Background
Methods
Survey instrument
Contents | Choices of answer | |
---|---|---|
I. USE OF ANTIBIOTICS, SOURCE OF ANTIBIOTICS AND REASON FOR TAKING ANTIBIOTICS
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AB1 | Have you taken any antibiotics orally such as tablets, powder or syrup in the last month? | Yes, No, Do not know |
AB2 (IF ‘YES’ to AB1) | Where did you obtain the last course of antibiotics that you used? | Choices of answer: Health center, Community hospital, General or regional hospital, University hospital, Other public hospital, Private hospital, Private clinic, Pharmacy, Online, Grocery store, Left over antibiotics from the previous treatment (your own and others), Mobile medical Unit, Others (Specify) |
fAB3 (IF ‘YES’ to AB1) a | What were the symptoms for last taking the antibiotics that you used? (Multiple answers possible) | Choices of answer: Sore throat, Cough, Fever, Loose stool, Headache, Muscle aches, Pustule/purulent wound, Fresh wound/bleeding wound, Dysuria, Leukorrhea, Toothache, Others (Specify), No symptom, Do not know |
AB4 (IF ‘YES’ to AB1) a | What were the illnesses for last taking the antibiotics that you used? (Multiple answers possible) | Choices of answer: Pneumonia, Bronchitis, Pharyngitis/tonsillitis, Flu/cold, Watery Diarrhea, Bloody diarrhea/dysentery, Skin infection/wound infection, Cystitis/pyelonephritis, Vaginitis/pelvic inflammatory disease, Acute otitis media/sinusitis, Gingivitis/periodontitis, Others (Specify), No illness, Do not know |
II. KNOWLEDGE ABOUT ANTIBIOTIC USE AND AMR
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AB5_1 | Please tell me whether you think it is true or false. “Antibiotics kill viruses” (The correct answer is a false statement.) | True, False, Do not know |
AB5_2 | Please tell me whether you think it is true or false. “Antibiotics are effective against colds and flu” (The correct answer is a false statement.) | True, False, Do not know |
AB5_3 | Please tell me whether you think it is true or false. “Unnecessary use of antibiotics makes them become ineffective or induces bacterial resistance” (The correct answer is a true statement.) | True, False, Do not know |
AB5_4 | Please tell me whether you think it is true or false. “Taking antibiotics often has side-effects such as diarrhea” (The correct answer is a true statement.) | True, False, Do not know |
AB5_5 a | Please tell me whether you think it is true or false. “Antibiotics are equal to anti-inflammatory drugs” (The correct answer is a false statement.) | True, False, Do not know |
AB6 | When do you think you should stop taking antibiotics once you have begun a course of treatment? | Choices of answer: When your illness is better, When you get full course of antibiotics (from doctor’s or health professionals recommendation), Others (Specify), Do not know |
III. AWARENESS OF THE IMPORTANCE OF APPROPRIATE ANTIBIOTIC USE AND AMR
a
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AB7_1 | How much do you agree with following statements: People should use antibiotics only when they are prescribed by a doctor, nurse or pharmacist | Strongly disagree, Slightly disagree, Neither agree nor disagree, Slightly agree, Strongly agree, Do not know |
