Prevalence of Self-Medication Essay

Antibiotic self- medicinal drug among university checkup checkup checkup examination undergraduates in Northern Nigeria Joseph O. Fadare 1* and Igbiks Tamuno 21Department of Medicine, Kogi State Specialist infirmary, Lokoja, Nigeria 2Department of Pharmaco lethargic, Bayero University, Kano, Kano State, Nigeria. Accepted 20 April, 2011Self- medicinal drug is becoming a common type of self- fearfulness behavior among the macrocosm of umteen countries. Many international studies pass on investigated the prevalence and nature of self-medication holds at the population level. In Nigeria, some workers have alike looked at the population prevalence of self-medication in commonplace however the prevalence of antibiotic dose drug self-medication among medical exam examination undergraduates has not yet been studied. The interest in canvasing this practice among this select sort out is due to the fact that they are the future prescribers and health educators of the popula tion of Nigeria. The cartoon was a cross-sectional pre-tested disbeliefnaire- base study carried out among medical students of the Bayero University, Kano, North-West Nigeria during a two-week period in August 2008. The discipline from the returned questionnaire were coded, entered and analyzed using SPSS magnetic declination 12 statistical software.A total of 183 students filled and returned the questionnaire giving a reply rate of 83.2%. Out of these answerings, 120 (65.6%) were males and the mean days of respondents was 23.2 2.5 eld (Range 17 to 31). 71 (38.8%) of the medical students admitted to the practice and at that place was no statistically significant engagement among the dis equal levels of medical direction (p >0.05). Antibiotics from the penicillin group (ampicillin/cloxacillin, amoxicillin and ampicillin) were the most frequently in use(p). Self-medication with antibiotics is prevalent among medical undergraduates in Northern Nigeria. in that respect is a quest for an intervention to address this practice. Key words Antibiotics, self-medication, medical undergraduates, Nigeria. INTRODUCTIONAntibiotics are one of the most prescribed drugs worldwide (Tnger et al., 2000). Self-medication with antibiotics is a common practice in many countries in the world although the thin seems to be more in build uping or re character reference- ridiculous nations (Awad et al., 2005). Some of the reasons that have been install responsible for this trend include lack of introduction to health care, availability of antibiotics as all over the counter (OTC) drugs and in open markets and poor regulatory practices (Vaananen et al., 2006). Self-medication with antibiotics has been identified as one form of irrational use of medicine contributing to *Corresponding author. E-mail jofadaregmail.com. Tel +234- 8138048127. increased healthcare salutes, antimicrobial drug rampart and sometimes increased morbidity among the popu- lation (Aswapoke e et al., 1990 Okeke et al., 1999).The practice of self-medication in widely distributed has been widely studied among populations of many countries in Africa, Asia and Europe (Martins et al., 2002 Yousef et al., 2008 Awad et al., 2007a). genius of the factors that have been found to influence this practice is the level of education of the look participants (Afolabi, 2008). Many studies have to a fault forwardly looked at the pre- valence, nature and reasons for self-medication among university undergraduates (non-medical) in different countries of the world (Zafar et al., 2008 Sawalha, 2008 Lucas et al., 2007). There are also studies on general self-medication practices among medical undergraduates in some other countries (Buke et al., 2005 Chowdhury 218 J. Public Health Epidemiol.et al., 2009). In Nigeria, previous studies have concen- trated on general self-medication practices among the population (Afolabi, 2008) and health care workers (Bamgboye et al., 2006). This study of antibiotic self- medication practice among university medical undergraduates in Nigeria is precise important as they are a segment of the population that is highly educated and with access to information regarding their health. Looking at this practice among medical undergraduates is also very vital as they represent the future contemporaries of drug prescribers and health educationists.The understanding of the level of antibiotic self-medication practice and the reasons for it aldepression for enable for different interventional strategies. It will also help policy makers to develop approaches