An Assessment of Knowledge, Attitude, and Practice of Medical Professionals on Factors Related to Antimicrobial Resistance in Three (3) Selected University Teaching Hospital Complexes in Sierra Leone: A Cross-Sectional Analytic Study

Download Article

DOI: 10.21522/TIJPH.2013.11.03.Art022

Authors : Aminata Tigiedankay Koroma, Sulaiman Lakoh, Amitabye Luximon-Ramma, Joseph Sam Kanu, James Sylvester Squire, Kadijatu Nabie Kamara, Binta Bah, Solomon Sogbeh, Josephine Amie Koroma, Fatmata Bangura, Zikan Koroma, Mohamed Alex Vandi, Abdul Razak Mansaray, Ishata Nannie, Ibrahim Franklyn Kamara, Amarina Adama Koroma, Gebrekrstos Negash Gebru, Adel Hussein Elduma Abdalla, Frederic Bontango Kweme, Pierre Yassa Yoniene

Abstract:

Although the growing increase of AMR is a major problem everywhere, developing nations like Sierra Leone are particularly at higher risk because of their limited resources to combat the problem. Medical Professionals are recognized as important determinants of antimicrobial abuse. To evaluate factors related to antimicrobial resistance patterns, a cross-sectional study was undertaken among 376 Medical Professionals. Doctors, nurses, pharmacists, laboratory Personnel and community health officer from three Sierra Leone University Teaching Hospital Complexes in Sierra Leone, formed the study population. KAP dimensions were assessed, and differences between groups were investigated, using descriptive statistics tests. The study highlighted the socio-demographic factors of health professionals (age, gender, profession, qualification, and years of experience) that were associated with antibiotic resistance training (p < 0.05). In the area of attitude towards antibiotics, 54% (203) and 72.9% (274) of study participants recommended that pharmacy staff be at their workstations to deliver services and dispense antibiotics prescribed by authorized prescribers as recommended by the Ministry of Health. Out of the total survey participants, 54.5% suggested antibiotics for laboratory-confirmed diseases. To prevent antibiotic resistance, 72.9% of survey participants advised patients to finish antibiotics. This study revealed the need for pharmacy staff to always be available to provide services and dispense antibiotics. Healthcare professionals must be monitored to combat AMR. More research is needed to understand and improve antibiotic stewardship practices in Sierra Leone.

Keywords: Antibiotic, Attitude, Knowledge, Practice, Resistance.

References:

