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INTRODUCTION: Contaminated mobile phones act as reservoirs for organisms causing hospital-acquired infections (HAI). Little is known about medical school students' awareness of infection prevention and control (IPC) regarding mobile phone use among medical students. We demonstrated the presence of organisms on mobile phones of final-year medical students at Makerere University College of Health Sciences and evaluated their awareness of IPC regarding mobile phone hygiene and use in a hospital setting. METHODS: In this cross-sectional study, organisms from swabs obtained from 79 medical students' mobile phones were identified and antimicrobial susceptibility test carried out using standard biochemical tests and the automated BD Phoenix instrument. Data were collected using a self-administered questionnaire to assess the students' awareness. The analysis was carried out using STATA software version 16. RESULTS: Seventy (88.6%) mobile phones were contaminated with at least one organism. One hundred forty-eight bacteria were isolated, of which 123 (83.1%) were Gram-positive, 24 (16.2%) were Gram-negative, and 1 (0.7%) was yeast (Candida spp). Coagulase negative staphylococci were the most frequently isolated among Gram-positive bacteria. Acinetobacter baumannii were the most frequently isolated among Gram-negative bacteria. The average IPC practical score regarding mobile phone hygiene (34%) was significantly lower than the average IPC awareness score (77%) (p ≤ 0.0001). Seventy-four (93.7%) students use their phones while rotating in the various wards. Forty (50.6%) of the students cleaned their phones with alcohol-based sanitizer after rotations in the ward. Thirty-five (44.3%) students were aware of IPC programs in the hospital they rotated in. CONCLUSION: There is a high prevalence of bacterial contamination from mobile phones of medical students. The students had lower IPC practical scores compared to IPC awareness scores regarding mobile phone hygiene irrespective of the ward of rotation. Curriculum of final-year medical students should include IPC-related topics, which incorporate practical skills.
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INTRODUCTION: Proper measures to combat antimicrobial resistance development and spread in Sub Saharan Africa are very crucial bearing in mind the projected burden of antimicrobial resistance which is expected to be increase by 2050. Training of medical doctor and pharmacy students in antimicrobial stewardship is vital to combat antimicrobial resistance. This study was designed to evaluate the knowledge, attitude, and perception of final year medical and pharmacy students on antimicrobial use and antimicrobial resistance at three universities in Uganda, Kenya, and Tanzania. METHODOLOGY: A cross-sectional survey was carried out among final year undergraduate medical and pharmacy students at three universities in East Africa. A Self-administered questionnaire was developed which included dichotomous questions and questions using a 4-point Likert scale. The questions were based on knowledge and attitude about antibiotics, and preparedness to use antibiotics in clinical scenarios. Data were analyzed using STATA version 16 following the objective of the study. RESULTS: Three hundred and twenty-eight final year students participated in the survey from MUK 75, MKU 75 and CUHAS 178. Slightly majority of participants were male 192(58.5%) and their median age was 25 [23 - 27] years. In general, 36.6% (120/328) of students had good overall total knowledge. More students at MUK had good knowledge compared to MKU, and CUHAS (72% vs, 40% vs. 20.2%; p<0.001). The mean scores for overall good total knowledge, general knowledge about antibiotics, knowledge about antibiotic resistance, and knowledge about antibiotic use in clinical scenarios were 58% (CI: 57%- 60%), 95% (CI: 94%- 97%), 54% (CI: 52% - 56%), and 46% (CI:44% - 48%) respectively. More pharmacy students compared to medical students had a good attitude and perception on antibiotic use (79.6% vs. 68.4%; p = 0.026). The students at CUHAS perceived being more prepared to use antibiotic in district hospitals compared to MKU and MUK (75.3% vs. 62.7% vs. 65.3%; p = 0.079). While two hundred and seventy (82.3%) students perceived knowing when to start antimicrobial therapy, 112 (34.2%) did not know how to select the appropriate antibiotic (p<0.0001), 97 (29.6%) did not know the antibiotic dose to give (p<0.0001), and 111 (33.8%) did not know when to switch form an intravenous antibiotic to oral regimen (p<0.0001). CONCLUSION: Final year students have low scores in knowledge about antimicrobial resistance and antibiotic use in clinical scenarios. This has exposed gaps in practical training of students, while they may feel confident, are not fully prepared to prescribe antibiotics in a hospital setting. A multidisciplinary and practical approach involving medical schools across the East African region should be undertaken to train final year undergraduate students in antimicrobial resistance and antimicrobial stewardship programs. Antimicrobial resistance and antimicrobial stewardship courses should be introduced into the curriculum of final year medicine and pharmacy programs.
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Anti-Bacterial Agents/therapeutic use , Drug Resistance, Microbial , Health Knowledge, Attitudes, Practice , Students, Medical , Students, Pharmacy , Adult , Africa, Eastern , Female , Humans , Male , Young AdultABSTRACT
BACKGROUND: Around 70-90% of peptic ulcer disease (PUD) is due to Helicobacter pylori and requires treatment with antimicrobials to which these bacteria are susceptible. Common H. pylori diagnostic tests do not provide drug susceptibility data. Using the GenoType HelicoDR PCR test designed for gastric biopsies for simultaneous detection of H. pylori and its resistance to clarithromycin (CLA)/fluoroquinolones (FLQ), we present evidence for stool as an optional test specimen and also provide data on prevalence of H. pylori resistance to CLA and FLQ in Uganda. METHODS: Stool from 142 symptomatic PUD patients at three hospitals in Kampala was screened for H. pylori using a rapid antigen test. The GenoType HelicoDR test was run on all H. pylori antigen positives to determine PCR positivity and resistance to CLA/FLQ. RESULTS: Thirty-one samples (22%) were H. pylori antigen positive, and 21 (68%) of these were H. pylori PCR positive. Six of the 21 (29%) were resistant to CLA and eight to FLQ (42%), while two gave invalid FLQ resistance results. CONCLUSION: Stool is a possible specimen for the GenoType HelicoDR test for rapid detection of H. pylori and drug resistance. In Uganda, Helicobacter pylori is highly resistant to CLA and FLQ.