AB7_2 | How much do you agree with following statements: People should not keep antibiotics and use them later for other illnesses | Strongly disagree, Slightly disagree, Neither agree nor disagree, Slightly agree, Strongly agree, Do not know |
AB7_3 | How much do you agree with following statements: Antibiotic resistance is one of the problems that should be considered | Strongly disagree, Slightly disagree, Neither agree nor disagree, Slightly agree, Strongly agree, Do not know |
AB7_4 | How much do you agree with following statements: I am worried about the impact that antibiotic resistance will have on my health, and that of my family | Strongly disagree, Slightly disagree, Neither agree nor disagree, Slightly agree, Strongly agree, Do not know |
AB7_5 | How much do you agree with following statements: I am not at risk of getting an antibiotic resistant infection, as long as I take my antibiotics correctly | Strongly disagree, Slightly disagree, Neither agree nor disagree, Slightly agree, Strongly agree, Do not know |
IV. PUBLIC INFORMATION ABOUT THE APPROPRIATE USE OF ANTIBIOTICS AND AMR
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AB8 | In the last 12 months, do you remember getting any information about not taking antibiotics unnecessarily, for example for a cold or the flu, or information on antimicrobial resistance? | Yes, No, Do not know |
AB9 (IF ‘YES’ to AB8) | Whom did you get this information about not taking antibiotics unnecessarily? | Choices of answer: Leaflet/poster, Newspaper, Radio, TV, Internet/social media, Family members/Friends, Doctor, Nurse, Pharmacist, Other health professionals, Others (Specify), Do not know |
Sampling and Data Collection
Data analysis
Results
Antibiotic use in the past month, sources, and reasons for taking antibiotics
2. Public information on appropriate use of antibiotics and AMR
Knowledge about appropriate antibiotic use and AMR
Awareness of appropriate antibiotic use and antimicrobial resistance
Factors associated with access to information, knowledge and awareness: a multivariate analysis
Characteristic | Public information on appropriate use of antibiotics and AMR | Knowledge about appropriate antibiotic use and AMR | Awareness of appropriate antibiotic use and AMR | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number of respondents who did not receive information (%) | Number of respondents who received information (%) | Adjusted OR | 95% CI | P-value | Number of respondents with ≤ 3 correct answers (%) | Number of respondents with > 3 correct answers (%) | Adjusted OR | 95% CI | P-value | Number of respondents with awareness score ≤ 3 (%) | Number of respondents with awareness score > 3 (%) | Adjusted OR | 95% CI | P-value | |
Gender
|
<0.001a (LR test) |
0.097
|
0.011a (LR test) | ||||||||||||
Male | 8,893 (41.4) | 2,302 (36.0) | Reference | 8,654 (39.9) | 2,541 (41.0) | Bivariate analysis is not statistically significant | 2,348 (41.3) | 8,847 (39.8) | Reference | ||||||
