Self-Medication Practices In Addis Ababa: A Prospective Study

BACKGROUND: Self-care is a response of individuals to promote or restore their health. Self-medication, one form of self-care, it is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms of illnesses. Although there are arguments for and against self-medication, its contribution in the promotion of health is beyond doubt. This study deals with self-medication on modern drugs and it attempts to assess self-medication practices of drug consumers. METHODS: A multi-stage stratified sampling of drug retail outlets in Addis Ababa was employed. Convenient sampling was used to select respondents from among those who came to the community pharmacies to purchase drugs for self-medication. Respondents were interviewed after they made their requests but before they were provided with information on the drugs they requested. Data were collected using a pre-tested semistructured questionnaire. RESULTS: Socio-demographic characteristics of respondents revealed that drug consumers consisted of all age categories of both genders; as well as pregnant and breast-feeding mothers of varying educational background levels. The most frequently reported illnesses that prompted self-medication of respondents were gastrointestinal diseases, headache, fever and respiratory tract infections. Slightly greater than 30% of illnesses/symptoms of illnesses were less than 24 hours and around one-fifth, one or more weeks of duration. The most common reasons reported for self-diagnosis and selfmedication were non-seriousness of the disease, emergency use and prior experience on the drug. Two-thirds of the drug consumers requested drugs by specifically mentioning the name of the drug or category to which it belongs and 20.7% by telling their illness or symptoms of illnesses. More than 100 different types of drugs were requested, the most frequent category of drugs being analgesics or antipyretics 30.1%, antimicrobials (26.4%) and gastrointestinal drugs (17.7%). CONCLUSION: Self-medication is widely practised for a wide range of illnesses or symptoms of illnesses, and for both over-the-counter and prescription only drugs. The public as well as the health care providers have to be educated on the scopes of selfmedication; i.e., the type of illnesses to be self-diagnosed and self-treated, and the type of drug products to be used in order to promote responsible self-medication.Ethiop J Health Sci. Vol. 14, No. 1 January 200

Antimicrobial resistance status of selected bacteria isolated from animal source foods and feed in Ethiopia

Antimicrobial resistance (AMR) of major food-borne pathogens has become an increasing public health problem worldwide. A cross-sectional study was conducted from August 2019 to July 2021 in high-potential meat and dairy products and commercial animal feed supply chain areas of Ethiopia. The objectives of the study was assessing AMR profile of target bacterial pathogens isolated from animal sources foods (ASFs) and feed. A total of 642 ASFs and feed samples collected from selected sampling sites were examined at the microbiology laboratory of animal products, veterinary drugs, and feed quality assessment center. Bacterial identification and antimicrobial susceptibility test (AST) were conducted using an automated Vitek 2 XL compact system. Out of 642 investigated samples, 24 different genera and 59 species of bacteria were identified. A total of 185 samples were positive for target bacteria of Staphylococcus aureus, Escherichia coli, and Salmonella Species. The AST results showed AMR of target bacteria isolates against some of the tested antimicrobials. Of these, 83%, 55%, and 92% isolates of Staphylococcus aureus, Escherichia coli, and Salmonella Species, showed high level of AMR to Benzylpenicillin, Tetracycline, and Cefalexin/Gentamicin, respectively. The target bacteria isolated from ASFs and feed demonstrated multidrug resistance against some of the tested antimicrobials having public and veterinary importance. This reflects that ASFs and feed could serve as one of the sources for the spread and transmission of antimicrobial-resistant bacterial pathogens. Hence, there is a need for improving hygiene and sanitation practices along the ASFs and feed supply chains. Besides raising community awareness about the risks of AMR, emphasis on the rational use of antimicrobials in animal health practice and further investigations on AMR are recommended

Measuring adherence to antiretroviral treatment in resource-poor settings: The feasibility of collecting routine data for key indicators

<p>Abstract</p> <p>Background</p> <p>An East African survey showed that among the few health facilities that measured adherence to antiretroviral therapy, practices and definitions varied widely. We evaluated the feasibility of collecting routine data to standardize adherence measurement using a draft set of indicators.</p> <p>Methods</p> <p>Targeting 20 facilities each in Ethiopia, Kenya, Rwanda, and Uganda, in each facility we interviewed up to 30 patients, examined 100 patient records, and interviewed staff.</p> <p>Results</p> <p>In 78 facilities, we interviewed a total of 1,631 patients and reviewed 8,282 records. Difficulties in retrieving records prevented data collection in two facilities. Overall, 94.2% of patients reported perfect adherence; dispensed medicine covered 91.1% of days in a six month retrospective period; 13.7% of patients had a gap of more than 30 days in their dispensed medication; 75.8% of patients attended clinic on or before the date of their next appointment; and 87.1% of patients attended within 3 days.</p> <p>In each of the four countries, the facility-specific median indicators ranged from: 97%-100% for perfect self-reported adherence, 90%-95% of days covered by dispensed medicines, 2%-19% of patients with treatment gaps of 30 days or more, and 72%-91% of appointments attended on time. Individual facilities varied considerably.</p> <p>The percentages of days covered by dispensed medicine, patients with more than 95% of days covered, and patients with a gap of 30 days or more were all significantly correlated with the percentages of patients who attended their appointments on time, within 3 days, or within 30 days of their appointment. Self reported recent adherence in exit interviews was significantly correlated only with the percentage of patients who attended within 3 days of their appointment.</p> <p>Conclusions</p> <p>Field tests showed that data to measure adherence can be collected systematically from health facilities in resource-poor settings. The clinical validity of these indicators is assessed in a companion article. Most patients and facilities showed high levels of adherence; however, poor levels of performance in some facilities provide a target for quality improvement efforts.</p

Assessment of Consumers Drug Knowledge in Addis Ababa: A Cross-Sectional Survey

No abstract - Available on PD

The potential role of the private sector in expanding postabortion care in Addis Ababa, Amhara and Oromia regions of Ethiopia

Background: Unsafe abortion is a major contributor of maternal mortality and morbidity in Ethiopia. High disease burden and underdeveloped infrastructure entail involvement of all partners in responding to health needs in the country. The private sector has apparently not been exploited to the fullest extent so far. Objective: To assess the potential of private facilities in expanding access to postabortion care (PAC). Methods: A cross-sectional study of private health facilities in Addis Ababa, Amhara and Oromia was conducted in 2001-2, using a pretested questionnaire and a checklist. Results: We assessed 88, 31 and 32 facilities in Addis Ababa, Amhara and Oromia, respectively. Treatment was provided by 44%, 52% and 63% of the eligible facilities in Addis Ababa, Amhara and Oromia, respectively. Manual vacuum aspiration (MVA) was used in treating 61% of Addis Ababa patients whereas sharp curettage was used in over 80% of those in Amhara and Oromia. About 80% of women did not get postabortion family planning methods. Patient-provider interaction was generally satisfactory. High-level disinfection (HLD) of non-autoclavable instruments needed improvement. All medium and above clinics have at least one GP and many have nurse/midwives. The vast majority of facilities not giving the service would like to provide comprehensive PAC if staff are trained and equipment made available in the market. Conclusion: Private health facilities can contribute substantially if given the necessary guidance and support with proper monitoring and evaluation. Ethiop.J.Health Dev. 2003;17(3):157-16

Situational analysis of antimicrobial resistance, laboratory capacities, surveillance systems and containment activities in Ethiopia: A new and one health approach

Antimicrobial resistance (AMR) has become a health, environmental, and economic threat around the globe. It is rising in Ethiopia. This analysis was designed to determine the current status of AMR on major bacterial pathogens, laboratory capacities, surveillance systems, and containment activities in the country. Data were collected from published literature and then supplemented by interviews with ten experts from key stakeholders. Data collections were guided by the AMR Situational Analysis Tool developed by Food Safety Officers at the Food Systems and Food Safety Division of the Food and Agriculture Organization of the United Nations. Published articles indicated the presence of gaps in knowledge, attitude, and practices by health professionals, students, and the community. AMR rates among E. coli, Salmonella, Staphylococci, and Campylobacter isolates ranged from 3.69‐88.41, 4.66–87.74, 17.03–85.08, and 8.41–86.63% to commonly prescribed antimicrobials, respectively. Microbiology laboratories are available. However, a considerable number of laboratories didn't have the basic equipment and consumables. AMR surveillance and reporting system have been established. The national strategic plan has been developed and updated three times. To contain AMR, a governance framework and regulations have been prepared. However, most of them were not fully implemented at all administrative levels. In conclusion, there was a high rate of AMR in the country; some activities have been conducted to prevent and contain AMR. However, more interventions and sustainable activities have to be performed to increase awareness, prevent and contain infectious diseases, rational use antimicrobials and generate more evidence in the country

Multidisciplinary and multisectoral coalitions as catalysts for action against antimicrobial resistance: Implementation experiences at national and regional levels

The multi-faceted complexities of antimicrobial resistance (AMR) require consistent action, a multidisciplinary approach, and long-term political commitment. Building coalitions can amplify stakeholder efforts to carry out effective AMR prevention and control strategies. We have developed and implemented an approach to help local stakeholders kick-start the coalition-building process. The five-step process is to (1) mobilise support, (2) understand the local situation, (3) develop an action plan, (4) implement the plan, and (5) monitor and evaluate. We first piloted the approach in Zambia in 2004, then used the lessons learned to expand it for use in Ethiopia and Namibia and to the regional level through the Ecumenical Pharmaceutical Network [EPN]. Call-to-action declarations and workshops helped promote a shared vision, resulting in the development of national AMR action plans, revision of university curricula to incorporate relevant topics, infection control activities, engagement with journalists from various mass media outlets, and strengthening of drug quality assurance systems. Our experience with the coalition-building approach in Ethiopia, Namibia, Zambia, and with the EPN shows that coalitions can form in a variety of ways with many different stakeholders, including government, academia, and faith-based organisations, to organise actions to preserve the effectiveness of existing antimicrobials and contain AMR