for a more rational use of antibiotics in the community in general. The main objective of this study was to determine the frequency and nature of antibiotic self-medication practice among university medical undergraduates in the Northern part of Nigeria. This study also sought if there is any relationship between the level of medical education and the self-medication practice. METHODS The study was a cross-sectional questionnaire-based study carried out among medical students of the Bayero University, Kano, North- West Nigeria during a two-week period in August 2008. SamplingA total of two hundred and twenty self-administered questionnaires were distributed to students from different level of medical education (200 to 500 Level) using a convenient sampling system. QuestionnaireThe questionnaire which had been pre-tested among students of another(prenominal) faculty in the university consisted of both open and close ended questions. The questionnaires were administered to the students finished their class representatives who also returned the filled ones. The act of filling and returning of the forms was interpreted as consent of the students to participate and the study was approved by the Hospital Ethics Committee. The lead question was Have you practiced self-medication with antibiotics in the hold water two months?The duration of two months was chosen becaus e of the belief that recall of medication use is still very reliable within that time frame. another(prenominal) questions include The reasons for indulging in self-medication, conditions for which the drugs were taken and the antibiotics that were being used. Statistical analysesThe information from the returned questionnaire were coded and entered using SPSS version 12 statistical software. Results were expressed as counts and percentages temporary hookup Chi-square test was used for to investigate possible associations between sex, level of medical education and antibiotic self-medication practice. A p-value < 0.05 was considered as statistically significant for the affair of this study. RESULTSA total of one 183 students filled and returned the questionnaire giving a response rate of 83.2%. Out of these respondents, one hundred and twenty (65.6%) were males and the mean age of all respondents was 23.2 2.5 years (Range 17 to 31 years). The distribution of the respondents ac cording to level of medical education is shown in tabularise 1. In response to the question whether respondents had practiced self- medication in the preceding two months, 71 (38.8%) of the medical students admitted to the practice and there was no statistically significant difference among the different levels of medical education (p >0.05). Though self-medication with antibiotics was more common among the male students, this difference was not statistically significant (p >0.05). The common conditions for which the antibiotics were taken include diarrhea, in the raw throat, feverishness, cough and catarrh among others (Table 2). Antibiotics from the penicillin group (ampicillin/cloxacillin, amoxicillin and ampicillin) were the most frequently used for self-medication among the respondents (Table 3).29 (42.6%) of the medical undergraduates who indulged in the practice did it because they considered their ailment as being whacky magic spell 24 (35.3%) were involved in i t because of their past experience with the fact antibiotic. Regarding the source of the antibiotics used for self-medication, majority of the respondents (57.4%) patronized patent medicine stores while hospital and community pharmacies were the suppliers for 13 (19.1%) and 11 (16.2%) of the respondents, respectively. Only 1 respondent (1.5%) used the leftover from a previous prescription in this study. majority of the medical undergraduates (89.6%) knew that the normal duration of treatment was supposed to be at least a minimum of 5 days however but 34 (49.3%) of the respondents actually completed the billet of treatment. This study also found out that gender of the respondents did not influence significantly the practice of antibiotic self-medication (p = 0.07). DISCUSSIONSample population and self-medicationThe frequency of antibiotic self- medication discovered in our study is slightly lower than that reported in similar studies in Africa (Awad and Eltayeb, 2007b) and close r to that found in population-based studies in Jordan and Lithuania (Al-Azzam et al., 2007 Berzanskyte et al., 2006). This goes to show that there index not be a signi- ficant difference in self-care or health-seeking