Knowledge, attitude, and practices regarding antibiotic use and antimicrobial resistance among urban slum dwellers in Uganda

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Abstract

Background

Antimicrobial resistance (AMR) remains a public health threat especially in low-and-middle-income countries (LMICs). Urban slum dwellers are at higher risk of developing AMR than the general population. The aim of this study was to assess the knowledge, attitude and practices (KAP) regarding antibiotic use and AMR and the associated socio-demographic determinants among urban slum dwellers in Uganda.

Methods

A cross sectional study was conducted among 371 adults of Bwaise slum in Uganda selected through multi-stage cluster sampling techniques. An interviewer administered questionnaire was used to collect data on participants’ socio-demographics, KAP regarding antibiotic use and AMR. The responses to the KAP were aggregated into scores for each participant which were later dichotomized by the mean to form the predictors variables. Analysis was done in STATA 17.0. A modified Poisson regression model was used to determine predictors of each of KAP, while considering a 5% significance level.

Results

The study enrolled 371 participants of which 238(64.2%) were females. The median (IQR) age of the participants was 31 [ 24, 40] years. Over half of the respondents, 205(55.3%) were married and 157(42.3%) had primary level education. Of all participants, 177 (47.7%), 184 (49.6%) and 205 (55.3%) had good knowledge, a positive attitude and good practices regarding antibiotic use and AMR respectively. Being single (aPR = 0.75, p-value = 0.040) was negatively associated with good knowledge of antibiotic use and resistance, while having acquired tertiary education level (aPR = 1.88, p-value < 0.001) and self-employed (aPR = 1.36, p = 0.017) were associated with good knowledge of antibiotic use and resistance. Male gender (aPR = 1.25, p-value = 0.036) and monthly income < 300,000 UGX (aPR = 1.42, p-value = 0.003) were associated with a positive attitude towards antibiotic use and resistance. Likewise tertiary level of education (aPR = 0.64, p-value = 0.033) was negatively associated with good practices of antibiotic use and resistance.

Conclusion and recommendations

Residents of urban slums have limited knowledge of antibiotic use and AMR with minimal understanding of AMR concepts. Education level, gender, occupational status are key players in people’s understanding and practices of antibiotic use and AMR. There’s need for context specific health education programs. Health promotion messaging should emphasize AMR concepts and dangers of drug misuse. Antimicrobial stewardship initiatives should trickle down to the local citizen.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13756-025-01517-6.

Related collections

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Author and article information

Contributors

Regina Ndagire: ndaginar@gmail.com

Journal

Journal ID (nlm-ta): Antimicrob Resist Infect Control

Journal ID (iso-abbrev): Antimicrob Resist Infect Control

Title: Antimicrobial Resistance and Infection Control

Publisher: BioMed Central (London )

ISSN (Electronic): 2047-2994

Publication date (Electronic): 21 February 2025

Publication date PMC-release: 21 February 2025

Publication date Collection: 2025

Volume: 14

Electronic Location Identifier: 12

Affiliations

[1 ]Africa Center for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, ( https://ror.org/03dmz0111) Kampala, Uganda

[2 ]Department of Pharmacology & Therapeutics, Makerere University, ( https://ror.org/03dmz0111) Kampala, Uganda

[3 ]School of Graduate Studies, Research and Innovations, Clarke International University, ( https://ror.org/03jfsyd35) Kampala, Uganda

[4 ]Clinical Epidemiology Unit, Makerere University College of Health Sciences, ( https://ror.org/03dmz0111) Kampala, Uganda

[5 ]Department of Global Health Security, Infectious Diseases Institute, Makerere University, ( https://ror.org/03dmz0111) Kampala, Uganda

[6 ]Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, ( https://ror.org/00a0jsq62) London, UK

Article

Publisher ID: 1517

DOI: 10.1186/s13756-025-01517-6

PMC ID: 11846299

PubMed ID: 39985071

SO-VID: 90bc616f-f13c-485a-92b3-a2158dcd2591

License:

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

History

Date received : 13 May 2024

Date accepted : 6 January 2025

Funding

Funded by: National Institute for Health Research (NIHR) through the Royal Society of Tropical Medicine and Hygiene (RSTMH) under the Early Career Grants Initiative (https://www.rstmh.org/grants/grant-awardees-2022/nihr-grant-awardees-2022).

Award ID: Not applicable

Funded by: Fogarty International Center of the National Institutes of Health, U.S. Department of State’s Office of the U.S. Global AIDS Coordinator and Health Diplomacy (S/GAC), and President’s Emergency Plan for AIDS Relief (PEPFAR)

Award ID: Award Number 1R25TW011213

Custom metadata

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: knowledge,attitude and practices (kap),antibiotic use,antimicrobial resistance,uganda

Data availability: