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乌干达北部自我药疗的模式及预测因素

Patterns and predictors of self-medication in northern Uganda.

作者信息

Ocan Moses, Bwanga Freddie, Bbosa Godfrey S, Bagenda Danstan, Waako Paul, Ogwal-Okeng Jasper, Obua Celestino

机构信息

Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda.

Department of Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.

出版信息

PLoS One. 2014 Mar 21;9(3):e92323. doi: 10.1371/journal.pone.0092323. eCollection 2014.

Abstract

Self-medication with antimicrobial agents is a common form of self-care among patients globally with the prevalence and nature differing from country to country. Here we assessed the prevalence and predictors of antimicrobial self-medication in post-conflict northern Uganda. A cross-sectional study was carried out using structured interviews on 892 adult (≥18 years) participants. Information on drug name, prescriber, source, cost, quantity of drug obtained, and drug use was collected. Households were randomly selected using multistage cluster sampling method. One respondent who reported having an illness within three months in each household was recruited. In each household, information was obtained from only one adult individual. Data was analyzed using STATA at 95% level of significance. The study found that a high proportion (75.7%) of the respondents practiced antimicrobial self-medication. Fever, headache, lack of appetite and body weakness were the disease symptoms most treated through self-medication (30.3%). The commonly self-medicated antimicrobials were coartem (27.3%), amoxicillin (21.7%), metronidazole (12.3%), and cotrimoxazole (11.6%). Drug use among respondents was mainly initiated by self-prescription (46.5%) and drug shop attendants (57.6%). On average, participants obtained 13.9±8.8 (95%CI: 12.6-13.8) tablets/capsules of antimicrobial drugs from drug shops and drugs were used for an average of 3.7±2.8 days (95%CI: 3.3-3.5). Over half (68.2%) of the respondents would recommend self-medication to another sick person. A high proportion (76%) of respondents reported that antimicrobial self-medication had associated risks such as wastage of money (42.1%), drug resistance (33.2%), and masking symptoms of underlying disease (15.5%). Predictors of self-medication with antimicrobial agents included gender, drug knowledge, drug leaflets, advice from friends, previous experience, long waiting time, and distance to the health facility. Despite knowledge of associated risks, use of self-medication with antimicrobial drugs in management of disease symptoms is a common practice in post-conflict northern Uganda.

摘要

在全球范围内,患者自行使用抗菌药物是一种常见的自我护理方式,其流行程度和性质因国家而异。在此,我们评估了乌干达北部冲突后地区抗菌药物自我药疗的流行情况及预测因素。采用结构化访谈对892名成年(≥18岁)参与者进行了一项横断面研究。收集了有关药物名称、开处方者、来源、费用、获得的药物数量以及用药情况的信息。使用多阶段整群抽样方法随机选择家庭。招募了每个家庭中报告在三个月内患病的一名受访者。在每个家庭中,仅从一名成年个体获取信息。使用STATA软件在95%的显著性水平上对数据进行分析。研究发现,很大一部分(75.7%)受访者进行了抗菌药物自我药疗。发热、头痛、食欲不振和身体虚弱是通过自我药疗治疗最多的疾病症状(30.3%)。常见的自我药疗使用的抗菌药物有蒿甲醚/本芴醇(27.3%)、阿莫西林(21.7%)、甲硝唑(12.3%)和复方新诺明(11.6%)。受访者的用药主要由自我开处方(46.5%)和药店店员(57.6%)发起。平均而言,参与者从药店获得13.9±8.8(95%置信区间:12.6 - 13.8)片/粒抗菌药物,药物平均使用3.7±2.8天(95%置信区间:3.3 - 3.5)。超过一半(68.2%)的受访者会向另一位病人推荐自我药疗。很大一部分(76%)受访者报告称抗菌药物自我药疗存在相关风险,如金钱浪费(42.1%)、耐药性(33.2%)以及掩盖潜在疾病症状(15.5%)。抗菌药物自我药疗的预测因素包括性别、药物知识、药品说明书、朋友的建议、既往经验、等待时间长以及到医疗机构的距离。尽管了解相关风险,但在乌干达北部冲突后地区,使用抗菌药物自我药疗来管理疾病症状仍是一种常见做法。

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