Exploring knowledge, attitude, and practices of the Malawian rural communities towards antimicrobial use and resistance prevention

Abstract

Abstract Background: The unnecessary use of antibiotics and concomitant rapid growth of antibiotic resistance (ABR) is a widely acknowledged threat to global health, development, and sustainability. While the underlying cause of ABR is undoubtedly the overall volume of antibiotic use in general, irrational antibiotic use, which is influenced by several interrelated factors, is a major contributory factor . There are few published articles in Africa on this topic, although the number of such articles appear to have been increasing recently. The patients may have certain knowledge and attitudes on antibiotic use but these have not been ascertained in Malawi . This study explored the knowledge, attitude and practices of Malawian rural Communities on antibiotic use and resistance prevention. Methods: A descriptive cross-sectional study was conducted (n=350) among community members of T/A Namkumba. Simple random sampling was used to select participants and a structured questionnaire was used to interview the respondents. Results: Female participants made up 71.4% of the total and the mean age was 25.8 (SD±13.34). From all participants, (99.1%) reported having ever heard of the antibiotics, and the most common antibiotics were Cotrimoxazole (82%), Amoxicillin (79.8%), and Metronidazole (50.9%). Cough and flue were the most prominent indication for taking antibiotics representing 41.5% and 21.6% respectively. The results also showed that the majority of the participants had a positive attitude towards appropriate antibiotic use, with 82.9% remembering to take and complete prescribed antibiotics. However, about 18% did not finish the last course of the antibiotic which were prescribed. We used Ordered Logistic Regression to determine the association between knowledge, attitude and practices of the study participants. A statistically significant association was declared at a p-value < 0.05. Conclusion: There is massive and in appropriate use of first-line antibiotics as people were taking antibiotics for conditions which were self- limiting like flue. However, people trust the hospital for their antibiotics and all the information related to their use. Despite this, a good number of participants got their medicines from a pharmacy without physician consultation and some did not finish their last course as prescribed hence putting the bacteria at risk of developing resistance.