Knowledge and perception on antimicrobial resistance and antibiotics prescribing attitude among physicians and nurses in Lambaréné region, Gabon: a call for setting-up an antimicrobial stewardship program
Antimicrobial Resistance and Infection Control, vol. 11, pp. 44
Abstract
BACKGROUND: Africa is challenged by the emergence of antimicrobial resistance (AMR). In order to improve patient management and to optimise approaches to curb the spread of antimicrobial resistance, we examined knowledge and perceptions of AMR and antibiotics prescription practices of HCW (healthcare workers) in Lambaréné, Gabon. METHODS: We conducted a self-administered, questionnaire-based survey in HCW at the regional referral hospital, a medical research centre, and peripheral health care facilities. The proportions of correct responses to questions were determined and compared between physicians and nurses using Fisher's Exact test. RESULTS: A total of 47 HCW took part in the survey. Of those, 64% (30/47) recognised antibiotic resistance as a major public health issue in Gabon, but only 14/47 (30%) recognised it as a problem in their health facility. Of note, 37/47 (79%) recognised excessive use of antibiotics without microbiological confirmation in case of infection, and buying antibiotics without a prescription, as possible cause of antimicrobial resistance. Some HCW (28%; 13/47) reported having prescribed antibiotics because the patients asked for them; and a total of 15/47 (32%) responded that antibiotics could help patients recover faster when added to malaria treatment. Compared to nurses, most of the physicians recognised that excessive use of antibiotics without microbiological confirmation of infection could contribute to AMR spread (18/19 (95%) vs 19/28 (68%); p = 0.028). CONCLUSION: Most HCW recognised AMR as public health issue. However, a quarter of the participants did not know about the causes fostering the emergence of antimicrobial resistance. There is a need to perform regular HCW training in antimicrobial prescription, and to set up an antimicrobial stewardship program.
Authors 6
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University of Amsterdam · Amsterdam University Medical Centers · Amsterdam Public Health · Amsterdam UMC Location University of Amsterdam · Centre de Recherche Médicales de Lambaréné
Affiliation as printed
Centre de Recherches Médicales en Lambaréné and African Partner Institution, German Centre for Infection Research (CERMEL), Lambaréné, Gabon
Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location AMC, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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University of Amsterdam · Amsterdam University Medical Centers · Amsterdam Public Health · Amsterdam UMC Location University of Amsterdam · Centre de Recherche Médicales de Lambaréné
Affiliation as printed
Centre de Recherches Médicales en Lambaréné and African Partner Institution, German Centre for Infection Research (CERMEL), Lambaréné, Gabon
Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location AMC, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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University of Münster · University Hospital Münster
Affiliation as printed
Institute of Medical Microbiology, University Hospital Muenster, Muenster, Germany
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Centre de Recherche Médicales de Lambaréné
Affiliation as printed
Centre de Recherches Médicales en Lambaréné and African Partner Institution, German Centre for Infection Research (CERMEL), Lambaréné, Gabon
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Leiden University · University of Tübingen · Leiden University Medical Center · Centre de Recherche Médicales de Lambaréné
Affiliation as printed
Centre de Recherches Médicales en Lambaréné and African Partner Institution, German Centre for Infection Research (CERMEL), Lambaréné, Gabon
Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
Institut Für Tropenmedizin, Universität Tübingen and German Centre for Infection Research, Tübingen, Germany
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Martin P. Grobusch corresponding
University of Amsterdam · University of Tübingen · University of Cape Town · Amsterdam University Medical Centers · Institute of Infectious Disease and Molecular Medicine · Amsterdam Public Health · Amsterdam UMC Location University of Amsterdam · Centre de Recherche Médicales de Lambaréné
Affiliation as printed
Centre de Recherches Médicales en Lambaréné and African Partner Institution, German Centre for Infection Research (CERMEL), Lambaréné, Gabon. m.p.grobusch@amsterdamumc.nl
Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location AMC, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.p.grobusch@amsterdamumc.nl
Institut Für Tropenmedizin, Universität Tübingen and German Centre for Infection Research, Tübingen, Germany. m.p.grobusch@amsterdamumc.nl
Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa. m.p.grobusch@amsterdamumc.nl
Masanga Medical Research Unit, Masanga, Sierra Leone. m.p.grobusch@amsterdamumc.nl
Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location AMC, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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