Patterns and predictors of self-medication in northern Uganda

• Published in: PloS one Vol. 9; no. 3; p. e92323
• Main Authors: Ocan, Moses, Bwanga, Freddie, Bbosa, Godfrey S, Bagenda, Danstan, Waako, Paul, Ogwal-Okeng, Jasper, Obua, Celestino
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21.03.2014; Public Library of Science (PLoS)
• Subjects: Adult; Amoxicillin; Amoxicillin - therapeutic use; Analysis; Anti-Infective Agents - therapeutic use; Antibiotics; Antiinfectives and antibacterials; Antimicrobial agents; Appetite loss; Artemisinins - therapeutic use; Cotrimoxazole; Cross-Sectional Studies; Data processing; Decision making; Developing countries; Disease control; Displaced persons; Drug Combinations; Drug Resistance; Drug self-administration; Drugs; Ethanolamines - therapeutic use; Female; Fever; Fluorenes - therapeutic use; Headache; Health care; Health care facilities; Health Knowledge, Attitudes, Practice; Health sciences; Households; Humans; LDCs; Male; Masking; Medical research; Medicine; Medicine and Health Sciences; Metronidazole; Metronidazole - therapeutic use; Pharmacology; Population; Prescription drugs; Research and Analysis Methods; Risk management; Rural areas; Sample size; Sampling methods; Self Care; Self care (Health); Self Medication; Studies; Surveys and Questionnaires; Tablets; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use; Uganda; Uganda; Nigeria; Kampala Uganda
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0092323

Self-medication with antimicrobial agents is a common form of self-care among patients globally with the prevalence and nature differing from country to country. Here we assessed the prevalence and predictors of antimicrobial self-medication in post-conflict northern Uganda. A cross-sectional study was carried out using structured interviews on 892 adult (≥18 years) participants. Information on drug name, prescriber, source, cost, quantity of drug obtained, and drug use was collected. Households were randomly selected using multistage cluster sampling method. One respondent who reported having an illness within three months in each household was recruited. In each household, information was obtained from only one adult individual. Data was analyzed using STATA at 95% level of significance. The study found that a high proportion (75.7%) of the respondents practiced antimicrobial self-medication. Fever, headache, lack of appetite and body weakness were the disease symptoms most treated through self-medication (30.3%). The commonly self-medicated antimicrobials were coartem (27.3%), amoxicillin (21.7%), metronidazole (12.3%), and cotrimoxazole (11.6%). Drug use among respondents was mainly initiated by self-prescription (46.5%) and drug shop attendants (57.6%). On average, participants obtained 13.9±8.8 (95%CI: 12.6-13.8) tablets/capsules of antimicrobial drugs from drug shops and drugs were used for an average of 3.7±2.8 days (95%CI: 3.3-3.5). Over half (68.2%) of the respondents would recommend self-medication to another sick person. A high proportion (76%) of respondents reported that antimicrobial self-medication had associated risks such as wastage of money (42.1%), drug resistance (33.2%), and masking symptoms of underlying disease (15.5%). Predictors of self-medication with antimicrobial agents included gender, drug knowledge, drug leaflets, advice from friends, previous experience, long waiting time, and distance to the health facility. Despite knowledge of associated risks, use of self-medication with antimicrobial drugs in management of disease symptoms is a common practice in post-conflict northern Uganda.