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Cited by 30Antibiotic Use and ResistanceAntibiotic Resistance in BacteriaPharmacy and Medical Practices

Antibiotics stewardship in Ghana: a cross-sectional study of public knowledge, attitudes, and practices among communities

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Jimah, Tamara, Fenny, Ama P., Ogunseitan, Oladele A.·2020·One Health Outlook
DOI 10.1186/s42522-020-00021-8PMC PMC7993532

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Abstract

Abstract Background Antibiotic resistance is a major contributing factor to global morbidity and mortality and is associated with inappropriate medication use. However, the level of antibiotic consumption and knowledge about antibiotic resistance in Ghana is inadequately quantified. Our study identifies strategies for improved stewardship of antibiotics to prevent the proliferation of resistant pathogens by assessing the level of antibiotic knowledge, attitudes, and consumption behaviors by region, gender, age, and education in rural and urban Ghana. Methods A cross-sectional study was conducted in 12 communities in the urban Greater Accra and rural Upper West regions of Ghana. A questionnaire survey was administered to 400 individuals aged 18 years and older in selected locations during September-October 2018 to collect data on individual knowledge, attitudes, and practices concerning antibiotics and antibiotic resistance. Multivariate analysis was used to investigate the association between demographic characteristics and knowledge, attitudes, and related behaviors. Results Over 30% (125/400) had not received a doctor’s prescription during their last illness. Seventy percent (278/400) had taken at least one antibiotic in the year prior to the survey. The top five frequently used antibiotics were Amoxicillin, Amoxicillin-clavulanic acid, Ampicillin, Ciprofloxacin, and Metronidazole. Women and older adults had higher knowledge compared to their respective counterparts (p<0.01). Furthermore, prudent antibiotic use was significantly more prevalent in women than men (p<0.05). Although no regional differences were found in overall knowledge, compared to urban residents, individuals residing in rural settings exhibited higher knowledge about the ineffectiveness of antibiotics for viruses like the cold and HIV/AIDS (p<0.001). Two hundred and fifty-two (63%) respondents were unaware of antibiotic resistance. There was generally a low level of self-efficacy among participants regarding their role in preserving the effectiveness of antibiotics. Conclusion Antibiotic knowledge, attitudes, and use varied significantly across demographics, suggesting a context-specific approach to developing effective community interventions.

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  • Most high-income countries have adopted guidelines for the rational use of antibiotics, but more efforts are needed in lower-middle-income countries.

    “While most high-income countries have adopted guidelines for the rational use of antibiotics, more efforts are needed in lower-middle-income countries [9,10,11].”

    From A Systematic Review on Antimicrobial Resistance in Ghana from a One Health Perspective (2024) · cites this paper as [10]

    The Background (page unavailable) says Ghana has guidelines restricting excessive antibiotic dispensing, but poor enforcement has made them ineffective. The Conclusion (page unavailable) calls for sustained public education and further efforts in Ghana. The paper does not establish that most high-income countries have adopted rational-use guidelines, or extend its recommendation specifically to lower-middle-income countries as a group. (LLM, conf=0.84)

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Research works printed but not linked: 26

