The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis
Abstract Background The global increase in the utilization of non - prescribed antibiotics (NPA), is concerning, with high persistence within the low and middle-income countries (LMICs). With a negative impact on the health of individuals and communities the use of NPA paves the way to the propagat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Archives of Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13690-020-00517-9 |
| _version_ | 1818728422399016960 |
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| author | Neusa F. Torres Buyisile Chibi Desmond Kuupiel Vernon P. Solomon Tivani P. Mashamba-Thompson Lyn E. Middleton |
| author_facet | Neusa F. Torres Buyisile Chibi Desmond Kuupiel Vernon P. Solomon Tivani P. Mashamba-Thompson Lyn E. Middleton |
| author_sort | Neusa F. Torres |
| collection | DOAJ |
| description | Abstract Background The global increase in the utilization of non - prescribed antibiotics (NPA), is concerning, with high persistence within the low and middle-income countries (LMICs). With a negative impact on the health of individuals and communities the use of NPA paves the way to the propagation of superbugs that potentially predisposes to changes in bacterial resistance patterns, antibiotic resistance (AR) and antimicrobial resistance (AMR). This study aimed at estimating through a systematic review and meta-analysis, the prevalence of NPA utilisation and describe its primary sources in LMICs. Methods The study is a systematic review and meta-analysis which study protocol was registered in PROSPERO (CRD42017072954). The review used The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The studies searched in databases were deemed eligible if reported evidence of practices of self-medication with antibiotics (SMA) and the prevalence of NPA utilisation within adult participants from LMICs, published between 2007 to 2017. The pooled analyses were carried out using Meta XL statistical software. The pooled prevalence was calculated with a 95% confidence interval (CI). The risk of bias of the included studies was assessed using the Quality in Prognosis Studies (QUIPS) tool. Results The review included a total of 11 cross-sectional studies, involving 5080 participants and conducted in LMICs from Asia (India, Laos, Nepal, Pakistan, Sri Lanka and Yemen), Latin America (Guatemala), Africa (Nigeria). All studies reported existing practices of SMA, with reported prevalence ranging from 50% to 93,8%. The pooled prevalence of SMA was 78% (95% CI: 65–89%). The main sources of NPA were; pharmacies, family and friends, old prescriptions, home cabinet and leftover antibiotics. Conclusion This study revealed a high prevalence of utilisation of NPA in the studied LMICs, these were found to be twice as high in women than men and those participants aged between 18 and 40 years old. The review suggests f considering broader qualitative and comprehensive contextuallized research to better understand the nuances of NPA use. These would be benefitial to uncover uncover gray areas, inform decisions, support the (re) design and implementation of multifaceted interventions towards antibiotic stewardship and conservancy in LMICs. |
| first_indexed | 2024-12-17T22:29:44Z |
| format | Article |
| id | doaj.art-aa50c0c6216348ef884dded1cd597088 |
| institution | Directory Open Access Journal |
| issn | 2049-3258 |
| language | English |
| last_indexed | 2024-12-17T22:29:44Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Archives of Public Health |
| spelling | doaj.art-aa50c0c6216348ef884dded1cd5970882022-12-21T21:30:13ZengBMCArchives of Public Health2049-32582021-01-0179111510.1186/s13690-020-00517-9The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysisNeusa F. Torres0Buyisile Chibi1Desmond Kuupiel2Vernon P. Solomon3Tivani P. Mashamba-Thompson4Lyn E. Middleton5Instituto Superior de Ciências de Saúde (ISCISA)Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu NatalDiscipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu NatalDiscipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu NatalFaculty of Health Sciences, University of PretoriaDiscipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu NatalAbstract Background The global increase in the utilization of non - prescribed antibiotics (NPA), is concerning, with high persistence within the low and middle-income countries (LMICs). With a negative impact on the health of individuals and communities the use of NPA paves the way to the propagation of superbugs that potentially predisposes to changes in bacterial resistance patterns, antibiotic resistance (AR) and antimicrobial resistance (AMR). This study aimed at estimating through a systematic review and meta-analysis, the prevalence of NPA utilisation and describe its primary sources in LMICs. Methods The study is a systematic review and meta-analysis which study protocol was registered in PROSPERO (CRD42017072954). The review used The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The studies searched in databases were deemed eligible if reported evidence of practices of self-medication with antibiotics (SMA) and the prevalence of NPA utilisation within adult participants from LMICs, published between 2007 to 2017. The pooled analyses were carried out using Meta XL statistical software. The pooled prevalence was calculated with a 95% confidence interval (CI). The risk of bias of the included studies was assessed using the Quality in Prognosis Studies (QUIPS) tool. Results The review included a total of 11 cross-sectional studies, involving 5080 participants and conducted in LMICs from Asia (India, Laos, Nepal, Pakistan, Sri Lanka and Yemen), Latin America (Guatemala), Africa (Nigeria). All studies reported existing practices of SMA, with reported prevalence ranging from 50% to 93,8%. The pooled prevalence of SMA was 78% (95% CI: 65–89%). The main sources of NPA were; pharmacies, family and friends, old prescriptions, home cabinet and leftover antibiotics. Conclusion This study revealed a high prevalence of utilisation of NPA in the studied LMICs, these were found to be twice as high in women than men and those participants aged between 18 and 40 years old. The review suggests f considering broader qualitative and comprehensive contextuallized research to better understand the nuances of NPA use. These would be benefitial to uncover uncover gray areas, inform decisions, support the (re) design and implementation of multifaceted interventions towards antibiotic stewardship and conservancy in LMICs.https://doi.org/10.1186/s13690-020-00517-9Non-prescribed antibioticsPrevalenceSelf-medicationSourcesMeta-analysisAntibiotic resistance |
| spellingShingle | Neusa F. Torres Buyisile Chibi Desmond Kuupiel Vernon P. Solomon Tivani P. Mashamba-Thompson Lyn E. Middleton The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis Archives of Public Health Non-prescribed antibiotics Prevalence Self-medication Sources Meta-analysis Antibiotic resistance |
| title | The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis |
| title_full | The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis |
| title_fullStr | The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis |
| title_full_unstemmed | The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis |
| title_short | The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis |
| title_sort | use of non prescribed antibiotics prevalence estimates in low and middle income countries a systematic review and meta analysis |
| topic | Non-prescribed antibiotics Prevalence Self-medication Sources Meta-analysis Antibiotic resistance |
| url | https://doi.org/10.1186/s13690-020-00517-9 |
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