[1] World Health Organization. Antimicrobial resistance: global report on surveillance [Internet]. World Health Organization; 2014 [cited 2023 Jul 22]. xxii, 232 p. Available from: https://apps.who.int/iris/handle/10665/112642.
[2] Murray CJL, Ikuta KS, Sharara F, Swetschinski L, Robles Aguilar G, Gray A, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022 Feb;399(10325):629–55.
[3] National Academies of Sciences E, Division H and M, Practice B on PH and PH, States C on the LTH and EE of AR in the U, Palmer GH, Buckley GJ. The Health and Economic Burden of Resistance. In: Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine [Internet]. National Academies Press (US); 2021 [cited 2023 Aug 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK577288/.
[4] Jasovský D, Littmann J, Zorzet A, Cars O. Antimicrobial resistance—a threat to the world’s sustainable development. Ups J Med Sci. 2016 Aug;121(3):159–64.
[5] Tadesse BT, Ashley EA, Ongarello S, Havumaki J, Wijegoonewardena M, González IJ, et al. antimicrobial resistance in Africa: a systematic review. BMC Infectious Diseases. 2017 Sep 11;17(1):616.
[6] AMR Review Paper - Tackling a crisis for the health and wealth of nations_1.pdf [Internet]. [cited 2022 Aug 12]. Available from: https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf.
[7] Kariuki S, Kering K, Wairimu C, Onsare R, Mbae C. Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? Infect Drug Resist. 2022 Jul 7; 15:3589–609.
[8] World Health Organization. Worldwide country situation analysis: response to antimicrobial resistance [Internet]. Geneva: World Health Organization; 2015 [cited 2021 Dec 9]. 42 p. Available from: https://apps.who.int/iris/handle/10665/163468.
[9] World Health Organization. Global action plan on antimicrobial resistance [Internet]. Geneva: World Health Organization; 2015 [cited 2023 Jul 25]. 28 p. Available from: https://apps.who.int/iris/handle/10665/193736.
[10] Hu Y, Wang X, Tucker JD, Little P, Moore M, Fukuda K, et al. Knowledge, Attitude, and Practice with Respect to Antibiotic Use among Chinese Medical Students: A Multicentre Cross-Sectional Study. Int J Environ Res Public Health. 2018 Jun;15(6):1165.
[11] Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev. 2017 Feb 9;2017(2):CD003543.
[12] Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015 Oct;109(7):309–18.
[13] Lakoh S, John-Cole V, Luke RDC, Bell N, Russell JBW, Mustapha A, et al. Antibiotic use and consumption in Freetown, Sierra Leone: A baseline report of prescription stewardship in outpatient clinics of three tertiary hospitals. IJID Reg. 2023 Feb 20; 7:43–51.
[14] Barchitta M, Sabbatucci M, Furiozzi F, Iannazzo S, Maugeri A, Maraglino F, et al. Knowledge, attitudes and behaviors on antibiotic use and resistance among healthcare workers in Italy, 2019: investigation by a clustering method. Antimicrobial Resistance & Infection Control. 2021 Sep 10;10(1):134.
[15] Liu C, Liu C, Wang D, Zhang X. Knowledge, Attitudes and Intentions to Prescribe Antibiotics: A Structural Equation Modeling Study of Primary Care Institutions in Hubei, China. Int J Environ Res Public Health. 2019 Jul;16(13):2385.
[16] Kamara IF, Tengbe SM, Fofanah BD, Bunn JE, Njuguna CK, Kallon C, et al. Infection Prevention and Control in Three Tertiary Healthcare Facilities in Freetown, Sierra Leone during the COVID-19 Pandemic: More Needs to Be Done! Int J Environ Res Public Health. 2022 Apr 26;19(9):5275.
[17] Tasneem U, Siddiqui M, Faryal R, Shah A. Prevalence, and antifungal susceptibility of Candida species in a tertiary care hospital in Islamabad, Pakistan. Journal of the Pakistan Medical Association. 2017 Jul 1; 67:986–91.
[18] Nguyen NT, Wereley ST, Shaegh SAM. Fundamentals and Applications of Microfluidics, Third Edition. Artech House; 2019. 567 p.
[19] Liu X, He P, Chen W, Gao J. Improving Multi-Task Deep Neural Networks via Knowledge Distillation for Natural Language Understanding [Internet]. arXiv; 2019 [cited 2023 Jul 22]. Available from: http://arxiv.org/abs/1904.09482.
[20] Kanyike AM, Olum R, Kajjimu J, Owembabazi S, Ojilong D, Nassozi DR, et al. antimicrobial resistance and rational use of medicine: knowledge, perceptions, and training of clinical health professions students in Uganda. Antimicrobial Resistance & Infection Control. 2022 Nov 25;11(1):145.
[21] Erku DA. Antimicrobial Stewardship: A Cross-Sectional Survey Assessing the Perceptions and Practices of Community Pharmacists in Ethiopia. Interdisciplinary Perspectives on Infectious Diseases [Internet]. 2016 Nov 22 [cited 2023 Jan 26];2016. Available from: https://www.hindawi.com/journals/ipid/2016/5686752/.
[22] McNulty CAM, Cookson BD, Lewis MAO. Education of healthcare professionals and the public. J Antimicrob Chemother. 2012 Jul;67 Suppl 1: i11-18.
[23] Kalungia AC, Mwambula H, Munkombwe D, Marshall S, Schellack N, May C, et al. antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice. J Chemother. 2019;31(7–8):378–87.
[24] Nathwani D, Varghese D, Stephens J, Ansari W, Martin S, Charbonneau C. Value of hospital antimicrobial stewardship programs [ASPs]: a systematic review. Antimicrobe Resist Infect Control. 2019 Feb 12;8(1):35.