ACCESS TO ESSENTIAL MEDICINES AND ANTIMICROBIAL AGENTS IN RURAL AREAS OF PAKISTAN SPECIFICALLY IN SINDH

Main Article Content

Mahrung Jamali
Roozina Shaikh
Muhammad Raza
Shazia Parveen Solangi
Waleed Khan
Ebad Ullah
Nida Ayesha
Farwah Batool
Maqbool Ahmed Soomro
Laraib Fatima Abro
Muhammad Umer Farooq Mujahid
Rabia Mehmood
Maryam
Muhammad Zeeshan Ahmad
Saba Javaid

Keywords

Anti microbial resistance, Sindh, Essential Medicines, Self Administration, Antibiotic

Abstract

The incidence of self-medication with antibiotics is increasing, propelled by a multitude of variables. A significant number of individuals who employ antibiotics in this method exhibit a lack of comprehensive knowledge regarding their appropriate utilization, encompassing aspects such as dose and probable adverse reactions. Therefore, the absence of regulation in antibiotic usage might lead to significant negative consequences for individuals. The objective of this study was to evaluate the prevalence and trends of self-medication practices involving antibiotics among individuals residing in rural regions of the Sindh province. A cross-sectional study was undertaken at the Outpatient Department of Civil Hospital Karachi over the period of January to March 2023. The research encompassed a sample of 375 individuals residing in rural areas on the periphery of Karachi in the Sindh province. The participants were chosen using a non-probability convenience sampling method. The results of the study indicated a significantly elevated occurrence of self-administration of antibiotics, with a prevalence rate of 81.19% observed among individuals residing in rural areas of Sindh. The predominant factor influencing self-medication among participants was economic considerations, as reported by 78.0% of respondents. Amoxicillin emerged as the predominant self-prescribed antibiotic, constituting 41.0% of instances. Surprisingly, a significant proportion of the participants exhibited a lack of awareness regarding the phenomenon of antibiotic resistance resulting from inappropriate antibiotic usage. Merely 19 persons demonstrated accurate knowledge by properly recognizing the role of this practice in exacerbating antibiotic resistance. The research highlights the alarming prevalence of self-administration of antibiotics in rural Sindh. Immediate action is imperative, specifically the implementation of more stringent laws pertaining to the dispensation of drugs, particularly antibiotics, by pharmacies in the absence of prescriptions. In addition, the implementation of cost-effective treatment options within the public sector has the potential to significantly mitigate the prevalence of self-medication practices involving antibiotics among rural inhabitants in the province of Sindh.