behavior between our segment of the population and the general population. This conclusion is also supported by findings from a study on self-medication in general among Fadare and Tamuno 219Table 1. Distribution of respondents by level of medical education and practice of self-medication. University level Self-medication (Y) Self-medication (N) Total number of respondent 200 10 31 41 300 20 26 46 400 27 43 70 500 12 9 21 absentminded value 2 3 5 Total 71 112 183 Table 2. Conditions for which self-medication was practiced. ConditionNo. of respondents (Percentage) Diarrhoea 17 (24.6) Sore throat 14 (20.3) Fever 12 (17.4) Cough 6 (8.7) Catarrh 4 (5.8) Toothache 4 (5.8) Body aches 2 (2.9) Others 10 (14.5) Table 3. Commonly used antibiotics by respondents.Antibiotics Fre quency (Percentage) Ampicillin/cloxacillin 15 (22.1) Amoxicillin 12 (17.6) Metronidazole 12 (17.6) Co-trimoxazole 8 (11.8) Ciprofloxacin 6 (8.8) Tetracycline 6 (8.8) Amoxicillin/Clavulanic bitter 3 (4.4) Penicillin G 1 (1.5) health care workers of a ordinal healthcare facility in South-West Nigeria where over 70% of them were engaged in the practice (Bamgboye et al., 2006). Another possible explanation is that the earlier quoted population- based studies were carried out in societies where the literacy levels are relatively high. It is also important to telephone circuit that such levels of antibiotic self-medication even exists in some countries with more slopped access to drugs, this being made possible by use of left-overs from previous prescriptions. Clinical features and self-medicationThere are similarities in the conditions for which self- medication was practiced in our study with several other university and community-based studies (Zafar et al., 2008 Shankar et al., 20 02 mob et al., 2006). These findings emphasize the fact that self-medication is unremarkably resorted to by individuals for perceived mild clinical conditions. The enigma with this practice is that fever and other similar symptoms which could be due to viral conditions are normally wrongly treated with antibiotics creating a foundation for possible development of resistance to antibiotics in addition to financial loss and possible adverse drug reactions. Antibiotic and self-medicationThe choice of the antibiotics from the penicillin group (especially ampicillin/cloxacillin and amoxicillin) by majority of respondents in our study is in keeping with findings from other studies (Awad et al., 2005 Awad and Eltayeb, 2007b Raz et al., 2005). The choice of the antibiotics from the penicillin group could be due to the following reasons 1. They are cheap, easily accessible, have a severe safety profile and somehow broad spectrum of antimicrobial activity. The relatively low patronage of antibiotics like amoxicillin/clavulanic acid could be due to its cost (about 1500 Naira /10 US Dollars) per course of treatment, this in a country where over 60% of the population survive on less than 2 US Dollars daily. 2. It is also pertinent to note that at the moment, there are no restrictions to how and where antibiotics can be sold in Nigeria hence the easy accessibility. near of our respondents got their supply from patent medicine stores, hospital and community pharmacies reinforcing the earlier mentioned problem of lack of regulation. This is at variance with findings from other studies where left-over from old prescriptions were the main source of supply reflecting a more regulated access to antibiotics in these societies (Awad and Eltayeb, 2007b mob et al., 2006). This study revealed no strong associations between gender, level of medical education and the practice of antibiotic self-medication, a finding that is somehow different from the go forth of similar research i n the Arabian Gulf (James et al., 2008) where the prevalence of self- medication was higher in the more senior medical students. Presently in many medical schools in Nigeria, 220 J. Public Health Epidemiol. pharmacology is taught all before the clinical training or at its initial floor and there is no significant reinforce- ment during the latter stages. Also too often attention is being placed on the basic aspect of pharmacology to the detriment of its clinical section and paying attention to this problem might be one level of intervention to address it. ConclusionThis study has shown that self-medication with antibiotics is common among medical undergraduates in Northern Nigeria. There is a need for a review of educational programs especially the teaching of clinical pharmaco- logy to include modules