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Determinants of misuse of antibiotics among parents of children attending clinics in regional referral hospitals in Tanzania.

ABSTRACT: Parents are the important implementers on appropriate/inappropriate use of antibiotics, especially in the pediatric population. Limited studies have associated poor knowledge, attitude, and practice (KAP) among parents with antibiotics misuse. Therefore, this study was conducted to determine the parents' KAP and factors associated with inappropriate use of antibiotics among Tanzanian children. A hospital-based cross-sectional study was conducted in 14 regional referral hospitals (RRHs) in Tanzania between June and September 2020. KAP was estimated using a Likert scale, whereas KAP factors were determined using logistic regression models. A total of 2802 parents were enrolled in the study. The median age (interquartile range) of parents was 30.0 (25-36) years where 82.4% (n = 2305) were female parents. The majority of the parents had primary education, 56.1% (n = 1567). Of 2802 parents, only 10.9% (n = 298) had good knowledge about antibiotics, 16.4% (n = 455) had positive attitude whereas 82.0% (n = 2275) had poor practice on the appropriate use of antibiotics. Parents' education level, i.e., having a university degree (aOR: 3.27 95% CI 1.62-6.63, p = 0.001), good knowledge (aOR: 1.70, 95% CI 1.19-2.23, p = 0.003) and positive attitudes (aOR: 5.56, 95% CI 4.09-7.56, p < 0.001) were significantly associated with the appropriate use of antibiotics in children. Most parents had poor knowledge, negative attitude, and poor practice towards antibiotics use in children. Parents' education level, employment status, knowledge on antibiotic use, and good attitude contributed to the appropriate use of antibiotics in children attending clinics at RRHs.

SUBMITTER: Mutagonda RF

PROVIDER: S-EPMC8941073 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Determinants of misuse of antibiotics among parents of children attending clinics in regional referral hospitals in Tanzania.

Mutagonda Ritah F RF Marealle Alphonce I AI Nkinda Lilian L Kibwana Upendo U Maganda Betty A BA Njiro Belinda J BJ Ndumwa Harrieth P HP Kilonzi Manase M Mikomangwa Wigilya P WP Mlyuka Hamu J HJ Felix Fatuma F FF Myemba David T DT Mwakawanga Dorkasi L DL Sambayi Godfrey G Kunambi Peter P PP Ndayishimiye Pacifique P Sirili Nathanael N Mfaume Rashid R Nshau Arapha A Nyankesha Elevanie E Scherpbier Robert R Bwire George M GM

Scientific reports 20220322 1

Parents are the important implementers on appropriate/inappropriate use of antibiotics, especially in the pediatric population. Limited studies have associated poor knowledge, attitude, and practice (KAP) among parents with antibiotics misuse. Therefore, this study was conducted to determine the parents' KAP and factors associated with inappropriate use of antibiotics among Tanzanian children. A hospital-based cross-sectional study was conducted in 14 regional referral hospitals (RRHs) in Tanzan ...[more]

PMID: 35318386

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Project description:BackgroundEctopic pregnancy is an abnormal condition in which implantation of the blastocyst occurs outside the endometrium of the uterus. It is gynecological important, particularly in the developing world, because of associated with enormous rate of high morbidity, during the first trimester of pregnancy. A better understanding of its risk factors can help to prevent its prevalence. However, the determinants of ectopic pregnancy are not well understood and few researches conducted in our country were based on secondary data covering small scale area. This study aimed to identify determinants of ectopic pregnancy among pregnant women attending referral hospitals in Southwestern part of Oromia regional state, Southwest Ethiopia.MethodsHospital-based case control study was employed from June 1 to September 30, 2019. The study was conducted in five referral hospitals in Southwestern part of Oromia regional state. Final sample size includes 59 cases and 118 controls. Data were entered by using Epidata version 3.1 and analyzed using SPSS version 23. Descriptive statistics were used to explore the data. All explanatory variables with p-value of < 0.25 in bi-variable analysis, then entered into multivariable logistic regression. Associated factors were identified at 95% confidence interval (p < 0.05).ResultsOut of 177 (59 cases and 118 controls) participants, 174 (58 cases and 116 controls) were participating in the study. Prior two or more induced abortions [AOR = 3.95:95% CI: 1.22-13.05], previous history of caesarean section [AOR = 3.4:95% CI: 1.11-10.94], marital status (being single) [AOR = 4.04:95%CI: 1.23-13.21], reporting prior recurrent sexual transmitted infection [AOR = 2.25:95%CI: 1.00-5.51], prior history of tubal surgery [AOR = 3.32:95%CI: 1.09-10.13], were more likely to have an ectopic pregnancy with their respective AOR with 95%CI.ConclusionIt was found that having a history of more than two induced abortions during previous pregnancies, marital status (single), recurrent sexual transmitted infection, prior history of tubal surgery and experiencing prior caesarean section were found to be determinants of ectopic pregnancy. Hospitals should give emphasis on prevention and early detection of risks of ectopic pregnancy and create awareness in order to reduce the burden of ectopic pregnancy.

