Knowledge And Awareness Of Antibiotic Use And Resistance:a Cross-sectional Study In Freetown,Sierra Leone

Introduction The emergence and spread of antibiotic resistance is among the most serious public health concerns threatening the health of the people globally.The misuse and overuse of antibiotics have been linked to the emergence of bacterial resistance.However,significant gaps remain in the public’s knowledge about appropriate antibiotic use and resistance development.There have been no studies regarding antibiotic use and resistance among the general public in Sierra Leone to the knowledge of the author.This study therefore explores the public’s knowledge about antibiotic use and awareness of antibiotic resistance,and also examines the strategies in place for the appropriate use of antibiotics at government hospitals providing secondary and tertiary care in Freetown,Sierra Leone.Material and Methods This was a cross-sectional study conducted between May and June 2017 using a structured questionnaire.The sample comprised 327 individuals from the general public,aged 18 years and above,recruited via convenient sampling,and 95 health personnel working at government hospitals in Freetown.Information regarding antibiotic use and resistance among the public,and strategies in place for the prudent use of antibiotics in the healthcare setting was obtained from respondents.Descriptive statistics and linear regression analysis were used to analyze the data.Results The response rate for the general public and health personnel were 90.2%(n=295)and 100%(n=95)respectively.According to the knowledge and awareness score,a vast majority of the respondents had average score(74.2%;n=219).69.8% correctly agreed that antibiotics are effective against bacterial infections;however,49.2% incorrectly agreed that antibiotics are also effective against viral infections.In terms of resistance,more respondents thought that people become resistant to antibiotics(63.4%),rather than that bacterium becomes resistant(58.3%).Age and education were found to be significantly associated with knowledge and awareness scores.Regarding strategies in place for appropriate antibiotics use in hospitals,this study found that there was no written guideline for antibiotic use,no surveillance systems for resistance monitoring,and data for antibiotics use and consumption were to a large extent not available in the hospitals.Most participants were not aware of the existence of National Medicines Policy(NMP)and a vast majority had no access to the national Essential Medicines List(EML),Standard Treatment Guidelines(STG)and national formulary.However,with the support of the Systems for Improved Access to Pharmaceuticals and Services(SIAPS)Program,there was an ongoing establishment of Drug and Therapeutic Committees(DTCs)in the three tertiary hospitals in Freetown and other district hospitals in the provinces,in order to help strengthen the pharmaceutical sector and hence minimize the irrational use of medicines by health personnel.All hospitals surveyed had infection prevention and control(IPC)committee in place.Conclusion These findings demonstrate misunderstanding among the general public about antibiotic use and resistance,and lack of sufficient strategies in place for prudent use of antibiotics in the healthcare setting,which provide avenue for the development of antibiotic resistance.