on self- medication and rational use of medicines. At the policy-making level, there is an urgent need to legislate and enforce laws restricting access to antibiotics in Nigeri a. Most importantly, there is a need for a strapping public enlightenment campaign to educate the populace of the disadvantages and possible complications of antibiotic self-medication. ACKNOWLEDGEMENTSThe authors gratitude goes to the medical undergraduates of Bayero University, Kano, Nigeria who participated in this study. He is also grateful to the organizers of the International schooling Course on the Promoting Rational Drug Use in the Community, Jaipur, India where the view for the work was conceptualized. The author was a participant in the 2008 training course and the contribution of the faculty and fellow participants is really appreciated. REFERENCESAfolabi AO (2008). Factors influencing the pattern of self-medication in an self-aggrandizing Nigerian population. Ann. Afr. Med., 7(3) 120-127. Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MS (2007). Self-Medication with antibiotics in Jordanian population. Int. J. Occup. Med. Environ. Health, 20 (4) 373-380. Aswapokee N, Vaithayapichet S, Heller RF (1990). Pattern of antibiotic use in medical wards of a university hospital, Bangkok, Thailand. Rev. Infect. Dis., 12 (1) 136-141. Awad A, Eltayeb I, Matowe L Thalib L (2005). Self-medication with antibiotics and antimalarials in the community of Khartoum State, Sudan. J. Pharm. Pharm. Sci., 8 326331. Awad AI, eyeball DE, Eltayeb IB (2007). Improving rational drug use in Africa the example of Sudan. east Mediterr. Health J., 13 (5) 1202- 1211. Awad AI, Eltayeb IB (2007). Self-medication practices with antibiotics and antimalarials among Sudanese undergraduate university students.Ann. Pharmacother., 41(7) 1249-1255. Bamgboye EA, Amoran OE, Yusuf OB (2006). Self medication practices among workers in a tertiary hospital in Nigeria. Afr. J. Med. Sci., 35(4) 411-415. Berzanskyte A, Valinteliene R, Haaijer-Ruskamp FM, Gurevicius R, Grigoryan L (2006). Self-medication with antibiotics in Lithuania. Int. J. Occup. Med. Environ. Health, 19 (4) 246-2 53. Buke C, Hosgor-Limoncu M, Ermertcan S, Ciceklioglu M, Tuncel M,Kse T, Eren S (2005) Irrational use of antibiotics among university students. J. Infect., 51(2) 135-139. Chowdhury N, Matin F, Chowdhury SF (2009). Medication victorious behavior of students attending a private university in Bangladesh. Int. J. Adolesc. Med. Health. 21 (3) 361-370. James H, Handu SS, Al Khaja KA, Otoom S, Sequeira RP (2006). military rating of the knowledge, attitude and practice of self-medication among first-year medical students. Med. Princ. Pract., 15 (4) 270- 275. James H, Handu SS, Khaja KA, Sequeira RP (2008). Influence of medical training on self-medication by students. Int. J. Pharmacol. Ther., 46 (1)23-29. Lucas R, Lunet N, Carvalho R, Langa J, Muanantatha M, Nkunda LP, Barros H (2007). Patterns in the use of medicines by university students in Maputo, Mozambique. Cad. Saude. Publica, 3(12) 2845- 2852. Martins AP, Miranda Ada C, Mendes Z, Soares MA, Ferreira P, Nogueira A (2002). Self- medication in a Portuguese urban population a prevalence study. Pharmacoepidemiol. Drug Saf., 11(5) 409-414. Okeke NI, Lamikanra A, Edelman R (1999).Socioeconomic and Behavioral Factors Leading to Acquired Bacterial justification to Antibiotics in Developing Countries. Emerg. Infect. Dis., 5 18-27. Raz R, Edelstein H, Grigoryan L, Haaijer-Ruskamp FM (2005). Self- medication with antibiotics by a population in northern Israel. Isr. Med. Assoc. J., 7(11) 722-725. Sawalha AF (2008). A descriptive study of self-medication practices among Palestinian medical and nonmedical university students. Res. Social. Adm. Pharm., 4 (2)164-172. Shankar PR, Partha P, Shenoy N (2002). Self-medication and non- doctor prescription practices in Pokhara valley, Hesperian Nepal a questionnaire-based study. BMC Fam. Pract., 3 17. Tnger O, Din G, Ozbakkaloglu B, Atman UC, Algn U (2000). Evaluation of rational antibiotic use. Int. J. Antimicrob. Agents, 15 (2) 131-135. Vaananen MH, Pietila K, Airaksinen M ( 2006). Self-medication with antibiotic does it really slide by in Europe, Health Policy, 77 166- 171. Yousef AM, Al-Bakri AG, Bustanji Y, Wazaify M (2008). Self-medication patterns in Amman, Jordan. Pharm World Sci., 30(1) 24-30. Zafar SN, Syed R, Waqar S, Zubairi AJ, Vaqar T, Shaikh M, Yousaf W, Shahid S, Saleem S (2008). Self-medication amongst university students of Karachi prevalence, knowledge and attitudes. J. Pak.