Health-seeking Behaviour and Practice of Antibiotic Self- medication Among Adults in Southeastern Nigeria, 2021

Anti-microbial resistance

Background: Inappropriate health-seeking behaviour (HSB) and self-medication with antibiotics (SMA) contribute to antimicrobial resistance (AMR). The global problem of AMR is particularly pressing in developing countries like Nigeria, where the infectious disease burden is high. We identified HSBs and SMA in an adult population to facilitate the promotion of rational use of antibiotics.
Methods: We conducted a cross-sectional study using multi-stage sampling to select 448 participants. A questionnaire was administered to all eligible and consenting adults in selected households. Independent variables included socio-demographic characteristics of respondents. Dependent variables were HSB and SMA. We considered appropriate HSB as “consulting a doctor” while other responses were inappropriate. We measured SMA by assessing usage in the preceding 3 months and grouped responses into “none” and “others.” Bivariate analysis of HSB and SMA against socio-demographic characteristics was done with crude odds ratio. Logistic regression for adjusted odds ratios (AOR) was done for variables that were significant on bivariate analyses at p-value of 0.2. P-value ≤0.05 was considered statistically significant.
Results: Mean age of the participants was 30.0±10.7 years. The majority were male (53.1%), single (59.4%), and had secondary education (44.4%). Only 35.9% had appropriate HSB when ill and 43.8% had not practiced SMA in the preceding 3 months. Predictors of appropriate HSB included marital status (being single, AOR=0.35, 95% CI=0.17–0.71), occupation (private/self-employed, AOR=0.34, 95% CI=0.16–0.72; unemployed, AOR=0.22, 95% CI=0.07–0.65), living status (with family members, AOR=0.55, 95% CI=0.31–0.98), and monthly income (≥US$242, AOR=3.62, 95% CI=1.27–10.30). Predictors of non-practice of SMA included marital status (being single, AOR=0.58, 95% CI=0.35–0.95), and monthly income (US$73–121, AOR=0.46, 95% CI=0.27–0.80).
Conclusions: A high proportion of adults still exhibit inappropriate HSBs with high prevalence of SMA. This calls for increased community engagement to improve rational use of antibiotics and HSBs in Nigeria. Study participants were educated on HSB, SMA and the dangers of AMR.

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