Project description:IntroductionSalmonella is one of the most common causes of food-borne outbreaks and infection worldwide. Non-typhoidal Salmonella (NTS) infections are common and remain a significant public health problem among important bacterial foodborne diseases. The current study aimed to establish the Non typhoidal Salmonella infection and antimicrobial resistance status among selected patients at Morogoro Regional Referral Hospital (MRRH), Morogoro Region, Tanzania, to inform clinical care management and public health interventions.MethodologyA cross-sectional study was conducted using medical records and samples were collected from hospitalised and outpatients between October and December 2021. A total of 153 participants were enrolled in the study and 132 consented to being sampled. The collected samples were analysed using standard microbiological techniques. The isolates were subjected to molecular genotyping, where Polymerase Chain Reaction (PCR) was performed targeting the 16S rDNA gene. PCR products were then submitted for sequencing to establish phylogenetic relatedness. Antimicrobial susceptibility testing and resistance genes screening were also conducted.ResultsThe phylogenetic analysis identified two Salmonella serovars; Salmonella Enteritidis and Salmonella Typhimurium. The isolates were from four adults and seven children patients. The isolates were tested against six antimicrobial agents: tetracycline, trimethoprim, gentamycin, ciprofloxacin, ampicillin and cefotaxime. Further antimicrobial assays were performed by screening 10 antimicrobial resistance genes using PCR. Overall, the highest resistance was observed in ampicillin (100%), whereas the lowest resistance was recorded for ciprofloxacin and gentamicin (9.1%). In addition, four (36.4%) of the isolates were resistant to cefotaxime and three (27.3%) to tetracycline and trimethoprim. The isolates also exhibit the presence of resistance genes for sulfamethoxazole 1&2, tetracycline (tet) A&B, Beta-lactamase CTXM, Beta-lactamase TEM, Beta-lactamase SHV, Gentamycine, Acra and acc3-1 in different occurrences. The overall prevalence of Salmonella species in Morogoro region was 8.3% (11/132) with Salmonella Enteritidis and Salmonella Typhimurium being the only serovars detected from adults and children stool samples.ConclusionOur investigation showed that both children and adults had been exposed to Salmonella spp. However, the occurrence of NTS was higher in children (5.3% (7/132) compared to adults (3.0% (4/132). To stop zoonotic infections and the development of antimicrobial resistance in the community, this calls for Infection Prevention and Control (IPC) and stewardship programmes on rational use of antimicrobials in both health facilities and at the community level.

Project description:IntroductionHealth insurance coverage is critical for persons living with chronic conditions such as heart failure. Lack of health insurance may affect the ability to access regular healthcare appointments, pay for medication refills which can result in frequent hospitalization that is associated with poor clinical outcomes. In scarce resource locations such as sub-Saharan Africa, where uptake of health insurance is still suboptimal, the effect of health insurance on chronic conditions such as heart failure is poorly understood. The objective of this study was to assess the association of health insurance on the severity of heart failure for patients attending outpatient clinics at tertiary hospitals in Mwanza, Tanzania.MethodsAs part of a larger cohort study, patients with heart failure were recruited from Bugando Medical Center (BMC) and Sekou Toure Regional Hospital (STRH) in Mwanza City, Tanzania. Heart failure was based on Framingham criteria and the severity was determined by New York Heart Association (NYHA) classification. Descriptive analysis and multivariable logistic regression were used to describe the study participants and to assess the association between health insurance status and the severity of heart failure at baseline.Results418 patients were enrolled, and majority were female (n = 264, 63%), small scale farmers (n = 278, 66.5%) and were from Mwanza City (n = 299, 71.5%). More than two-thirds of patients did not have health insurance (n = 295, 70.6%) and the majority were in the NYHA I and II classification (n = 267, 64.7%). There was no association between health insurance status and the severity of heart (aOR 0.97; 95% CI 0.84-1.60). Being male, small-scale businessperson and those seen at STRH was associated with higher odds of being in NYHA Class III/IV (aOR = 1.97; 95% CI: 1.21-3.17), (aOR = 2.61; 95% CI: 1.27-5.34) and (aOR 1.91 95% CI: 1.17-3.13) respectively. Having secondary and college education was associated with lower odds of being in Class III/IV (0.42; 95% CI: 0.18-0.98) and (aOR = 0.23 95% CI: 0.06-0.86) respectively.ConclusionIn this study, only a third of the patients had health insurance. Health insurance was not associated with the severity of heart failure. Since heart failure is a chronic condition patients who do not have health insurance may incur out of pocket expenses, future research should focus on the effect of out-of-pocket expenditures on clinical outcomes.

