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Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries.

Ocan M, Obuku EA, Bwanga F, Akena D, Richard S, Ogwal-Okeng J, Obua C - BMC Public Health (2015)

Bottom Line: The main determinants of antimicrobial self-medication include, level of education, age, gender, past successful use, severity of illness and income.The commonly reported positive outcome was recovery from illness (4/34: 11.8 %).The prevalence of antimicrobial self-medication is high and varies in different communities as well as by social determinants of health and is frequently associated with inappropriate drug use.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacology & Therapeutics, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. mss_ocan@yahoo.co.uk.

ABSTRACT

Background: Antimicrobial self-medication is common in most low and middle income countries (LMICs). However there has been no systematic review on non-prescription antimicrobial use in these settings. This review thus intended to establish the burden, risk factors and effects of antimicrobial self-medication in Low and Middle Income Countries.

Methods: In 2012, we registered a systematic review protocol in PROSPERO (CRD42012002508). We searched PubMed, Medline, Scopus, and Embase databases using the following terms; "self-medication", "non-prescription", 'self-treatment', "antimicrobial", "antimalarial", "antibiotic", "antibacterial" "2002-2012" and combining them using Boolean operators. We performed independent and duplicate screening and abstraction of study administrative data, prevalence, determinants, type of antimicrobial agent, source, disease conditions, inappropriate use, drug adverse events and clinical outcomes of antibiotic self-medication where possible. We performed a Random Effects Meta-analysis.

Results: A total of thirty four (34) studies involving 31,340 participants were included in the review. The overall prevalence of antimicrobial self-medication was 38.8 % (95 % CI: 29.5-48.1). Most studies assessed non-prescription use of antibacterial (17/34: 50 %) and antimalarial (5/34: 14.7 %) agents. The common disease symptoms managed were, respiratory (50 %), fever (47 %) and gastrointestinal (45 %). The major sources of antimicrobials included, pharmacies (65.5 %), leftover drugs (50 %) and drug shops (37.5 %). Twelve (12) studies reported inappropriate drug use; not completing dose (6/12) and sharing of medicines (4/12). The main determinants of antimicrobial self-medication include, level of education, age, gender, past successful use, severity of illness and income. Reported negative outcomes of antimicrobial self-medication included, allergies (2/34: 5.9 %), lack of cure (4/34: 11.8 %) and causing death (2/34: 5.9 %). The commonly reported positive outcome was recovery from illness (4/34: 11.8 %).

Conclusion: The prevalence of antimicrobial self-medication is high and varies in different communities as well as by social determinants of health and is frequently associated with inappropriate drug use.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of study selection
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Fig1: Flow diagram of study selection

Mentions: The search of PubMed, Embase, Medline and Scopus data bases provided a total of 4,400 citations. After adjusting for duplicates 3,572 citations remained. Of these 3,401 studies were discarded since after reviewing their titles and abstracts, they did not meet the criteria. Seven studies were discarded as their full text was not available. The full text of the remaining 171 studies was reviewed in detail. A total of 143 studies did not meet the criteria and were discarded. Thirty four (34) studies met the inclusion criteria and were included in the systematic review. Additional six studies that met the criteria for inclusion were identified through searching the reference lists of located, relevant papers and searching for the studies that had cited these papers (Fig. 1). Two reviewers OM and EO screened the studies for inclusion and exclusion in the review with a kappa agreement of 0.74 (74 %).Fig. 1


Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries.

Ocan M, Obuku EA, Bwanga F, Akena D, Richard S, Ogwal-Okeng J, Obua C - BMC Public Health (2015)

Flow diagram of study selection
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4522083&req=5

Fig1: Flow diagram of study selection
Mentions: The search of PubMed, Embase, Medline and Scopus data bases provided a total of 4,400 citations. After adjusting for duplicates 3,572 citations remained. Of these 3,401 studies were discarded since after reviewing their titles and abstracts, they did not meet the criteria. Seven studies were discarded as their full text was not available. The full text of the remaining 171 studies was reviewed in detail. A total of 143 studies did not meet the criteria and were discarded. Thirty four (34) studies met the inclusion criteria and were included in the systematic review. Additional six studies that met the criteria for inclusion were identified through searching the reference lists of located, relevant papers and searching for the studies that had cited these papers (Fig. 1). Two reviewers OM and EO screened the studies for inclusion and exclusion in the review with a kappa agreement of 0.74 (74 %).Fig. 1

Bottom Line: The main determinants of antimicrobial self-medication include, level of education, age, gender, past successful use, severity of illness and income.The commonly reported positive outcome was recovery from illness (4/34: 11.8 %).The prevalence of antimicrobial self-medication is high and varies in different communities as well as by social determinants of health and is frequently associated with inappropriate drug use.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacology & Therapeutics, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. mss_ocan@yahoo.co.uk.

ABSTRACT

Background: Antimicrobial self-medication is common in most low and middle income countries (LMICs). However there has been no systematic review on non-prescription antimicrobial use in these settings. This review thus intended to establish the burden, risk factors and effects of antimicrobial self-medication in Low and Middle Income Countries.

Methods: In 2012, we registered a systematic review protocol in PROSPERO (CRD42012002508). We searched PubMed, Medline, Scopus, and Embase databases using the following terms; "self-medication", "non-prescription", 'self-treatment', "antimicrobial", "antimalarial", "antibiotic", "antibacterial" "2002-2012" and combining them using Boolean operators. We performed independent and duplicate screening and abstraction of study administrative data, prevalence, determinants, type of antimicrobial agent, source, disease conditions, inappropriate use, drug adverse events and clinical outcomes of antibiotic self-medication where possible. We performed a Random Effects Meta-analysis.

Results: A total of thirty four (34) studies involving 31,340 participants were included in the review. The overall prevalence of antimicrobial self-medication was 38.8 % (95 % CI: 29.5-48.1). Most studies assessed non-prescription use of antibacterial (17/34: 50 %) and antimalarial (5/34: 14.7 %) agents. The common disease symptoms managed were, respiratory (50 %), fever (47 %) and gastrointestinal (45 %). The major sources of antimicrobials included, pharmacies (65.5 %), leftover drugs (50 %) and drug shops (37.5 %). Twelve (12) studies reported inappropriate drug use; not completing dose (6/12) and sharing of medicines (4/12). The main determinants of antimicrobial self-medication include, level of education, age, gender, past successful use, severity of illness and income. Reported negative outcomes of antimicrobial self-medication included, allergies (2/34: 5.9 %), lack of cure (4/34: 11.8 %) and causing death (2/34: 5.9 %). The commonly reported positive outcome was recovery from illness (4/34: 11.8 %).

Conclusion: The prevalence of antimicrobial self-medication is high and varies in different communities as well as by social determinants of health and is frequently associated with inappropriate drug use.

No MeSH data available.


Related in: MedlinePlus