  1. [2]Gyansa-Lutterodt M Antibiotic resistance in Ghana Lancet Infect Dis 2013 13 12 1006 1007 10.1016/s1473-3099(13)70196-8 24252479 · DOI
  2. [3]Versporten A Zarb P Caniaux I Gros MF Drapier N Miller M Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey Lancet Glob Health 2018 6 6 e619 ee29 10.1016/s2214-109x(18)30186-4 29681513 · DOI
  3. [5]Gupta I Guin P Communicable diseases in the South-East Asia region of the World Health Organization: towards a more effective response Bull World Health Organ 2010 88 3 199 205 10.2471/blt.09.065540 20428387 PMC2828785 · DOI
  4. [6]GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117-71. 10.1016/s0140-6736(14)61682-2. PMC4340604 25530442 · DOI · Paper page
  5. [7]Okeke IN Antimicrobial resistance in developing countries. Part II: strategies for containment Lancet Infect Dis 2005 5 9 568 580 10.1016/s1473-3099(05)70217-6 16122680 · DOI
  6. [8]O’Neill JI. Antimicrobial resistance: tackling a crisis for the health and wealth of nations. Rev Antimicrob Resist. 2014;20:1-6.
  7. [9]Hawkey PM Multidrug-resistant gram-negative bacteria: a product of globalization J Hosp Infect 2015 89 4 p241 p247 10.1016/j.jhin.2015.01.008 25737092 · DOI
  8. [10]MacPherson DW Gushulak BD Baine WB Bala S Gubbins PO Holtom P Population mobility, globalization, and antimicrobial drug resistance Emerg Infect Dis 2009 15 11 1727 1732 19891858 PMC2857230
  9. [11]Travis DA Sriramarao P Cardona C One medicine one science: a framework for exploring challenges at the intersection of animals, humans, and the environment Ann N Y Acad Sci 2014 1334 26 44 10.1111/nyas.12601 25476836 PMC4383647 · DOI
  10. [12]Forzley M Global Health security agenda: joint external evaluation and legislation-a 1-year review Health Secur 2017 15 3 312 319 10.1089/hs.2017.0013 28534717 · DOI
  11. [15]Opintan JA Newman MJ Arhin RE Donkor ES Gyansa-Lutterodt M Mills-Pappoe W Laboratory-based nationwide surveillance of antimicrobial resistance in Ghana Infect Drug Resist 2015 8 379 389 10.2147/idr.S88725 26604806 PMC4655947 · DOI
  12. [16]Laxminarayan R Chaudhury RR Antibiotic resistance in India: drivers and opportunities for action PLoS Med 2016 3 3 e1001974 10.1371/journal.pmed.1001974 PMC4775002 26934098 · DOI
  13. [17]Zarb P Goossens H Human use of antimicrobial agents Rev Sci Tech 2012 31 1 121 133 10.20506/rst.31.1.2108 22849272 · DOI
  14. [18]Kotwani A Holloway K Trends in antibiotic use among outpatients in New Delhi, India BMC Infect Dis 2011 11 99 10.1186/1471-2334-11-99 21507212 PMC3097160 · DOI
  15. [19]Holmes AH Moore LS Sundsfjord A Steinbakk M Regmi S Karkey A Understanding the mechanisms and drivers of antimicrobial resistance Lancet 2016 387 10014 176 187 10.1016/S0140-6736(15)00473-0 26603922 · DOI
  16. [20]Demore B Mangin L Tebano G Pulcini C Thilly N Public knowledge and behaviours concerning antibiotic use and resistance in France: a cross-sectional survey Infection. 2017 45 4 513 520 10.1007/s15010-017-1015-2 28405941 · DOI
  17. [22]Lv B Zhou Z Xu G Yang D Wu L Shen Q Knowledge, attitudes and practices concerning self-medication with antibiotics among university students in western China Tropical Med Int Health 2014 19 7 769 779 10.1111/tmi.12322 24941883 · DOI
  18. [23]McNulty CA Boyle P Nichols T Clappison P Davey P Don't wear me out--the public's knowledge of and attitudes to antibiotic use J Antimicrob Chemother 2007 59 4 727 738 10.1093/jac/dkl558 17307770 · DOI
  19. [24]Prigitano A Romano L Auxilia F Castaldi S Tortorano AM Antibiotic resistance: Italian awareness survey 2016 J Infect Public Health 2018 11 1 30 34 10.1016/j.jiph.2017.02.010 28285971 · DOI
  20. [25]Gualano MR Gili R Scaioli G Bert F Siliquini R General population's knowledge and attitudes about antibiotics: a systematic review and meta-analysis Pharmacoepidemiol Drug Saf 2015 24 1 2 10 10.1002/pds.3716 25251203 · DOI
  21. [27]Saba CKS Amenyona JK Kpordze SW Prevalence and pattern of antibiotic resistance of Staphylococcus aureus isolated from door handles and other points of contact in public hospitals in Ghana Antimicrob Resist Infect Control 2017 6 44 10.1186/s13756-017-0203-2 28491294 PMC5424397 · DOI · Paper page
  22. [28]Nielsen MV Sarpong N Krumkamp R Dekker D Loag W Amemasor S Incidence and characteristics of bacteremia among children in rural Ghana PLoS One 2012 7 9 e44063 10.1371/journal.pone.0044063 22970162 PMC3438186 · DOI
  23. [31]Gu J Zhao J Huang Y Yang W Ren Z Li W Use of antibiotics by urban and rural residents in Heilongjiang Province, China: cross-sectional study Tropical Med Int Health 2015 20 12 1815 1822 10.1111/tmi.12602 26376187 · DOI
  24. [32]McNulty CA Boyle P Nichols T Clappison P Davey P The public's attitudes to and compliance with antibiotics J Antimicrob Chemother 2007 60 Suppl 1 i63 i68 10.1093/jac/dkm161 17656386 · DOI
  25. [33]Church J Maitland K Invasive bacterial co-infection in African children with plasmodium falciparum malaria: a systematic review BMC Med 2014 12 31 10.1186/1741-7015-12-31 24548672 PMC3928319 · DOI · Paper page
  26. [34]Maltha J Guiraud I Kabore B Lompo P Ley B Bottieau E Frequency of severe malaria and invasive bacterial infections among children admitted to a rural hospital in Burkina Faso PLoS One 2014 9 2 e89103 10.1371/journal.pone.0089103 24551225 PMC3925230 · DOI

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Sorted by citations

Authors
Jimah, T., Fenny, A. P., & Ogunseitan, O. A.
Affiliations
  • University of California, Irvine (US)
  • University of Ghana (GH)
Corresponding author
Ogunseitan, Oladele A.
ORCID
Venue
One Health Outlook
Publisher
Springer Science and Business Media LLC
Published
2020-08-18
Volume
2
Issue
1
Pages
12-12
ISSN
2524-4655 (ISSN-L)
DOI
10.1186/s42522-020-00021-8
PMC
PMC7993532
OpenAlex
W3078536339
Cited by
30
References
3
Citations by year
2026: 2 · 2025: 9 · 2024: 1 · 2023: 2 · 2022: 10 · 2021: 5 · 2019: 1
FWCI
2.53
Type
journal article
Language
en
Open access
Licence
Locations
  • One Health Outlook (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
University of California, Irvine
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
Keywords
antibiotic stewardship, antibiotic resistance, public knowledge of antibiotics, antibiotic use practices, inappropriate antibiotic use, self-medication, prescribing patterns, gender differences, urban-rural differences, community awareness, Ghana

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