'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.

Tytuł:: 'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.
Autorzy:: Burtscher D; Vienna Evaluation Unit, Médecins Sans Frontières, Vienna, Austria.
Van den Bergh R; Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium.
Nasim M; Médecins Sans Frontières Afghanistan, Kabul, Afghanistan.
Mahama G; Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium.
Au S; Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium.
Williams A; Operational Research (LuxOR) Unit, Médecins Sans Frontières, Luxembourg, Luxembourg.; Middle East Medical Unit (MEMU), Médecins Sans Frontières, Beirut, Lebanon.
Sattar A; Ahmad Shah Baba Hospital, Ministry of Public Health, Kabul, Afghanistan.
Penfold S; Independent Public Health Research Consultant, Trnava, Slovakia.
Van Overloop C; Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium.
Bajis S; The Kirby Institute, UNSW Sydney, Sydney, Australia.
Źródło:: PloS one [PLoS One] 2021 Nov 19; Vol. 16 (11), pp. e0260096. Date of Electronic Publication: 2021 Nov 19 (Print Publication: 2021).
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms:: Antimicrobial Stewardship/*methods
Health Knowledge, Attitudes, Practice/*ethnology
Inappropriate Prescribing/*trends
Afghanistan ; Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship/trends ; Clinical Competence/statistics & numerical data ; Drug Resistance, Microbial/physiology ; Health Facilities ; Health Workforce ; Knowledge ; Outpatients ; Patients/psychology ; Personnel, Hospital ; Pharmacies ; Pharmacists/psychology ; Physicians ; Practice Patterns, Physicians'/trends ; Surveys and Questionnaires
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Substance Nomenclature:: 0 (Anti-Bacterial Agents)
Entry Date(s):: Date Created: 20211119 Date Completed: 20220104 Latest Revision: 20240215
Update Code:: 20240215
PubMed Central ID:: PMC8604360
DOI:: 10.1371/journal.pone.0260096
PMID:: 34797865
: Czasopismo naukowe

Pełny tekst

Background: Antibiotic resistance is a growing public health threat. In Afghanistan, high levels of indiscriminate antibiotic use exist, and healthcare programmes are not informed by understanding of local attitudes towards rational antibiotic use. Médecins Sans Frontières is an international non-governmental organization providing healthcare services to the Ahmad Shah Baba (ASB) District Hospital in Kabul, Afghanistan, since 2009. This mixed-methods study aimed to explore the perceptions and attitudes toward antibiotics among patients, prescribers, and pharmacists in the ASB District hospital outpatient department.
Methods and Findings: Knowledge of antibiotics including their purpose and function, how and why they are used, and drivers for choice of antibiotic was examined at patient, prescriber, and provider-level. The first phase of the study, an exploratory qualitative component using an interpretative approach, was used to inform the second phase, a structured survey. Thirty-six interviews were conducted with 39 participants (21 patients or caretakers and 18 hospital health workers). Three hundred and fifty-one (351) patients and caretakers completed the second phase, the structured survey. This study found that poor knowledge of antibiotics and antibiotic resistance is a driving factor for inappropriate use of antibiotics. Participant perceptions of living in a polluted environment drove the high demand and perceived 'need' for antibiotics: patients, doctors and pharmacists alike consider dirty and dusty living conditions as causes of 'disease' in the body, requiring antibiotics to 'clean' and 'strengthen' it.
Conclusions: Findings highlight the need for strategies to improve awareness and knowledge of the general public, improve practice of doctors and pharmacists, regulate antibiotic dispensing in private pharmacies, and implement antibiotic stewardship in hospitals.
Competing Interests: The authors have declared that no competing interests exist.

Erratum in: PLoS One. 2024 Feb 15;19(2):e0299303. (PMID: 38359074)

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