Public Knowledge and Belief Regarding Antibiotic Use and Antimicrobial Resistance in Qatar

Nesiya Hassan; Jibin Kunjavara; Kamaruddeen Mannethodi; Kalpana  Singh; Annamma  Varghese; Bincymary  Varughese; Jeena Rajan  Thomas; Hamza Mohamad  Salhab; Noor Bibi Khial Bad  Shah; Noreen Chua  Vinluan; Marivic Arroyo  Nonato; Raed Hashim  Alghazawi; Vipin  Augusthy; Rajvir Singh

doi:10.55489/njcm.131120222498

Authors

Nesiya Hassan Nursing Midwifery Research department, HMC, Qatar https://orcid.org/0000-0002-2038-4844
Jibin Kunjavara Nursing Midwifery Research department, HMC, Qatar https://orcid.org/0000-0001-6718-181X
Kamaruddeen Mannethodi Nursing Midwifery Research department, HMC, Qatar https://orcid.org/0000-0002-7051-1426
Kalpana Singh Nursing Midwifery Research department, HMC, Qatar https://orcid.org/0000-0002-2273-5062
Annamma Varghese Hamad General Hospital, HMC, Qatar
Bincymary Varughese Al- Khor Hospital, HMC, Qatar
Jeena Rajan Thomas Hamad General Hospital, HMC, Qatar
Hamza Mohamad Salhab Hamad General Hospital, HMC, Qatar
Noor Bibi Khial Bad Shah Hamad General Hospital, HMC, Qatar
Noreen Chua Vinluan Al- Khor Hospital, HMC, Qatar
Marivic Arroyo Nonato Al- Khor Hospital, HMC, Qatar
Raed Hashim Alghazawi Hamad General Hospital, HMC, Qatar https://orcid.org/0000-0003-3047-8315
Vipin Augusthy Al- Khor Hospital, HMC, Qatar
Rajvir Singh Academic Heath System, HMC, Qatar https://orcid.org/0000-0003-2756-3164

DOI:

https://doi.org/10.55489/njcm.131120222498

Keywords:

Antibiotic, Antibiotic resistance, Self-medication, Antimicrobial resistance

Abstract

Background: Antibiotics act as a therapeutic weapon in eradicating pathogens. Antibiotics are the most common group of drugs misused for self-medication. This is a global public health concern and is one of the major contributing factors to antibiotic resistance (ABR).

Objective: This study aimed to assess the knowledge and beliefs of the public in Qatar regarding appropriate antibiotic use and antimicrobial resistance.

Methods: A cross-sectional research design was used to collect the information from the participants based on an adapted questionnaire from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) between September – November 2018. The study enrolled 1000 participants who visited two large emergency departments (ED) of public hospitals in Qatar.

Results: The mean knowledge and belief scores were 55.07±15.87 and 66.57±23.13 respectively. 42% of the participants had moderate knowledge regarding antibiotic and antimicrobial resistance. The majority of the participants (64.8%) believed that antibiotics fight against bacteria and viruses. The educational level significantly influences the belief of the participants. Graduates possess a higher belief score of 11.75±12.5 (P=0.001) compared to others.

Conclusion: The key findings of this study highlighted the existing gap in knowledge among the public. A community-based health education program should be launched to raise citizen responsibility to use antibiotics judiciously.

References

Letek M. Alexander Fleming, The discoverer of the antibiotic effects of penicillin. Front. Young Minds. 2020 Jan;7:159. Doi: https://doi.org/10.3389/frym.2019.00159

Alhomoud F, Aljamea Z, Almahasnah R, et al. Self-medication and self-prescription with antibiotics in the Middle East-do they real-ly happen? A systematic review of the prevalence, possible reasons, and outcomes. International journal of infectious diseases. 2017 Apr 1;57:3-12. Doi: https://doi.org/10.1016/j.ijid.2017.01.014 PMid:28111172

Jairoun A, Hassan N, Ali A, et al. Knowledge, attitude and practice of antibiotic use among university students: a cross sectional study in UAE. BMC public health. 2019 Dec;19(1):1-8. Doi: https://doi.org/10.1186/s12889-019-6878-y PMid:31060543 PMCid:PMC6501289

Jamhour A, El-Kheir A, Salameh P, et al. Antibiotic knowledge and self-medication practices in a developing country: A cross-sectional study. American journal of infection control. 2017 Apr 1;45(4):384-8. Doi: https://doi.org/10.1016/j.ajic.2016.11.026 PMid:28087169

Awad AI, Aboud EA. Knowledge, attitude and practice towards antibiotic use among the public in Kuwait. PloS one. 2015 Feb 12;10(2):e0117910. Doi: https://doi.org/10.1371/journal.pone.0117910 PMid:25675405 PMCid:PMC4326422

Bhardwaj K, Shenoy MS, Baliga S, et al. A cross-sectional survey of community pharmacist's knowledge, behavior and attitude to-ward antibiotic dispensation, Southern Karnataka, India. Journal of Datta Meghe Institute of Medical Sciences University. 2021 Jan 1;16(1):175.

Aslam B, Wang W, Arshad MI, et al. Antibiotic resistance: a rundown of a global crisis. Infection and drug resistance. 2018;11:1645. Doi: https://doi.org/10.2147/IDR.S173867 PMid:30349322 PMCid:PMC6188119

WHO Antibiotic resistance Available at: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance Accessed December 20th, 2021.

Jinks T, Lee N, Sharland M, et al. A time for action: antimicrobial resistance needs global response. Bulletin of the World Health Or-ganization. 2016 Aug 8;94(8):558. Doi: https://doi.org/10.2471/BLT.16.181743 PMid:27516629 PMCid:PMC4969997

Amann S, Neef K, Kohl S. Antimicrobial resistance (AMR). European Journal of Hospital Pharmacy. 2019 May 1;26(3):175-7. Doi: https://doi.org/10.1136/ejhpharm-2018-001820 PMid:31428328 PMCid:PMC6684015

Aljayyousi GF, Abdel-Rahman ME, El-Heneidy A, et al. Public practices on antibiotic use: A cross-sectional study among Qatar Uni-versity students and their family members. PloS one. 2019 Nov 26;14(11):e0225499. Doi: https://doi.org/10.1371/journal.pone.0225499 PMid:31770408 PMCid:PMC6879134

Alnemri AR, Almaghrabi RH, Alonazi N, et al. Misuse of antibiotic: A systemic review of Saudi published studies. Current Pediatric Research. 2016.

Kamata K, Tokuda Y, Gu Y, et al. Public knowledge and perception about antimicrobials and antimicrobial resistance in Japan: A na-tional questionnaire survey in 2017. PLoS One. 2018 Nov 5;13(11):e0207017. Doi:https://doi.org/10.1371/journal.pone.0207017 PMid:30395640 PMCid:PMC6218087

Almohammed RA, Bird EL. Public knowledge and behaviours relating to antibiotic use in Gulf Cooperation Council countries: A sys-tematic review. Journal of infection and public health. 2019 Mar 1;12(2):159-66. Doi: https://doi.org/10.1016/j.jiph.2018.09.002 PMid:30245158

Al Omari S, Al Mir H, Wrayde S, et al. First Lebanese Antibiotic Awareness Week campaign: knowledge, attitudes and practices to-wards antibiotics. Journal of Hospital Infection. 2019 Apr 1;101(4):475-9. Doi: https://doi.org/10.1016/j.jhin.2018.07.009 PMid:30012377

Abdelmalek S, AlEjielat R, Rayyan WA, et al. Changes in public knowledge and perceptions about antibiotic use and resistance in Jor-dan: a cross-sectional eight-year comparative study. BMC public health. 2021 Dec;21(1):1-2. Doi: https://doi.org/10.1186/s12889-021-10723-x PMid:33874935 PMCid:PMC8054398

Rabbani SA, Sridhar SB, Abazer D, et al. Impact of community-based educational intervention on antibiotic use and resistance awareness among the people living in Ras Al Khaimah, United Arab Emirates. Journal of Pharmaceutical Health Services Research. 2020 Sep;11(3):197-204. Doi: https://doi.org/10.1111/jphs.12347

WHO antibiotic awareness campaigns Available at : https://www.who.int/selection_medicines/committees/expert/21/applications/s6_antibiotic_awareness_campaigns.pdf. Ac-cessed December 20th, 2021.

Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/antibiotic-use/q-a.html. Accessed December 20th, 2021.

Zajmi D, Berisha M, Begolli I, et al. Public knowledge, attitudes and practices regarding antibiotic use in Kosovo. Pharmacy Practice (Granada). 2017 Mar;15(1). Doi: https://doi.org/10.18549/PharmPract.2017.01.827 PMid:28503216 PMCid:PMC5386617

Huttner B, Saam M, Moja L, et al. How to improve antibiotic awareness campaigns: findings of a WHO global survey. BMJ global health. 2019 May 1;4(3):e001239. Doi: https://doi.org/10.1136/bmjgh-2018-001239 PMid:31179029 PMCid:PMC6528771

Shehadeh M, Suaifan G, Darwish RM, et al. Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi Pharmaceutical Journal. 2012 Apr 1;20(2):125-33. Doi: https://doi.org/10.1016/j.jsps.2011.11.005 PMid:23960783 PMCid:PMC3744980

Higuita-Gutiérrez LF, Roncancio Villamil GE, Jiménez Quiceno JN. Knowledge, attitude, and practice regarding antibiotic use and re-sistance among medical students in Colombia: a cross-sectional descriptive study. BMC public health. 2020 Dec;20(1):1-2. Doi: https://doi.org/10.1186/s12889-020-09971-0 PMid:33276767 PMCid:PMC7718705

Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations. Re-search in nursing & health. 2006 Oct;29(5):489-97. Doi: https://doi.org/10.1002/nur.20147 PMid:16977646

DeVon HA, Block ME, Moyle‐Wright P, et al. A psychometric toolbox for testing validity and reliability. Journal of Nursing scholar-ship. 2007 Jun;39(2):155-64. Doi: https://doi.org/10.1111/j.1547-5069.2007.00161.x PMid:17535316

Singh R, Agarwal TM, Al-Thani H, et al. Validation of a survey questionnaire on organ donation: An Arabic world scenario. Journal of transplantation. 2018 Feb 8;2018. Doi: https://doi.org/10.1155/2018/9309486 PMid:29593894 PMCid:PMC5822804

Qatar statistics, Qatar population Available at: www.psa.gov.qa. Accessed December 20th, 2021.

Karuniawati H, Hassali MA, Suryawati S, et al. Assessment of knowledge, attitude, and practice of antibiotic use among the popula-tion of Boyolali, Indonesia: a cross-sectional study. International journal of environmental research and public health. 2021 Aug 4;18(16):8258. Doi: https://doi.org/10.3390/ijerph18168258 PMid:34444015 PMCid:PMC8394957

SNELL B. Factors That Get in the Way of Appropriate Use of Antimicrobial Medicines in Humans.

Wang X, Lin L, Xuan Z, et al. Keeping antibiotics at home promotes self-medication with antibiotics among Chinese university stu-dents. International journal of environmental research and public health. 2018 Apr;15(4):687. Doi: https://doi.org/10.3390/ijerph15040687 PMid:29621165 PMCid:PMC5923729

Special Eurobarometer 445. Report: antimicrobial resistance. Brussels: TNS Opinion & Social, European Commission; 2016

Mazińska B, Strużycka I, Hryniewicz W. Surveys of public knowledge and attitudes with regard to antibiotics in Poland: Did the Eu-ropean Antibiotic Awareness Day campaigns change attitudes?. PloS one. 2017 Feb 17;12(2):e0172146. Doi: https://doi.org/10.1371/journal.pone.0172146 PMid:28212400 PMCid:PMC5315279

Karimy M, Rezaee-Momtaz M, Tavousi M, et al. Risk factors associated with self-medication among women in Iran. BMC public health. 2019 Dec;19(1):1-7. Doi: https://doi.org/10.1186/s12889-019-7302-3 PMid:31370891 PMCid:PMC6676788

Mason T, Trochez C, Thomas R, et al. Knowledge and awareness of the general public and perception of pharmacists about antibiotic resistance. BMC public health. 2018 Dec;18(1):1-0. Doi: https://doi.org/10.1186/s12889-018-5614-3 PMid:29884154 PMCid:PMC5994078