Browsing by Author "Mabilika, Richard"

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Community antibiotic usage and the characterization of antibiotic resistance among common bacterial isolates in selected rural and urban districts of the DODOMA Region, Central TANZANIA
(NM-AIST, 2023-07) Mabilika, Richard
Antibiotic resistance threatens the treatment of bacterial infections globally. This cross- sectional study was conducted from August 2019 to May 2021 in Dodoma. The aim was to understand the prevalence and determinants of self-medication with antibiotics (SMA), antibiotic dispensing in community drug outlets, antibiotic prescribing in primary health care facilities and determine resistance profiles of bacterial pathogens in primary health care facilities (PHCF). Regarding SMA, 430 respondents were interviewed in Chemba District Council (rural) (161/430) and Dodoma City Council (urban) (269/430). The prevalence of SMA was 23.6% (38/161) and 23.4% (63/269) in the rural and urban respondents respectively. A shorter perceived distance to a health care facility than to a drug outlet was associated with decreased SMA practices among participants. Furthermore, 643 drug purchases were recorded in Accredited Drug Dispensing Outlets (ADDO) and community pharmacies, 84.1 % (541/643) were in Dodoma City Council (urban) and only 24.9% (160/643) purchased antibiotics. Antibiotics were dispensed in ADDO without prescriptions and beyond jurisdiction. Children <5 years accounted for over 45% (474/1021) of all the consultations recorded in the primary health care facility (PHCF); 76.3% (779/1021) of the consultations had an antibiotic with up to 55% (429/779) adherence to Standard Treatment Guidelines (STG). Pneumonia and respiratory symptoms were 16 times (adjusted OR=15.918; 95% CI: 2.151, 17.973; p = 0.007) and almost 2 times (adjusted OR=1.709; 95% CI: 1.129, 2.587; p = 0.011) more likely to prompt antibiotics, respectively. Furthermore, 621 clinical specimens were collected from out-patients in Chemba District Council (38.1%; 237/621) and Dodoma City Council (61.9%; 384/621) respectively. S. aureus (44) and E. coli (35) were the most prevalent isolates. There were high resistance rates of E. coli and S. aureus against ampicillin, ciprofloxacin and trimethoprim/sulfamethoxazole: 31.8% (14/44) of S. aureus were methicillin-resistant (MRSA). This study reports high SMA among those living close to community drug outlets, high un-prescribed antibiotic dispensing in ADDO, poor adherence to STG and relatively lower methicillin-resistant Staphylococcus aureus (MRSA) levels in PHCF. The study calls for more concerted efforts against the misuse of antibiotics as a means of confronting the emergence and spread of antibiotic resistance.
Prevalence and Predictors of Antibiotic Prescriptions at Primary Healthcare Facilities in the Dodoma Region, Central Tanzania: A Retrospective, Cross-Sectional Study
(MDPI, 2022-07-31) Mabilika, Richard; Shirima, Gabriel; Mpolya, Emmanuel
Background: Accelerated by the misuse or overuse of antibiotics, antibiotic resistance remains a global public health threat. We report the prevalence and predictors of antibiotic prescriptions in primary healthcare facilities in Dodoma, Tanzania. Methods: This retrospective cross-sectional study by medical records review was conducted in the Dodoma region, Central Tanzania. Results: In this study, children < 5 years accounted for over 45% (474/1021) of the patients consulted. The majority, 76.3% (779/1021), of consultations had an antibiotic prescribed; amoxicillin and cotrimoxazole were the most prescribed. Over 98% (766/779) of the antibiotics prescribed were on the National Essential Medicines List, but only 45% (429/779) of the antibiotic prescriptions adhered to the Standard Treatment Guidelines. The prescribing of antibiotics by clinical officers was almost 2.55 times higher than that among medical doctors (Odds Ratio (OR) = 2.546; 95% Confidence Interval (CI): 1.359, 4.769; p = 0.0035). Patients with pneumonia and upper respiratory tract infection were 15.9 (OR = 15.928; 95% CI: 2.151, 17.973; p = 0.0067) and 2 (OR = 2.064; 95% CI: 1.184, 3.600; p = 0.0106) times more likely to be prescribed antibiotics, respectively. Conclusions: We, therefore, report high rates of antibiotic prescriptions, poor adherence to standard treatment guidelines and high levels of antibiotic prescribing practices among prescribers with a diploma in clinical medicine
Prevalence and predictors of self-medication with antibiotics in selected urban and rural districts of the Dodoma region, Central Tanzania: a cross-sectional study
(Springer Nature., 2022-06-22) Mabilika, Richard; Mpolya, Emmanuel; Shirima, Gabriel
Background: Antibiotic resistance is a global health threat driven partly by self-medication with antibiotics (SMA). This study aims to assess the prevalence and predictors of SMA in selected rural and urban communities of the Dodoma region, Central Tanzania. Methods: This cross-sectional study was conducted in Chemba District Council (rural) and Dodoma City Council (urban) from August to November 2019 using multistage stratifed random sampling. Data were collected through face-to-face interviews using structured questionnaires. Results: A total of 430 respondents were interviewed in Chemba District Council (rural) (161/430) and Dodoma City Council (urban) (269/430). The prevalence of SMA was 23.6% (38/161) among rural respondents and 23.4% (63/269) among urban respondents. The median amount of SMA in both settings was 2, while the maximum amounts were 4 and 5, respectively. SMA among rural and urban participants was associated mostly with perceived cough (76.3%/82%), body pain (71.1%/41.5%) and fever (63.2%/39.7%), and amoxicillin was the most commonly used antibiotic in both settings (47.3%/41%). Rural participants who reported a shorter perceived distance to a health care facility than to a drug outlet were 58.9% less likely to practise SMA (adjusted OR: 0.421; 95% CI: 0.388, 0.458; p<0.001), whereas SMA decreased by 16.3% among urban participants who reported a shorter perceived distance to a health care facility than to a drug outlet (adjusted OR: 0.837; 95% CI: 0.755, 0.929; p<0.001). SMA was 17.3% lower among farmers than among nonfarmers in the urban area (adjusted OR: 0.827; 95% CI: 0.716, 0.955; p=0.01), while farming had no efect in the rural area. Conclusions: The prevalence of SMA is similar among participants in rural and urban districts. In both localities, a shorter perceived distance to a drug outlet is an independent risk factor for SMA, while having health insurance reduces the risk. Equally weighted interventions to reduce SMA are required in rural and urban communities.