Prevalence of self-medication with antibiotics and associated factors in the community of Asmara, Eritrea: a descriptive cross sectional survey.

BACKGROUND: Development of drug resistance caused by self-medication with antibiotics, can be seen as one of the growing global threats. Self-medication is defined as the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. The purpose of this study is to assess the practice of self-medication with antibiotics and associated factors among the community of Asmara, Eritrea. METHODS: This was a community based descriptive cross-sectional study conducted in 16 selected sub-districts of Asmara from September to November 2017. A Two-stage cluster sampling was employed to select study sites and participants. Data was collected in a face to face interview with a structured questionnaire and entered to CSPro version 6.2. Descriptive statistics, cross-tabulation and logistic regression were executed using SPSS version 22. RESULTS: A total of 580 study participants were recruited with a response rate of 99.5% (N = 577). The prevalence of Self-medication with antibiotics (SMA) in this study was found to be 45.1% [95% CI (40.5, 49.6)] and majority of them practiced once or twice in a period of 12 months. The main reasons for SMA were previous successful experience (34.4%) and the illness being 'not serious enough to seek medical care' (25.7%). Of those who self-medicated, 84.1% of used amoxicillin at least once. Wound infection (17.9%) and sore throat (13.9%) were the most self-recognized complaints that required self-medication. Antibiotics were supplied and recommended mostly by the community drug outlets. Only Sex (p = 0.046), knowledge (p = 0.019) and attitude (p < 0.001) of the participants were found significantly associated with the practice of SMA in the multivariate logistic regression. CONCLUSIONS: Though majority of the respondents considered self-medication with antibiotics as inappropriate practice, about half of them were practicing it anyway. Therefore immediate attention from relevant bodies is required.

Self-medication with over the counter drugs, prevalence of risky practice and its associated factors in pharmacy outlets of Asmara, Eritrea.

BACKGROUND: Although over the counter (OTC) drugs are believed to be relatively safe, their inappropriate use could have serious implications. The aim of the study was to assess the practice of self-medication, prevalence of risky practice and its associated factors in pharmacy outlets of Asmara, Eritrea. METHODS: A descriptive cross-sectional study was conducted among 609 customers in 20 pharmacy outlets in Asmara between August and September, 2017. Two-stage cluster sampling was employed and data were collected using a structured questionnaire through face to face exit interviews. Descriptive statistics and multivariate logistic regression were performed using SPSS (version 22). RESULTS: Of the 609 customers, 93.7% had practiced self-medication with OTC drugs; of which 81.8% were at risky practice. On average, each participant was using OTC drugs at least once a month (Median = 1, IQR = 3.67). Educational level (p < 0.0001), religion (p = 0.047), occupation (p = 0.027) and knowledge regarding OTC drugs (p = 0.019) were significantly associated with risky practice. Respondents with elementary and below educational level were fifteen times (AOR = 15.49, CI: 1.97, 121.80) at higher risk compared to those with higher education, and students were almost three times (AOR = 2.96, CI: 1.13, 7.73) at higher risk than governmental employees. Furthermore, respondents with below average score in knowledge were more likely to be engaged in risky practice (AOR = 1.83, CI: 1.11, 3.04) compared to those with above average score. The most frequently preferred OTC drug group was analgesics (34.3%) followed by antipyretics (15.7%) and cough and cold preparations (14.2%). About 14% of the respondents admitted that they had taken more than the recommended dose and 6.9% had experienced drug related problems following the consumption of OTC drugs. Always, 35% of the respondents read package insert(s) and 73.9% check expiry dates while purchasing OTC drugs. Refrigerating OTC drugs, where it is not recommended, was also one of the prominent risky practices. CONCLUSIONS: This study revealed that inappropriate self-medication practice with OTC drugs was prevalent requiring early intervention to minimize the risks.