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References

1. Ahmad A, Patel I, Mohanta G, Balkrishnan R. Evaluation of self medication practices in rural area of town sahaswan at northern India. Ann Med Health Sci Res. 2014;4(Suppl 2):S73-8.
2. Sarahroodi S, Mikaili P. Self-medication with antibiotics:a global challenge of our generation. Pak J Biol Sci. 2012;15(14):707-08.
3. Kiyingi KS, Lauwo JA. Drugs in the home: danger and waste. World Health Forum. 1993;14(4):381-84.
4. Napolitano F, Izzo MT, Di Giuseppe G, Angelillo IF. Public knowledge, attitudes, and experience regarding the use of antibiotics in Italy. PLoS One. 2013;8(12):e84177.
5. Grigoryan L, Burgerhof JG, Degener JE, Deschepper R, Lundborg CS, Monnet DL, et al. Self-Medication with Antibiotics and Resistance (SAR) Consortium. Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system. J AntimicrobChemother. 2008;61:1172-79.
6. Drug Utilization Research Group, Latin America WHO. Multicenter study on self- medication and self-prescription in six Latin American Countries. Clin Pharmacol Ther. 1996;61:478–93.
7. Kafle KK, Gartoulla RP. Self-Medication and its Impact on Essential Drugs Schemes in Nepal: A Socio-Cultural Research Project: Action Programme on Essential Drugs. Geneva: World Health Organization; 1993.
8. Mumtaz Y, Jahangeer SA, Mujtaba T, Zafar S, Adnan S. Self medication among university students of Karachi. JLUMHS. 2011;10(03):102–05.
9. Ali SM, Fatima M, Ali L. Self-Medication Among Downtown Urban Population of Karachi, Pakistan. Indian Journal of Medical Research and Pharmaceutical Sciences. 2015;2(4).
10. Phalke VD, Phalke DB, Durgawale PM. Self-medication practices in rural Maharashtra. Indian J Community Med. 2006;31:34-35.
11. World Health Organization: The role of the pharmacist in self-care and self- medication. In Report of the 4th WHO Consultative Group on the Role of the Pharmacist in Health Care System. Geneva: WHO; 1998.
12. Laporte JR, Castel JM. [The physician and self medication]. Med Clin (Barc). 1992;99(11):414-16.
13. Stratchounski LS, Andreeva IV, Ratchina SA, Galkin DV, Petrotchenkova NA, Demin AA, et al. The inventory of antibiotics in Russian home medicine cabinets. Clin Infect Dis. 2003;37(4):498-505.
14. Pan H, Cui B, Zhang D, Farrar J, Law F, Ba-Thein W. Prior knowledge, older age, and higher allowance are risk factors for self-medication with antibiotics among university students in southern China. PLoS One. 2012;7(7):e41314.
15. Awad AI, Eltayeb IB. Self-medication practices with antibiotics and antimalarials among Sudanese undergraduate university students. Ann Pharmacother. 2007;41(7):1249-55.
16. Emeka PM, Al-Omar M, Khan TM. Public attitude and justification to purchase antibiotics in the Eastern region Al Ahsa of Saudi Arabia. Saudi Pharm J. 2014;22(6):550-54.
17. Abasaeed A, Vlcek J, Abuelkhair M, Kubena A. Self-medication with antibiotics by the community of Abu Dhabi Emirate, United Arab Emirates. J Infect Dev Ctries. 2009;3(7):491-97.
18. Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MA. Self- medication with antibiotics in Jordanian population. Int J Occup Med Environ Health. 2007;20(4):373-80.
19. Jorgji K, Bebeci E, Apostoli P, Apostoli A. Evaluation of use of antibiotics without prescription among young adults in Albania case study: Tirana and Fier District. Hippokratia. 2014;18(3):217-20.
20. Vaananen MH, Pietila K, Airaksinen M. Self-medication with antibiotics—does it really happen in Europe? Health Policy. 2006;77(2):166-71.
21. Muscat M, Monnet DL, Klemmensen T, Grigoryan L, Jensen MH, Andersen M, et al. Patterns of antibiotic use in the community in Denmark. Scand J Infect Dis. 2006;38(8):597-603.
22. Borg MA, Scicluna EA, Over-the-counter acquisition of antimicrobial drugs in the Maltese general population. Inter J Antimicrob Agents. 2002;20:193-57.
23. Berzanskyte A, Valinteliene R, Haaijer-Ruskamp FM, Gurevicius R, Grigoryan L. Self-medication with antibiotics in Lithuania. Int J Occup Med Environ Health. 2006;19(4):246-53.
24. Angeles P, Maria Luisa M, Juan Francisco M. Auto medicacion enpoblacionurbana de Cuernavaca. Salud Publica Mex. 1992;34:554–61.
25. Goossens H, Ferech M, Vander Stichele R, Elseviers M. ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross- national database study. Lancet. 2005;365:579-87.
26. Contopoulos-Ioannidis DI, Koliofoti ID, Koutroumpa IC, Giannakakis IA, Ioannidis JP. Pathways for inappropriate dispensing of antibiotics for rhinosinusitis: a randomized trial. Clin Infect Dis. 2001;33:76-82.
27. Ahmad A, Parimalakrishnan S, Patel I, Kumar NV, Balkrishnan TR, Mohanta GP. Evaluation of self-medication antibiotics use pattern among patients attending community pharmacies in rural India, Uttar Pradesh. J Pharm Res. 2012;5:765-68.
28. Memish ZA, Balkhy HH, Shibl AM, Barrozo CP, Gray GC. Streptococcus pneumoniae in Saudi Arabia: antibiotic resis-tance and serotypes of recent clinical isolates. Int J Antimicrob Agents. 2004;23(1):32–8. http://dx.doi.org/10.1016/j. ijantimicag. 2003.05.008.
29. Bronzwaer SL, Cars O, Buchholz U, Mölstad S, Goettsch W, Veldhuijzen IK, et al. A European study on the relationship between antimicrobial use and antimicrobial resistance. Emerg Infect Dis. 2002;8:278-82.
30. Ghaieth MF, Elhag SR, Hussien ME, Konozy EH. Antibiotics self-medication among medical and nonmedical students at two prominent Universities in Benghazi City, Libya. J Pharm Bioallied Sci. 2015;7(2):109-15.

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