title: Patterns and predictors of self-medication in northern Uganda.
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.
authors.affiliation: Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Moses
authors.initials: M
authors.lastname: Ocan
authors.affiliation: Department of Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Freddie
authors.initials: F
authors.lastname: Bwanga
authors.affiliation: Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Godfrey S
authors.initials: GS
authors.lastname: Bbosa
authors.affiliation: Department of Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Danstan
authors.initials: D
authors.lastname: Bagenda
authors.affiliation: Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Paul
authors.initials: P
authors.lastname: Waako
authors.affiliation: Faculty of Medicine, Gulu University, Gulu, Uganda.
authors.forename: Jasper
authors.initials: J
authors.lastname: Ogwal-Okeng
authors.affiliation: Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Celestino
authors.initials: C
authors.lastname: Obua
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D004351:Drug Resistance; D004983:Ethanolamines / Q000627:therapeutic use; D005260:Female; D005449:Fluorenes / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D012648:Self Care; D012651:Self Medication; D011795:Surveys and Questionnaires; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014454:Uganda
chemical_list: D000890:Anti-Infective Agents; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; D008795:Metronidazole; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination