Use and misuse of aspirin in rural Ethiopia.
OBJECTIVE
To investigate ability to distinguish simple analgesics, to document misconceptions about aspirin use, and to identify strategies to diminish potentially harmful aspirin use in Ethiopia.


METHODS
Qualitative study (eight focus group discussions) used to inform cross-sectional survey.


METHODS
Butajira, a small town in southern Ethiopia, and surrounding rural areas.


METHODS
Purposively selected informants for focus groups; random sample of urban and rural residents for cross-sectional survey.


METHODS
Ability to distinguish aspirin from paracetamol; proportion using aspirin; proportion aware of common risks of aspirin.


RESULTS
Questionnaires were completed by 204 of the 250 residents sampled (82% response). Three-quarters of survey participants knew the difference between aspirin and paracetamol. Aspirin was used by 7.3% of respondents, and was mainly taken for headache and fever. In focus group discussions there was a suggestion that aspirin was considered particularly useful for children. There was very low awareness of the risks of using aspirin in children (2.5% unprompted, 18.6% prompted) or in people with asthma (1% unprompted, 5.9% prompted). Aspirin is cheap and widely available in urban and rural areas.


CONCLUSIONS
Awareness of the risks of aspirin use by children and in asthma is extremely low in this rural Ethiopian setting. Medications are purchased with minimal packaging by a population with low literacy. Drug dispensers and vendors must be trained to convey simple verbal warnings about aspirin use.
Duncan
P
P
Division of Epidemiology and Public Health, University of Nottingham, City Hospital, Hucknall Road, Nottingham NG5 1PB.
Aref-Adib
G
G
Venn
A
A
Britton
J
J
Davey
G
G
D000082:Acetaminophen / Q000009:adverse effects / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D005334:Fever / Q000188:drug therapy; D017144:Focus Groups; D006261:Headache / Q000188:drug therapy; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D036301:Qualitative Research; D019035:Rural Health Services; D012424:Rural Population / Q000706:statistics & numerical data*; D012651:Self Medication / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D000082:Acetaminophen; D001241:Aspirin