Prevalence of Self-Medication Essay

Antibiotic self-medicament among university aesculapian examination undergraduates in no.thern Nigeria Joseph O. Fad atomic number 18 1* and Igbiks Tamuno 21Department of Medicine, Kogi State Specialist Hospital, Lokoja, Nigeria 2Department of Pharmacology, Bayero University, Kano, Kano State, Nigeria. Accepted 20 April, 2011Self-medication is becoming a common type of self-care behavior among the tribe of many countries. Many internationalistic studies call for investigated the prevalence and nature of self-medication utilizes at the population level. In Nigeria, rough workers permit excessively looked at the population prevalence of self-medication in superior general however the prevalence of antibiotic drug drug drug self-medication among aesculapian undergraduates has not yet been studied. The gratify in reputationing this dedicate among this select multitude is due to the occurrence that they are the future prescribers and health educators of the population of Nigeria. The take was a cross-sectional pre-tested questionnaire-based study carried out among medical students of the Bayero University, Kano, North-West Nigeria during a dickens-week period in August 2008. The information from the returned questionnaire were coded, entered and analyzed using SPSS Version 12 statistical software.A gist of 183 students filled and returned the questionnaire giving a response stray of 83.2%. bulge out of these respondents, 120 (65.6%) were males and the mean age of respondents was 23.2 2.5 eld (Range 17 to 31). 71 (38.8%) of the medical students admitted to the practice and on that point was no statistically significant variation among the antithetical levels of medical rearing (p 0.05). Antibiotics from the penicillin group (ampicillin/cloxacillin, amoxicillin and ampicillin) were the most frequently utilise. Self-medication with antibiotics is prevalent among medical undergraduates in Northern Nigeria. in that location is a acqu ire for an intervention to address this practice. Key words Antibiotics, self-medication, medical undergraduates, Nigeria. INTRODUCTIONAntibiotics are oneness of the most prescribed drugs cosmoswide (Tnger et al., 2000). Self-medication with antibiotics is a common practice in many countries in the world although the trend seems to be more(prenominal) than in developing or resource-poor nations (Awad et al., 2005). Some of the reasons that have been demonstrate liable for this trend include lack of find to health care,availability of antibiotics as over the counter (OTC) drugs and in open markets and poor regulatory practices (Vaananen et al., 2006). Self-medication with antibiotics has been place as one form of ir thinking(prenominal) use of medicine lend to *Corresponding author. E-mail jofadaregmail.com. Tel +234- 8138048127. increased healthcare costs, antimicrobial drug protection and sometimes increased morbidity among the popu- lation (Aswapokee et al., 1990 Okeke et al., 1999).The practice of self-medication in general 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). One of the factors that have been found to influence this practice is the level of genteelness of the look for participants (Afolabi, 2008). Many studies have also previously 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 wellness 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 practi ce among university medical undergraduates in Nigeria is rattling 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 generation of drug prescribers and health educationists.The understanding of the level of antibiotic self-medication practice and the reasons for it will enable for different interventional strategies. It will also help policy makers to develop approaches for a more rational use of antibiotics in the residential district in general. The main accusive 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-medicationpractice. METHODSThe 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 vitamin D Level) using a convenient sampling system. QuestionnaireThe questionnaire which had been pre-tested among students of another cogency in the university consisted of both open and close ended questions. The questionnaires were administered to the students through their class representatives who also returned the filled ones. The act of filling and returning of the forms was taken as swallow of the students to participate and the study was approved by the Hospital Ethics Committee. The breaking wind question was Have you practiced self-medication with antibiotics in the last two months?The length of two months was chosen because of the belief that recall of medication use is glos s over very reliable within that time frame. Other questions include The reasons for craziness in self-medication, conditions for which the drugs were taken and the antibiotics that were creation utilize. