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Prescribers’, Dispensers’ and Users’ Knowledge, Attitudes and Practices Relative to Antimicrobial Resistance in Douala, Cameroon

Received: 4 August 2022    Accepted: 24 August 2022    Published: 5 September 2022
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Abstract

Antimicrobial resistance (AMR) is one of the most serious threats to global health today. It is now expanding exponentially in all regions of the world. Every day, new resistance mechanisms are emerging and spreading globally, compromising our ability to treat the most common infectious diseases. Given the fact that on AMR is insufficient in Cameroun our country, this study aimed to identify some determinants of AMR. A descriptive cross-sectional study was conducted. Convenience non-probabilistic sampling was chosen. Participants enrolled were: prescribers, providers and users of antimicrobials in Douala III subdivisions from Cameroun. Recruitment was done using a questionnaire, while the laboratories were described via an observation grid. The Chi 2 test was done with a significance rate of 5% and a 95% confidence interval. 300 participants and 12 laboratories were identified, the female gender was the most represented with 59%, the age group the most represented was that of 26- years and nurses represent (56%) of the prescribers. The informal sector was overwhelmingly represented by pharmacy salespersons (55%), most of whom were antimicrobial dispensers (53%). The AMR problem was perceived by the vast majority of the population as a problem in practice, locally and nationally. The management of AM waste was mainly done in dustbins, returned to the source and incinerators depending on the target (users, dispensers). The only laboratory with a quality system had an adequate technical platform for diagnosis. Standardized protocols were not available in some, nor commonly used in the mostly private laboratories. Users resorted first to street vendors, then to pharmacies and finally to hospitals. Antibiotics were the most widely used, prescribed and dispensed antimicrobials. Some baseline characteristics significantly influence antimicrobial resistance. Efforts remain to be made in all sectors such as user awareness, regulation of antimicrobial prescribing and implementation of a national action plan.

Published in World Journal of Public Health (Volume 7, Issue 3)
DOI 10.11648/j.wjph.20220703.13
Page(s) 111-118
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Knowledge, Attitudes, Practices, Antimicrobial Resistance, Douala

References
[1] Centers of Disease Control and Prevention. Antibiotic resistance threats in the United States. U.S. department of health and human services, United States. 2013; pp: 31–57. Available on www.cdc.gov/drugresistance/threat-report-2013/
[2] Schlemmer B. Regulation of antibiotics use: objectives, means and prospects Scientific and medical publications Elsevier SAS. 2000; 403-4083.
[3] Assar A, Abdelraoof MI, Abdel-Maboud M, Shaker KH, Menshawy A, Swelam AH and al. Knowledge, Attitudes and practices of Egypt’s future physicians towards antimicrobial resistance (KAP-AMR study): a multicenter cross-sectional study. Environmental Science and Pollution Research. 2020; 27 (17): 21292-8.
[4] WHO (2015). Worlwide Country Situation Analysis: Response to Antimicrobial Resistance. WHO. Available at http://apps.who.int/iris/handle/10665/163473
[5] Ayukekbong JA, Ntemgwa M and Atabe AN. The threat of antimicrobial resistance in developing countries: causes and control strategies. Antimicrobial Resistance and Infection Control. 2017; 6 (1): 1-8.
[6] Yeon Sook Cho, Byung Soo Kim, Chan Kyu Sim, Inki Kim, Myeong Sup Lee Nord –west PLOS ONE 2018; 13 (3).
[7] WHO. Antimicrobial resistance. 2018. Available at who.int/news-room/facts-n-pictures/detail/antimicrobial-resistance
[8] Dr MOSTAFA DIDOUH. The determinants of the prescription of antibiotics in the hospital, case of the Mohamed v hospital in Meknes) Final dissertation MOSTAFA DIDOUH July 2017).
[9] Oumor Bassoum, Ndeyemareine Mayassine, and al; In Subsaharan Africa Assessment of generalpublics knowledge and opinions to words antibiotic use and bacterial resistance. A cross sectional study in an urban setting Rufiq, Senegal pharmacy September 2018 (6) P103.
[10] David Darmon, Manon Belhassen, Sophie Quien, Carole Langlois, Pascal Staccini, Laurent Letrilliart. Factors associated with drug prescribing in general practice: a multicenter cross-sectional study; Public health. 2015/3 (Vol. 27), pages 353 to 362.
[11] Statistical directory of the Littoral region by the national institute of statistics Agence Régionale du Littoral; Edition 2015.
[12] Davey P. The 2015 Garrod lecture: why is improvement difficult?. Journal of Antimicrobial Chemotherapy. 2015; 70 (11): 2931-44.
[13] Hulscher ME, Grol RP, van der Meer JW. Antibiotic prescribing in hospitals: a social and behavioural scientific approach. Lancet Infect Dis. 2010; 10: 167-5.
[14] Fasina FO, LeROUX-Pullen, Smith P, Debusho LK, Shittu A, Jajere SM and al. Knowledge, Attitudes and perceptions associated with antimicrobial stewardship among veterinary students: A multi-country survey from Nigeria, South Africa and Sudan. Frontiers in public health. 2020; 8: 517964.
[15] BassoumO., MayassineN., et all; In Subsaharan Africa Assessment of general publics knowledge and opinions to words antibiotic use and bacterial resistance. A cross sectional study in an urban setting Rufiq, Senegal pharmacy September 2018; 15 (6): 103.
[16] Celine Brochier, Joseph AIGUIER. Origin and evolution of microorganisms, 1340.2. Maseille Cedex 20, France.
[17] Kalam MA, Rahman MS, Alim MA, Shano S, Afrose S, Jalal FA and al. Knowledge, Attitudes and common practices of livestock and poultry veterinary practitioners on AMU and AMR in Bangladesh. Antibiotics (Basel). 2022.
[18] Kalam MA, Alim MA, Shano S, Nayem MR, Badsha MR, Mamun MA and al. Knowledge, Attitudes and practices on antimicrobial use and antimicrobial resistance among poultry drug and feed sellers in Bangladesh. Veterinary Sciences. 2021; 8 (6): 111.
[19] Phillipe TELLIER. Antimicrobial resistance factor. The opinion of the general public.antibioresponsible.fr Dis 2016. 16: 465.
[20] Smira AZZEGAG. Antimicrobial resistance. misuse of drugs implicated Sud Horizons 27 Mars 2019.
[21] Jin J, Sklar GE, Min Sen Oh V, Chuen Li S. Factors affecting therapeutic non-compliance: A review from the patient’s perspective. Ther Clin Risk Manag. 2008; 4 (1): 269-86.
[22] H. C. WEGENER, F. BAGER, F. BAGER Surveillance de la RAM chez l’Homme 2. N°3 Mars 1997.
[23] OUEDRAOGO A. S. Jean Pierre H., BANULS A. L. GORDEUI S. Emergence and spread of antimicrobial resistance in West Africa. Medicine and tropical health. February 2006.
[24] J. F. ASCAR, G. MALIN. Antimicrobial resistance. A complex issue Dev Sci Tech of Int 2012. 31 (1). 23-31.
[25] Julie Perron, B. Pharm., M.Sc., Mélanie Gilbert, B. Pharm, M.Sc., Vincent Nault, B.Sc., Mathieu Beaudoin, M.Sc., Louis Valiquette, M.D., M.Sc., FRCPC. 6th MIM Pan-African Malaria ConferenceDurban, moving towards malaria elimination: investing in research and control combi South Africa 6-11 October 2013.
[26] Genga EK, Achieng L, Njiri F, Ezzi MS. Knowledge, Attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a hospital setting in Nairobi, Kenya. Knowledge, Attitudes and practices survey about antimicrobial resistance and prescribing among physicians in a hospital setting in Nairobi, Kenya Risk factors for pulmonary Tuberculosis Treatment failure in rural settings in Benin, West Africa: A cohort study. 2017; 3.
[27] Darmon D., BELHASSEN M., Quien S., Langlois C., Pascal Staccini, Laurent Letrilliart. Factors associated with drug prescribing in general practice: a multicenter cross-sectional study. Public health 2015; 3 (27): pages 353 à 362.
[28] Nickerson EK, Hongsuwan M, Limmathurotsakul D, Wuthiekanun V, Shah KR, Srisomang P. Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance. PLoS One. 2009; 4, e4308.
[29] Balamurugan E, Ganesh K. Prevalence and Pattern of self-medication use in coastal regions of South India. BJMP. 2011; 4 (3): a428.
[30] World Health Organization. The World Medicines Situation. Geneva, Switzerland: WHO; 2011. http://www.who.int/medicines/areas/policy/ world_medicines_situation/WMS_ch6_wPricing_v6.pdf. Accessed on 22 June 2015.
[31] Christophe Commeyras, Jean Rolin Ndo, Omar Merabet, Hamidou Kone, Faraniaina Patricia Rakotondrabe. Behavior of seeking care and drugs in Cameroon Cahiers Santé vol. 16, n° 1, janvier-février-mars 2006.
[32] Jeannette W., From the quest to the consumption of medicine in Cameroon. International Review of Medicines, vol. 3, 2010.
[33] Iruka N. Okeke, Adebayo Lamikanra and Robert Edelman, Socioeconomic and Behavioral Factors Leading to Acquired Bacterial Resistance to Antibiotics in Developing Countries. Emerging Infectious Diseases Vol. 5, No. 1, January. February 1999.
[34] Noel Essomba, Dieudonné Adiog, Jolivet Essome Mbole, Léopold Lehman, Yves Coppieters. habits of drug supply by the populations of a semi-rural town in Cameroon. Health Sci. Dis: Vol 15 (4) October- November-December 2014 Available at www.hsd-fmsb.org
[35] Andrew Nyerere Kimang’a. A situational analysis of antimicrobial drug resistance in africa: are we losing the battle? Ethiop J Health Sci. Vol. 22, No. 2 July 2012.
[36] R. Pouillot, C. Bilong, P. Boisier, M. Ciss, A. Moumouni, I. Amani & P. Nabeth. The informal drug circuit in Yaoundé and Niamey: study of the population of sellers and the quality of the drugs distributed. Bull Soc Pathol Exot, 2008, 101, 2, 113-118.
[37] Moses Ocan, Ekwaro A. Obuku, Freddie Bwanga, Dickens Akena, Sennono Richard, Jasper Ogwal-Okeng and Celestino Obua1 Ocan et al. Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries. BMC Public Health (2015) 15: 742 DOI 10.1186/s12889-015-2109-3.
[38] Ouedraogo A. S., Jean Pierre H., Banuls A. L., Oue´draogo R., Godreuil S. Emergence and spread of antibiotic resistance in West Africa: contributing factors and threat assessment. Tropical Medicine and Health 2017; 27: 147-154.
Cite This Article
  • APA Style

    Cecile Ingrid Djuikoue, Cedric Dylan Seugnou Nana, Ngaleu Ngouambe Audrey Pamela, Dorine Ngatcheu Ekeu, Grace Wanda, et al. (2022). Prescribers’, Dispensers’ and Users’ Knowledge, Attitudes and Practices Relative to Antimicrobial Resistance in Douala, Cameroon. World Journal of Public Health, 7(3), 111-118. https://doi.org/10.11648/j.wjph.20220703.13

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    ACS Style

    Cecile Ingrid Djuikoue; Cedric Dylan Seugnou Nana; Ngaleu Ngouambe Audrey Pamela; Dorine Ngatcheu Ekeu; Grace Wanda, et al. Prescribers’, Dispensers’ and Users’ Knowledge, Attitudes and Practices Relative to Antimicrobial Resistance in Douala, Cameroon. World J. Public Health 2022, 7(3), 111-118. doi: 10.11648/j.wjph.20220703.13

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    AMA Style

    Cecile Ingrid Djuikoue, Cedric Dylan Seugnou Nana, Ngaleu Ngouambe Audrey Pamela, Dorine Ngatcheu Ekeu, Grace Wanda, et al. Prescribers’, Dispensers’ and Users’ Knowledge, Attitudes and Practices Relative to Antimicrobial Resistance in Douala, Cameroon. World J Public Health. 2022;7(3):111-118. doi: 10.11648/j.wjph.20220703.13

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  • @article{10.11648/j.wjph.20220703.13,
      author = {Cecile Ingrid Djuikoue and Cedric Dylan Seugnou Nana and Ngaleu Ngouambe Audrey Pamela and Dorine Ngatcheu Ekeu and Grace Wanda and Celianthe Guegang Guegang and Wega Farid and Benjamin Longo-Mbenza and Tchokonte-Nana Venant and Dieudone Adiogo and Omer Njajou},
      title = {Prescribers’, Dispensers’ and Users’ Knowledge, Attitudes and Practices Relative to Antimicrobial Resistance in Douala, Cameroon},
      journal = {World Journal of Public Health},
      volume = {7},
      number = {3},
      pages = {111-118},
      doi = {10.11648/j.wjph.20220703.13},
      url = {https://doi.org/10.11648/j.wjph.20220703.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20220703.13},
      abstract = {Antimicrobial resistance (AMR) is one of the most serious threats to global health today. It is now expanding exponentially in all regions of the world. Every day, new resistance mechanisms are emerging and spreading globally, compromising our ability to treat the most common infectious diseases. Given the fact that on AMR is insufficient in Cameroun our country, this study aimed to identify some determinants of AMR. A descriptive cross-sectional study was conducted. Convenience non-probabilistic sampling was chosen. Participants enrolled were: prescribers, providers and users of antimicrobials in Douala III subdivisions from Cameroun. Recruitment was done using a questionnaire, while the laboratories were described via an observation grid. The Chi 2 test was done with a significance rate of 5% and a 95% confidence interval. 300 participants and 12 laboratories were identified, the female gender was the most represented with 59%, the age group the most represented was that of 26- years and nurses represent (56%) of the prescribers. The informal sector was overwhelmingly represented by pharmacy salespersons (55%), most of whom were antimicrobial dispensers (53%). The AMR problem was perceived by the vast majority of the population as a problem in practice, locally and nationally. The management of AM waste was mainly done in dustbins, returned to the source and incinerators depending on the target (users, dispensers). The only laboratory with a quality system had an adequate technical platform for diagnosis. Standardized protocols were not available in some, nor commonly used in the mostly private laboratories. Users resorted first to street vendors, then to pharmacies and finally to hospitals. Antibiotics were the most widely used, prescribed and dispensed antimicrobials. Some baseline characteristics significantly influence antimicrobial resistance. Efforts remain to be made in all sectors such as user awareness, regulation of antimicrobial prescribing and implementation of a national action plan.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Prescribers’, Dispensers’ and Users’ Knowledge, Attitudes and Practices Relative to Antimicrobial Resistance in Douala, Cameroon
    AU  - Cecile Ingrid Djuikoue
    AU  - Cedric Dylan Seugnou Nana
    AU  - Ngaleu Ngouambe Audrey Pamela
    AU  - Dorine Ngatcheu Ekeu
    AU  - Grace Wanda
    AU  - Celianthe Guegang Guegang
    AU  - Wega Farid
    AU  - Benjamin Longo-Mbenza
    AU  - Tchokonte-Nana Venant
    AU  - Dieudone Adiogo
    AU  - Omer Njajou
    Y1  - 2022/09/05
    PY  - 2022
    N1  - https://doi.org/10.11648/j.wjph.20220703.13
    DO  - 10.11648/j.wjph.20220703.13
    T2  - World Journal of Public Health
    JF  - World Journal of Public Health
    JO  - World Journal of Public Health
    SP  - 111
    EP  - 118
    PB  - Science Publishing Group
    SN  - 2637-6059
    UR  - https://doi.org/10.11648/j.wjph.20220703.13
    AB  - Antimicrobial resistance (AMR) is one of the most serious threats to global health today. It is now expanding exponentially in all regions of the world. Every day, new resistance mechanisms are emerging and spreading globally, compromising our ability to treat the most common infectious diseases. Given the fact that on AMR is insufficient in Cameroun our country, this study aimed to identify some determinants of AMR. A descriptive cross-sectional study was conducted. Convenience non-probabilistic sampling was chosen. Participants enrolled were: prescribers, providers and users of antimicrobials in Douala III subdivisions from Cameroun. Recruitment was done using a questionnaire, while the laboratories were described via an observation grid. The Chi 2 test was done with a significance rate of 5% and a 95% confidence interval. 300 participants and 12 laboratories were identified, the female gender was the most represented with 59%, the age group the most represented was that of 26- years and nurses represent (56%) of the prescribers. The informal sector was overwhelmingly represented by pharmacy salespersons (55%), most of whom were antimicrobial dispensers (53%). The AMR problem was perceived by the vast majority of the population as a problem in practice, locally and nationally. The management of AM waste was mainly done in dustbins, returned to the source and incinerators depending on the target (users, dispensers). The only laboratory with a quality system had an adequate technical platform for diagnosis. Standardized protocols were not available in some, nor commonly used in the mostly private laboratories. Users resorted first to street vendors, then to pharmacies and finally to hospitals. Antibiotics were the most widely used, prescribed and dispensed antimicrobials. Some baseline characteristics significantly influence antimicrobial resistance. Efforts remain to be made in all sectors such as user awareness, regulation of antimicrobial prescribing and implementation of a national action plan.
    VL  - 7
    IS  - 3
    ER  - 

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Author Information
  • Faculty of Health Sciences, University of Mountains, Bangangte, Cameroon

  • Faculty of Health Sciences, University of Mountains, Bangangte, Cameroon

  • Faculty of Sciences, University of Douala, Douala, Cameroon

  • Faculty of Health Sciences, University of Mountains, Bangangte, Cameroon

  • Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovation, Yaounde, Cameroon

  • Faculty of Sciences, University of Douala, Douala, Cameroon

  • Faculty of Health Sciences, University of Mountains, Bangangte, Cameroon

  • Faculty of Health Sciences, LOMO University for Research, Kinshasa, Democratic Republic of Congo

  • Faculty of Health Sciences, University of Mountains, Bangangte, Cameroon

  • Faculty of Sciences, University of Douala, Douala, Cameroon

  • Ministry of Public Health, Foundation Prevention and Control, Bangangte, Cameroon

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