Female | 12,608 (58.6) | 4,097 (64.0) | 1.26 | 1.19-1.34 | <0.001a | 13,054 (60.1) | 3,651 (59.0) | 3,333 (58.7) | 13,372 (60.2) | 1.08 | 1.02-1.15 | 0.011a | |||
Age group, years
|
<0.001a (LR test) |
<0.001a (LR test) |
<0.001a (LR test) | ||||||||||||
15-24 | 1,105 (5.1) | 273 (4.3) | Reference | 1,042 (4.8) | 336 (5.4) | Reference | 278 (4.9) | 1,100 (5.0) | Reference | ||||||
25-59 | 13,153 (61.2) | 3,957 (61.8) | 1.19 | 1.03-1.37 | 0.016a | 12,912 (59.5) | 4,198 (67.8) | 1.07 | 0.94-1.22 | 0.322 | 3,131 (55.1) | 13,979 (62.9) | 1.22 | 1.05-1.40 | 0.007a |
≥ 60 | 7,243 (33.7) | 2,169 (33.9) | 1.30 | 1.12-1.51 | 0.001a | 7,754 (35.7) | 1,658 (26.8) | 0.87 | 0.76-1.01 | 0.064 | 2,272 (40.0) | 7,140 (32.1) | 1.02 | 0.88-1.19 | 0.749 |
Area of residence
|
0.177
|
0.546 (LR test)
|
0.002a (LR test) | ||||||||||||
Urban | 11,857 (55.2) | 3,590 (56.1) | Bivariate analysis is not statistically significant | 11,870 (54.7) | 3,577 (57.8) | Reference | 2,917 (51.3) | 12,530 (56.4) | Reference | ||||||
Rural | 9,644 (44.8) | 2,809 (43.9) | 9,838 (45.3) | 2,615 (42.2) | 1.02 | 0.96-1.08 | 0.545 | 2,764 (48.7) | 9,689 (43.6) | 0.91 | 0.86-0.96 | 0.002a | |||
Education level
|
<0.001a (LR test) |
<0.001a (LR test) |
<0.001a (LR test) | ||||||||||||
Uneducated | 1,122 (5.2) | 190 (3.0) | Reference | 1,154 (5.3) | 158 (2.6) | Reference | 449 (7.9) | 863 (3.9) | Reference | ||||||
Primary school | 12,282 (57.1) | 3,474 (54.3) | 1.58 | 1.35-1.85 | <0.001a | 12,982 (59.8) | 2,774 (44.8) | 1.40 | 1.18-1.66 | <0.001a | 3,652 (64.3) | 12,104 (54.5) | 1.51 | 1.34-1.71 | <0.001a |
Secondary school | 5,994 (27.9) | 1,835 (28.6) | 1.73 | 1.46-2.04 | <0.001a | 5,704 (26.3) | 2,125 (34.3) | 2.16 | 1.81-2.59 | <0.001a | 1,245 (21.9) | 6,584 (29.6) | 2.18 | 1.90-2.50 | <0.001a |
University and above | 2,063 (9.6) | 895 (14.0) | 2.16 | 1.80-2.59 | <0.001a | 1,829 (8.4) | 1,129 (18.2) | 3.27 | 2.70-3.97 | <0.001a | 318 (5.6) | 2,640 (11.9) | 3.03 | 2.54-3.61 | <0.001a |
Others and unknown | 40 (0.2) | 5 (0.1) | 0.89 | 0.35-2.29 | 0.809 | 39 (0.2) | 6 (0.1) | 1.11 | 0.46-2.67 | 0.816 | 318 (0.3) | 2,640 (0.1) | 0.88 | 0.48-1.63 | 0.688 |
Wealth quintile
|
<0.001a (LR test) |
<0.001a (LR test) |
<0.001a (LR test) | ||||||||||||
Q1 (poorest) | 5,298 (24.6) | 1,177 (18.4) | Reference | 5,448 (25.1) | 1,027 (16.6) | Reference | 1,825 (32.1) | 4,650 (20.9) | Reference | ||||||
Q2 | 4,725 (22.0) | 1,276 (19.9) | 1.16 | 1.06-1.26 | 0.001a | 4,789 (22.1) | 1,212 (19.6) | 1.25 | 1.14-1.37 | <0.001a | 1,226 (21.6) | 4,775 (21.5) | 1.41 | 1.29-1.53 | <0.001a |
Q3 | 4,293 (20.0) | 1,331 (20.8) | 1.31 | 1.20-1.44 | <0.001a | 4,424 (20.4) | 1,200 (19.4) | 1.28 | 1.17-1.41 | <0.001a | 1,079 (19.0) | 4,545 (20.5) | 1.48 | 1.36-1.62 | <0.001a |
Q4 | 4,107 (19.1) | 1,400 (21.9) | 1.39 | 1.27-1.52 | <0.001a | 4,424 (18.8) | 1,200 (22.9) | 1.48 | 1.35-1.63 | <0.001a | 949 (16.7) | 4,558 (20.5) | 1.55 | 1.41-1.69 | <0.001a |
Q5 (wealthiest) | 3,078 (14.3) | 1,215 (19.0) | 1.49 | 1.35-1.65 | <0.001a | 2,958 (13.6) | 1,335 (21.5) | 1.57 | 1.42-1.75 | <0.001a | 602 (10.6) | 3,691 (16.6) | 1.66 | 1.49-1.86 | <0.001a |
Total | 21,501 (100.0) | 6,399 (100.0) | 21,708 (100) | 6,192 (100.0) | 5,681 (100.0) | 22,219 (100.0) |