Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe [version 2; peer review: 1 approved, 2 approved with reservations]

Background Overuse of antibiotics is one of the main drivers for antimicrobial resistance (AMR). Globally, most antibiotics are prescribed in the outpatient setting. This survey aimed to explore attitudes and practices with regards to microbiology tests, AMR and antibiotic prescribing among healthca...

Full description

Bibliographic Details
Main Authors: Prosper Chonzi, Katharina Kranzer, Rashida A. Ferrand, Ioana D. Olaru, Kudzai P.E. Masunda, Rudo Chingono, Shunmay Yeung, Justin Dixon
Format: Article
Language:English
Published: Wellcome 2022-04-01
Series:Wellcome Open Research
Subjects:
Online Access:https://wellcomeopenresearch.org/articles/6-72/v2
_version_ 1827805502686363648
author Prosper Chonzi
Katharina Kranzer
Rashida A. Ferrand
Ioana D. Olaru
Kudzai P.E. Masunda
Rudo Chingono
Shunmay Yeung
Justin Dixon
author_facet Prosper Chonzi
Katharina Kranzer
Rashida A. Ferrand
Ioana D. Olaru
Kudzai P.E. Masunda
Rudo Chingono
Shunmay Yeung
Justin Dixon
author_sort Prosper Chonzi
collection DOAJ
description Background Overuse of antibiotics is one of the main drivers for antimicrobial resistance (AMR). Globally, most antibiotics are prescribed in the outpatient setting. This survey aimed to explore attitudes and practices with regards to microbiology tests, AMR and antibiotic prescribing among healthcare providers at public primary health clinics in Harare, Zimbabwe. Methods This cross-sectional survey was conducted in nine primary health clinics located in low-income suburbs of Harare between October and December 2020. In Zimbabwe, primary health clinics provide nurse-led outpatient care for acute and chronic illnesses. Healthcare providers who independently prescribe antibiotics and order diagnostic tests were invited to participate. The survey used self-administered questionnaires. A five-point Likert scale was used to determine attitudes and beliefs. Results A total of 91 healthcare providers agreed to participate in the survey. The majority of participants (62/91, 68%) had more than 10 years of work experience. Most participants reported that they consider AMR as a global (75/91, 82%) and/or national (81/91, 89%) problem, while 52/91 (57%) considered AMR to be a problem in their healthcare facilities. A fifth of participants (20/91, 22%) were unsure if AMR was a problem in their clinics. Participants felt that availability of national guidelines (89/89, 100%), training sessions on antibiotic prescribing (89/89, 100%) and regular audit and feedback on prescribing (82/88, 93%) were helpful interventions to improve prescribing. Conclusions These findings support the need for increased availability of data on AMR and antibiotic use in primary care. Educational interventions, regular audit and feedback, and access to practice guidelines may be useful to limit overuse of antibiotics.
first_indexed 2024-03-11T21:27:05Z
format Article
id doaj.art-9f1014844fc84bca92342c8790b2a05d
institution Directory Open Access Journal
issn 2398-502X
language English
last_indexed 2024-03-11T21:27:05Z
publishDate 2022-04-01
publisher Wellcome
record_format Article
series Wellcome Open Research
spelling doaj.art-9f1014844fc84bca92342c8790b2a05d2023-09-28T01:00:00ZengWellcomeWellcome Open Research2398-502X2022-04-01619797Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe [version 2; peer review: 1 approved, 2 approved with reservations]Prosper Chonzi0Katharina Kranzer1Rashida A. Ferrand2https://orcid.org/0000-0002-7660-9176Ioana D. Olaru3https://orcid.org/0000-0003-3392-9257Kudzai P.E. Masunda4Rudo Chingono5https://orcid.org/0000-0002-7061-7861Shunmay Yeung6Justin Dixon7https://orcid.org/0000-0002-9659-7926Department of Health, Harare City Council, Harare, ZimbabweDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UKDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UKDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UKDepartment of Health, Harare City Council, Harare, ZimbabweBiomedical Research and Training Institute, Harare, ZimbabweDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UKBackground Overuse of antibiotics is one of the main drivers for antimicrobial resistance (AMR). Globally, most antibiotics are prescribed in the outpatient setting. This survey aimed to explore attitudes and practices with regards to microbiology tests, AMR and antibiotic prescribing among healthcare providers at public primary health