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Antibiotic dispensing practices during COVID-19 and implications for antimicrobial resistance (AMR) : parallel mystery client studies in Uganda and Tanzania
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dc.contributor.author | Olamijuwon, Emmanuel | |
dc.contributor.author | Konje, Eveline | |
dc.contributor.author | Kansiime, Catherine | |
dc.contributor.author | Kesby, Mike | |
dc.contributor.author | Keenan, Katherine | |
dc.contributor.author | Neema, Stella | |
dc.contributor.author | Asiimwe, Benon | |
dc.contributor.author | Mshana, Stephen E | |
dc.contributor.author | Mushi, Martha F | |
dc.contributor.author | Loza, Olga | |
dc.contributor.author | Sunday, Benjamin | |
dc.contributor.author | Sandeman, Alison | |
dc.contributor.author | Sloan, Derek J | |
dc.contributor.author | Benitez-Paez, Fernando | |
dc.contributor.author | Mwanga, Joseph R | |
dc.contributor.author | Sabiiti, Wilber | |
dc.contributor.author | Holden, Matthew T G | |
dc.contributor.author | CARE Consortium | |
dc.date.accessioned | 2023-02-23T11:30:03Z | |
dc.date.available | 2023-02-23T11:30:03Z | |
dc.date.issued | 2023-02-11 | |
dc.identifier | 282672172 | |
dc.identifier | a6f5cd8e-a6cb-4344-8ce5-5488735e1c58 | |
dc.identifier | 36774512 | |
dc.identifier | 85147834937 | |
dc.identifier.citation | Olamijuwon , E , Konje , E , Kansiime , C , Kesby , M , Keenan , K , Neema , S , Asiimwe , B , Mshana , S E , Mushi , M F , Loza , O , Sunday , B , Sandeman , A , Sloan , D J , Benitez-Paez , F , Mwanga , J R , Sabiiti , W , Holden , M T G & CARE Consortium 2023 , ' Antibiotic dispensing practices during COVID-19 and implications for antimicrobial resistance (AMR) : parallel mystery client studies in Uganda and Tanzania ' , Antimicrobial Resistance & Infection Control , vol. 12 , no. 1 , 10 . https://doi.org/10.1186/s13756-022-01199-4 | en |
dc.identifier.issn | 2047-2994 | |
dc.identifier.other | PubMedCentral: PMC9919751 | |
dc.identifier.other | ORCID: /0000-0002-6109-8131/work/130203900 | |
dc.identifier.other | ORCID: /0000-0002-7888-5449/work/130204385 | |
dc.identifier.other | ORCID: /0000-0002-9670-1607/work/130204419 | |
dc.identifier.other | ORCID: /0000-0002-4958-2166/work/130204514 | |
dc.identifier.other | ORCID: /0000-0002-4742-2791/work/130204523 | |
dc.identifier.other | ORCID: /0000-0001-7789-870X/work/130203879 | |
dc.identifier.other | ORCID: /0009-0005-4229-8129/work/151190569 | |
dc.identifier.uri | https://hdl.handle.net/10023/27038 | |
dc.description | Funding: CARE: COVID-19 and Antimicrobial Resistance in East Africa—impact and response is a Global Effort on COVID-19 (GECO) Health Research Award (MR/V036157/1) funded by UK Research and Innovation (Medical Research Council) and the Department of Health and Social Care (National Institute for Health Research). | en |
dc.description.abstract | Background Over-the-counter antibiotic access is common in low-and-middle-income countries and this may accelerate antimicrobial resistance. Our study explores critical aspects of the drug seller-client interaction and antibiotic dispensing patterns for simulated COVID-19 symptoms during the pandemic in two study sites in Tanzania and Uganda, countries with different government responses to the pandemic. Methods Research assistants posing as clients approached different types of drug sellers such as pharmacies (Pharms), drug shops (DSs), and accredited drug dispensing outlets (ADDOs) in Mwanza, Tanzania (nPharms = 415, nADDOs = 116) and Mbarara, Uganda (nPharms = 440, nDSs = 67), from June 10 to July 30, 2021. The mystery clients held no prescription and sought advice for simulated COVID-19 symptoms from the drug sellers. They documented the quality of their interaction with sellers and the type of drugs dispensed. Results Adherence to COVID-19 preventive measures and vigilance to COVID-19 symptoms was low in both sites but significantly higher in Uganda than in Tanzania. A higher percentage of drug sellers in Mbarara (Pharms = 36%, DSs = 35%, P-value = 0.947) compared to Mwanza (Pharms = 9%, ADDOs = 4%, P-value = 0.112) identified the client's symptoms as possibly COVID-19. More than three-quarters of drug sellers that sold prescription-only medicines in both Mbarara (Pharms = 86%, DSs = 89%) and Mwanza (Pharms = 93%, ADDOs = 97%) did not ask the MCs for a prescription. A relatively high percentage of drug sellers that sold prescription-only medicines in Mwanza (Pharms = 51%, ADDOs = 67%) compared to Mbarara (Pharms = 31%, DSs = 42%) sold a partial course without any hesitation. Of those who sold antibiotics, a higher proportion of drug sellers in Mbarara (Pharms = 73%, DSs = 78%, P-value = 0.580) compared to Mwanza (Pharms = 40% ADDOs = 46%, P-value = 0.537) sold antibiotics relevant for treating secondary bacterial infections in COVID-19 patients. Conclusion Our study highlights low vigilance towards COVID-19 symptoms, widespread propensity to dispense prescription-only antibiotics without a prescription, and to dispense partial doses of antibiotics. This implies that drug dispensing related to COVID-19 may further drive AMR. Our study also highlights the need for more efforts to improve antibiotic stewardship among drug sellers in response to COVID-19 and to prepare them for future health emergencies. | |
dc.format.extent | 14 | |
dc.format.extent | 2747885 | |
dc.language.iso | eng | |
dc.relation.ispartof | Antimicrobial Resistance & Infection Control | en |
dc.subject | COVID-19 | en |
dc.subject | Uganda | en |
dc.subject | Tanzania | en |
dc.subject | Drug sale | en |
dc.subject | Pharmacy | en |
dc.subject | Antimicrobial resistance | en |
dc.subject | Mystery client | en |
dc.subject | RA0421 Public health. Hygiene. Preventive Medicine | en |
dc.subject | RM Therapeutics. Pharmacology | en |
dc.subject | NDAS | en |
dc.subject | SDG 3 - Good Health and Well-being | en |
dc.subject | MCC | en |
dc.subject.lcc | RA0421 | en |
dc.subject.lcc | RM | en |
dc.title | Antibiotic dispensing practices during COVID-19 and implications for antimicrobial resistance (AMR) : parallel mystery client studies in Uganda and Tanzania | en |
dc.type | Journal article | en |
dc.contributor.sponsor | Medical Research Council | en |
dc.contributor.institution | University of St Andrews. School of Geography & Sustainable Development | en |
dc.contributor.institution | University of St Andrews. Geographies of Sustainability, Society, Inequalities and Possibilities | en |
dc.contributor.institution | University of St Andrews. School of Medicine | en |
dc.contributor.institution | University of St Andrews. Infection and Global Health Division | en |
dc.contributor.institution | University of St Andrews. Biomedical Sciences Research Complex | en |
dc.contributor.institution | University of St Andrews. St Andrews Bioinformatics Unit | en |
dc.identifier.doi | 10.1186/s13756-022-01199-4 | |
dc.description.status | Peer reviewed | en |
dc.identifier.grantnumber | MR/V036157/1 | en |
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