Behavioral Practices Towards Antibiotic Use Among Health Care Workers, Sierra Leone, 2021
Background: Antimicrobial resistance (AMR) is a global public health threat. Globally, 700,000 people die from AMR annually. Understanding health care workers’ (HCWs) behavioral practice towards antibiotic use can help reduce irrational use of antibiotics and decrease the development of drug-resistant pathogens. However, in Sierra Leone, there is limited data on antibiotic use among HCWs. We assessed antibiotic prescribing practices and associated factors among HCWs in Sierra Leone.
Methods: We conducted a cross-sectional survey among HCWs. We used a multistage sampling to select participants and collected data using a pretested questionnaire containing a Likert scale for 5 categories for 10 antibiotic prescribing practices. Scores (6–10) were categorized as good practice and coded as “1”; scores (0–5) were categorized as poor and coded as “0”. Bivariate and multivariate logistic regression models calculated adjusted odds ratios (aOR) and 95 % confidence intervals (CI) to identify risk factors.
Results: All 337 (100%) HCWs selected for this study responded and 45% scored good practice. A total of 292 (86.6%) HCWs reported that the more antibiotics are used, the higher the risk of AMR. However, 131 (38.9%) considered that fever is always an indication of antibiotics. The majority of HCWs, 280 (83.1%) agreed that they prescribe antibiotics without performing microbiological tests and 114 (33.8%) reported that they prescribe a shorter course of antibiotics compared to guidelines. Factors significantly associated with good practice were being a doctor (aOR=1.95; CI=1.07–3.56), internet as a source of information (aOR=2.00; CI=1.10–3.66), having a high perception that AMR is a problem in the health facility (aOR=1.80; CI=1.01–3.23), and believing that there is a connection between one’s prescription and AMR (aOR=2.15; CI=1.07–4.32).
Conclusions: This study identified a low level of good practice towards antibiotic prescription. We initiated health education campaigns and recommended continuous professional development programs on antibiotic use and AMR.