Project description:BackgroundColorectal cancer (CRC) is one of the top ten causes of cancer deaths in the world. Despite an increased prevalence of colorectal cancer has been documented from developing countries, there is no any report regarding gut microbiota among colorectal cancer patients in Ethiopia. Therefore, the current study evaluated cultivable aerobic gut bacterial distributions among malignant and its adjacent normal biopsies of CRC patients.MethodsCRC patients who were under colorectal cancer resection surgery during April 2017 to February 2018 at Felege Hiwot Referral and University of Gondar Teaching Hospitals enrolled in the study. Biopsy specimens were taken from malignant and its adjacent normal-appearing tissues. Bacterial cultivation, quantification and characterization of saline washed biopsies were performed under aerobic and candle jar conditions. Differences in bacterial microbiota compositions between malignant and normal tissue biopsies were evaluated and analyzed using Microsoft excel 2010 and GraphPad Prism5 statistical software.ResultsFifteen CRC patients were participated with a mean age of 53.8 ± 10.8 years old and majorities (73.3 %) of patients were in between the age groups of 40 and 60 years old. The mean ± SD bacterial microbiota of malignant biopsies (3.2 × 105 ± 1.6 × 105 CFU/ml) was significantly fewer than that of adjacent normal tissue biopsies (4.0 × 105 ± 2.2 × 105 CFU/ml). This dysbacteriosis is positively correlated with the occurrence of CRC (p = 0.019). Proteobacteria (55.6 %), Firmicutes (33.3 %) and Fusobacteria (11.1 %) were the most frequently isolated phyla from non-malignant biopsies while only Proteobacteria (58.8 %) and Firmicutes (41.2 %) were from malignant ones. Family level differences were observed among phyla (Firmicutes and Proteobacteria) isolated from the study participants. For instance, the relative abundance of family Bacillaceae from malignant (26 %) was lower than the normal biopsies (39 %). On other hand, family Enterobacteriaceae was twice more abundant in malignant tissues (45 %) than in its matched normal tissues (23 %). Furthermore, the family Enterococcaceae (14 %) of phylum Firmicutes was solely isolated from malignant tissue biopsies.ConclusionsThe overall microbial composition of normal and malignant tissues was considerably different among the study participants. Further culture independent analysis of mucosal microbiota will provide detail pictures of microbial composition differences and pathogenesis of CRC in Ethiopian settings.

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Project description:BackgroundPelvic organ prolapse is a common disorder, with up to 40% of women worldwide having some form of anatomical prolapse, and it is a significant public health problem in developing countries including Ethiopia. The prevalence of pelvic organ prolapse in Ethiopia is 13% in Benchi Maji. This study is designed to provide information about the determinants of pelvic organ prolapse among gynecologic patients attending public referral hospitals in the Amhara region, 2020.MethodInstitution-based unmatched case-control study design was conducted from March to June 2020 among randomly selected 348 mothers (116 cases and 232 controls). A convenient sampling technique was used to select cases, and controls were selected by systematic random sampling technique. A pre-tested and structured interviewer-administered questionnaire was used to collect the data. Data were coded and entered into Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Finally, adjusted odds ratio and 95% confidence intervals were used to declare statistical significance.ResultThe result showed that being unable to read and write (illiterate) (adjusted odds ratio = 3.91; 95% confidence interval = 1.06-14.39), age of women >= 40 (adjusted odds ratio = 2.91; 95% confidence interval = 1.255-6.736), giving first birth before age of 20 (adjusted odds ratio = 5.72; 95% confidence interval = 1.73-18.94), carrying heavy objects (adjusted odds ratio = 2.296; 95% confidence interval = 1.102-4.785), parity ⩾ 4 (adjusted odds ratio = 7.02; 95% confidence interval = 1.16-42.45), and family history of pelvic organ prolapse (adjusted odds ratio = 3.09; 95% confidence interval = 1.24-7.71) were significantly associated with pelvic organ prolapse.ConclusionThis study concluded that being unable to read and write, age ⩾ 40, multiparity, family history of pelvic organ prolapse, early childbirth, and carrying heavy objects were the risk factors of pelvic organ prolapse. Providing health education on planning the number of children, and the impact of carrying heavy loads on pelvic organs, preventing early childbirth, and encouraging women to pursue their education at least up to primary school level is recommended.

Dataset Information

Determinants of misuse of antibiotics among parents of children attending clinics in regional referral hospitals in Tanzania.

Publications

Determinants of misuse of antibiotics among parents of children attending clinics in regional referral hospitals in Tanzania.

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