Sorato Mende Mensa
Department of Pharmacy, School of Medicine, Komar University of Science and Technology, Sulaymania, Iraq.
Department of Pharmacy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
BMJ Public Health. 2025 Apr 17;3(1):e002314. doi: 10.1136/bmjph-2024-002314. eCollection 2025 Jan.
Antimicrobial resistance (AMR) threatens millions of lives and poses significant health, economic and development challenges. Policies implemented to prevent and contain AMR should address it through a One Health Approach. This study assessed health professional and facility engagement in Southern Ethiopia's AMR prevention and containment strategic initiatives and associated factors.
A hospital-based cross-sectional study was conducted among 634 health professionals.
Five randomly selected public hospitals from three (Gofa, Gamo and South Omo) zones.
Health professionals working in the outpatient department in the randomly selected hospitals.
Health professional and facility engagement in AMR prevention and containment strategies. A binary logistic regression model was used to evaluate the association between the explanatory variables (socio-demographic characteristics, institutional and professional factors) and dependent variables (professional engagement in AMR PCSIs). To avoid many variables and unstable estimates and control possible confounders in the subsequent model, only variables that reached a p value less than 0.25 at binary analysis were used in the multivariate logistic regression analysis to identify factors independently associated with health professional and facility engagement level in AMR prevention and containment strategies.
This study included 634 participants (56.5% males). Among these professionals, the vast majority (n=444, 70.0%) were aware of the One Health perspective on AMR. Concerning health facility engagement in AMR PCSIs, about one-third (n=203; 32.0%) of professionals reported full engagement in the facilities. Nearly one-fourth of professionals (n=169; 26.7%) reported including AMR prevention and containment procedures in their facility's annual plan. The overall health professional and facility engagement in AMR PCSIs was 412 (65.0%). Having a history of sharp injury (adjusted odds ratio (AOR)=1.88 (1.19, 2.97; p=0.007)), working in a general hospital (AOR=3.746 (2.657, 5.282; p=0.000)), having good knowledge on healthcare waste management (AOR=1.99 (1.225, 3.258; p=0.006)) and being from a facility that included AMR prevention and containment in the annual plan (AOR=3.796 (2.01, 7.180; p=0.000)) were positively and independently associated with the dependent variable (professional engagement in AMR PCSIs). However, a working experience of 6-10 years (AOR=0.6 (0.32, 0.96, p<0.05)), receiving infection prevention control training (AOR=1.47 (1.02, 2.13, p=0.041)) and lack of adequate knowledge on One Health approach (AOR=0.50 (0.32, 0.79; p=0.003)) were negatively associated with professional and facility engagement in AMR PCSIs.
In the study area, professional and facility engagement in AMR PCSIs was low. Providing training on infection prevention and control, healthcare waste handling, One Health approach, antimicrobial stewardship for all and disseminating national strategic initiatives to all levels in the healthcare system are important. Researchers willing to work in similar areas must use mixed-method study designs to evaluate the engagement of all (human, animal and environmental) stakeholders toward AMR PCSIs.
抗菌药物耐药性（AMR）威胁着数百万人的生命，并带来重大的健康、经济和发展挑战。为预防和控制AMR而实施的政策应通过“同一健康”方法来应对这一问题。本研究评估了埃塞俄比亚南部卫生专业人员和医疗机构参与AMR预防和控制战略举措的情况及相关因素。
对634名卫生专业人员进行了一项基于医院的横断面研究。
从三个区（戈法、加莫和南奥莫）随机选取的五家公立医院。
在随机选取的医院门诊部工作的卫生专业人员。
卫生专业人员和医疗机构参与AMR预防和控制战略的情况。采用二元逻辑回归模型评估解释变量（社会人口统计学特征、机构和专业因素）与因变量（卫生专业人员参与AMR预防和控制战略举措）之间的关联。为避免后续模型中变量过多和估计不稳定，并控制可能的混杂因素，在多变量逻辑回归分析中仅使用在二元分析中p值小于0.25的变量，以确定与卫生专业人员和医疗机构参与AMR预防和控制战略水平独立相关的因素。
本研究纳入了634名参与者（56.5%为男性）。在这些专业人员中，绝大多数（n = 444，70.0%）了解关于AMR的“同一健康”观点。关于医疗机构参与AMR预防和控制战略举措，约三分之一（n = 203；32.0%）的专业人员报告在其机构中全面参与。近四分之一的专业人员（n = 169；26.7%）报告在其机构的年度计划中纳入了AMR预防和控制程序。卫生专业人员和医疗机构对AMR预防和控制战略举措的总体参与率为412（65.0%）。有锐器伤史（调整优势比（AOR）= 1.88（1.19，2.97；p = 0.007））、在综合医院工作（AOR = 3.746（2.657，5.282；p = 0.000））、对医疗废物管理有良好了解（AOR = 1.99（1.225，3.258；p = 0.006））以及所在机构在年度计划中纳入了AMR预防和控制（AOR = 3.796（2.01，7.180；p = 0.000））与因变量（卫生专业人员参与AMR预防和控制战略举措）呈正相关且独立相关。然而，6 - 10年的工作经验（AOR = 0.6（0.32，0.96，p < 0.05））、接受过感染预防控制培训（AOR = 1.47（1.02，2.13，p = 0.041））以及对“同一健康”方法缺乏足够了解（AOR = 0.50（0.32，0.79；p = 0.003））与卫生专业人员和医疗机构参与AMR预防和控制战略举措呈负相关。
在研究地区，卫生专业人员和医疗机构对AMR预防和控制战略举措的参与度较低。提供感染预防与控制、医疗废物处理、“同一健康”方法、全员抗菌药物管理等方面的培训，并向医疗系统各级传播国家战略举措非常重要。愿意在类似领域开展研究的人员必须采用混合方法研究设计来评估所有（人类、动物和环境）利益相关者对AMR预防和控制战略举措的参与情况。