clinics in Harare, Zimbabwe. Methods This cross-sectional survey was conducted in nine primary health clinics located in low-income suburbs of Harare between October and December 2020. In Zimbabwe, primary health clinics provide nurse-led outpatient care for acute and chronic illnesses. Healthcare providers who independently prescribe antibiotics and order diagnostic tests were invited to participate. The survey used self-administered questionnaires. A five-point Likert scale was used to determine attitudes and beliefs. Results A total of 91 healthcare providers agreed to participate in the survey. The majority of participants (62/91, 68%) had more than 10 years of work experience. Most participants reported that they consider AMR as a global (75/91, 82%) and/or national (81/91, 89%) problem, while 52/91 (57%) considered AMR to be a problem in their healthcare facilities. A fifth of participants (20/91, 22%) were unsure if AMR was a problem in their clinics. Participants felt that availability of national guidelines (89/89, 100%), training sessions on antibiotic prescribing (89/89, 100%) and regular audit and feedback on prescribing (82/88, 93%) were helpful interventions to improve prescribing. Conclusions These findings support the need for increased availability of data on AMR and antibiotic use in primary care. Educational interventions, regular audit and feedback, and access to practice guidelines may be useful to limit overuse of antibiotics.https://wellcomeopenresearch.org/articles/6-72/v2AMR antibiotic resistance antibiotic use outpatientseng
spellingShingle Prosper Chonzi
Katharina Kranzer
Rashida A. Ferrand
Ioana D. Olaru
Kudzai P.E. Masunda
Rudo Chingono
Shunmay Yeung
Justin Dixon
Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe [version 2; peer review: 1 approved, 2 approved with reservations]
Wellcome Open Research
AMR
antibiotic resistance
antibiotic use
outpatients
eng
title Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe [version 2; peer review: 1 approved, 2 approved with reservations]
title_full Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe [version 2; peer review: 1 approved, 2 approved with reservations]
title_fullStr Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe [version 2; peer review: 1 approved, 2 approved with reservations]
title_full_unstemmed Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe [version 2; peer review: 1 approved, 2 approved with reservations]
title_short Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe [version 2; peer review: 1 approved, 2 approved with reservations]
title_sort knowledge attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in harare zimbabwe version 2 peer review 1 approved 2 approved with reservations
topic AMR
antibiotic resistance
antibiotic use
outpatients
eng
url https://wellcomeopenresearch.org/articles/6-72/v2
work_keys_str_mv AT prosperchonzi knowledgeattitudesandpracticesrelatingtoantibioticuseandresistanceamongprescribersfrompublicprimaryhealthcarefacilitiesinhararezimbabweversion2peerreview1approved2approvedwithreservations
AT katharinakranzer knowledgeattitudesandpracticesrelatingtoantibioticuseandresistanceamongprescribersfrompublicprimaryhealthcarefacilitiesinhararezimbabweversion2peerreview1approved2approvedwithreservations
AT rashidaaferrand knowledgeattitudesandpracticesrelatingtoantibioticuseandresistanceamongprescribersfrompublicprimaryhealthcarefacilitiesinhararezimbabweversion2peerreview1approved2approvedwithreservations
AT ioanadolaru knowledgeattitudesandpracticesrelatingtoantibioticuseandresistanceamongprescribersfrompublicprimaryhealthcarefacilitiesinhararezimbabweversion2peerreview1approved2approvedwithreservations
AT kudzaipemasunda knowledgeattitudesandpracticesrelatingtoantibioticuseandresistanceamongprescribersfrompublicprimaryhealthcarefacilitiesinhararezimbabweversion2peerreview1approved2approvedwithreservations
AT rudochingono knowledgeattitudesandpracticesrelatingtoantibioticuseandresistanceamongprescribersfrompublicprimaryhealthcarefacilitiesinhararezimbabweversion2peerreview1approved2approvedwithreservations
AT shunmayyeung knowledgeattitudesandpracticesrelatingtoantibioticuseandresistanceamongprescribersfrompublicprimaryhealthcarefacilitiesinhararezimbabweversion2peerreview1approved2approvedwithreservations
AT justindixon knowledgeattitudesandpracticesrelatingtoantibioticuseandresistanceamongprescribersfrompublicprimaryhealthcarefacilitiesinhararezimbabweversion2peerreview1approved2approvedwithreservations