entre les facteurs socio-démographiques, cliniques et l’automédication aux AINS. Résultats : La fréquence hospitalière de consommation des AINS en automédication était de 76,67% soit 388 sur 506 personnes recensées pendant la période d’étude. L’effectif comprenait 257 femmes (66,20%) et 131 hommes (33,80%) avec un âge moyen de 52 +/- 16 ans [Extrêmes : 8 et 84 ans]. La catégorie socio-professionnelle dominante était le secteur informel (35,80%). La majorité des patients était scolarisée (85,10%) avait un niveau socio-économique bas (77,30%) et vivait en milieu urbain (88,90%). Les AINS étaient consommés en majorité pour des rachialgies (70,10%) et des rachialgies avec radiculalgies (64,17%), chroniques (75,50%) mécaniques (63,70%) d’installation progressive (85,80%). Le diclofénac appartenant à la famille des arylcarboxyliques (89,20%) était l’AINS le plus utilisé (76,28%) pour une durée de consommation de moins de 14 jours (75,20 %). Le lieu de prédilection de fourniture en AINS des patients était la pharmacie (76%) et la rue (51,50%) avec une efficacité partielle sur la douleur (79,90%). Les patients avaient une satisfaction mitigée après la prise des AINS (64,70%) et jugeaient leur attitude d’automédication mauvaise (70,60%). Les principales raisons motivant l’automédication étaient l’accessibilité (66,85%) et le conseil d’un tiers (52,83). Le niveau d’étude (p =0,046), le niveau socio-économique (p=0,039) et l’intensité de la douleur (p=0,011) influençaient la prise d’AINS en automédication. Conclusion: La fréquence de consommation des AINS en automédication est très élevée à Abidjan et les facteurs déterminant cette consommation sont le niveau d’étude, le niveau socio-économique et l’intensité de la douleur. Objective: To identify the factors associated with self-medication with NSAIDs by patients seen in rheumatology in Abidjan. Methodology: A cross-sectional, analytical study was conducted in the rheumatology department of the CHU of Cocody (Abidjan) from 1st February 2023 to 31st July 2023, involving 388 patients with osteoarticular pain seen in rheumatology consultations who had done self-medication with NSAIDs, irrespective of the route of administration, duration of use and length of time on the drug. We looked for a correlation between socio-demographic, clinical factors, and self-medication with NSAIDs. Results: The hospital frequency of self-medication with NSAIDs was 76.67%, i.e. 388 out of 506 people surveyed during the study period. There were 257 women (66.20%) and 131 men (33.80%) with an average age of 52 +/- 16 years [extremes: 8 and 84 years]. The dominant socio-professional category was the informal sector (35.80%). The majority of patients were educated (85.10%), had a low socioeconomic level (77.30%) and lived in urban areas (88.90%). NSAIDs were mainly used for chronic (75.50%), mechanical (63.70%) and progressive (85.80%) rachialgia (70.10%) and rachialgia with radiculalgia (64.17%). Diclofenac, a member of the arylcarboxylic family (89.20%), was the most commonly used NSAID (76.28%), with a duration of use of less than 14 days (75.20%). The preferred place of supply for NSAIDs was the pharmacy (76%) and the street (51.50%), with partial efficiency on pain (79.90%). Patients had mixed satisfaction after taking NSAIDs (64.70%) and considered their self-medication attitude to be poor (70.60%). The main reasons for self-medication were accessibility (66.85%) and advice from a third party (52.83%). Level of education (p=0.046), socioeconomic status (p=0.039) and pain intensity (p=0.011) influenced self-medication with NSAIDs. Conclusion: The frequency of self-medication with NSAIDs is very high in Abidjan, and the factors determining this consumption are level of education, socio-economic status and pain intensity.

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L'automédication chez des patients reçus aux urgences médicales des Cliniques Universitaires de Kinshasa

Cited by 15 publications

References 23 publications

Extent of induced abortions and occurrence of complications in Kinshasa, Democratic Republic of the Congo

Extent of induced abortions and occurrence of complications in Kinshasa, Democratic Republic of the Congo

National guidelines for malaria treatment in Democratic Republic of the Congo: A critical appraisal

Facteurs Associés à la Consommation des AINS en Automédication chez les Patients vus en Rhumatologie à Abidjan

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