Identifying the commonly used antibiotics for self-medication in urban Mozambique: a qualitative study

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Abstract

Objectives

The study aimed at identifying the commonly used non-prescribed antibiotics (NPAs) and the main health conditions leading to the practices of self-medication with antibiotics (SMAs) in Maputo city, Mozambique.

Design

Cross-sectional qualitative study based on individual and group interviews.

Setting

The study was conducted in nine pharmacies of three socioeconomic areas of Maputo city, from October 2018 to March 2019.

Participants

The study included 32 pharmacy clients and 17 pharmacists. The pharmacy clients included men 10 (31%) and women 22 (69%) ranging from 19 to 67 years while the pharmacists included men 6 (35,3%) and women 11 (64,7%) with ages ranging from 24 to 47 years.

Findings

The majority of the pharmacy clients 30 (93.75%) admitted frequent use of NPAs, 15 (88.2%) out of the 17 pharmacists admitted dispensing NPAs. While the majority of the participants (16) mentioned the use of amoxicillin, also known as ‘two colours medicine’, 14 mentioned the use of cotrimoxazole and seven mentioned amoxicillin with clavulanic acid. Two to five participants also used tetracycline, ciprofloxacin, azithromycin, doxycycline, erythromycin, metronidazole and phenoxymethylpenicillin. The above mentioned NPAs were used to treat self-perceived sore throat, fever, pain, cough, vaginal discharge, eye problems, the common influenza, urinary infections, respiratory tract infections, wounds and toothaches.

Conclusions

Antibiotics are perceived as essential medical resources to manage health and illnesses. While taking an active role in their health-disease process, participants commonly used amoxicillin, ‘two colours’, cotrimoxazole and amoxicillin with clavulanic acid to manage their health and that of their families. In this sense, the practices of SMAs were perceived as part of the self-care process and not necessarily as misuse of antibiotics. A wideunderstanding of health-seeking beliefs and behaviours regarding the utilisation of antibiotics is needed to inform public health experts, health policymakers and other stake-holders in designing and implementing public health education and health promotion programsat all levels in Mozambique.

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Most cited references 55

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Access to effective antimicrobials: a worldwide challenge.

Ramanan Laxminarayan, Precious Matsoso, Suraj Pant … (2016)

Recent years have seen substantial improvements in life expectancy and access to antimicrobials, especially in low-income and lower-middle-income countries, but increasing pathogen resistance to antimicrobials threatens to roll back this progress. Resistant organisms in health-care and community settings pose a threat to survival rates from serious infections, including neonatal sepsis and health-care-associated infections, and limit the potential health benefits from surgeries, transplants, and cancer treatment. The challenge of simultaneously expanding appropriate access to antimicrobials, while restricting inappropriate access, particularly to expensive, newer generation antimicrobials, is unique in global health and requires new approaches to financing and delivering health care and a one-health perspective on the connections between pathogen transmission in animals and humans. Here, we describe the importance of effective antimicrobials. We assess the disease burden caused by limited access to antimicrobials, attributable to resistance to antimicrobials, and the potential effect of vaccines in restricting the need for antibiotics.

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A Brief History of the Antibiotic Era: Lessons Learned and Challenges for the Future

Rustam Aminov (2010)

This article gives a very brief overview of the antibiotic era, beginning from the discovery of first antibiotics until the present day situation, which is marred by the emergence of hard-to-treat multiple antibiotic-resistant infections. The ways of responding to the antibiotic resistance challenges such as the development of novel strategies in the search for new antimicrobials, designing more effective preventive measures and, importantly, better understanding the ecology of antibiotics and antibiotic resistance are discussed. The expansion of conceptual frameworks based on recent developments in the field of antimicrobials, antibiotic resistance, and chemotherapy is also discussed.

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Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review

Rachel Davis, Rona Campbell, Zoe Hildon … (2014)

Interventions to change health-related behaviours typically have modest effects and may be more effective if grounded in appropriate theory. Most theories applied to public health interventions tend to emphasise individual capabilities and motivation, with limited reference to context and social factors. Intervention effectiveness may be increased by drawing on a wider range of theories incorporating social, cultural and economic factors that influence behaviour. The primary aim of this paper is to identify theories of behaviour and behaviour change of potential relevance to public health interventions across four scientific disciplines: psychology, sociology, anthropology and economics. We report in detail the methodology of our scoping review used to identify these theories including which involved a systematic search of electronic databases, consultation with a multidisciplinary advisory group, web searching, searching of reference lists and hand searching of key behavioural science journals. Of secondary interest we developed a list of agreed criteria for judging the quality of the theories. We identified 82 theories and 9 criteria for assessing theory quality. The potential relevance of this wide-ranging number of theories to public health interventions and the ease and usefulness of evaluating the theories in terms of the quality criteria are however yet to be determined.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2020

Publication date (Electronic): 21 December 2020

Volume: 10

Issue: 12

Electronic Location Identifier: e041323

Affiliations

[1 ]departmentResearch Unit , Instituto Superior de Ciências de Saúde - ISCISA , Maputo, Mozambique

[2 ]departmentSchool of Nursing and Public Health , University of KwaZulu-Natal , Durban, South Africa

[3 ]departmentDiscipline of Pharmaceutical Sciences , University of KwaZulu-Natal , Durban, South Africa

Author notes

[Correspondence to ] Neusa F Torres; torresneusa@ 123456gmail.com

Author information

Neusa F Torres http://orcid.org/0000-0001-7568-9971

Article

Publisher ID: bmjopen-2020-041323

DOI: 10.1136/bmjopen-2020-041323

PMC ID: 7754657

SO-VID: 8a809279-8924-4ca1-b572-15db3b172aec

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 05 June 2020

Date revision received : 15 November 2020

Date accepted : 24 November 2020

Funding

Funded by: NORHED Project/ISCISA;

Award ID: Not Applicable

Funded by: UKZN - College of Health Sciences;

Award ID: Not applicable

Custom metadata

special-feature unlocked

ScienceOpen disciplines: Medicine

Keywords: public health,qualitative research,health & safety,substance misuse,anthropology,pharmacology

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ScienceOpen disciplines: Medicine

Keywords: public health, qualitative research, health & safety, substance misuse, anthropology, pharmacology

Identifying the commonly used antibiotics for self-medication in urban Mozambique: a qualitative study

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Abstract

Objectives

Design

Setting

Participants

Findings

Conclusions

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PLOS Global Public Health

Most cited references 55

Access to effective antimicrobials: a worldwide challenge.

A Brief History of the Antibiotic Era: Lessons Learned and Challenges for the Future

Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review

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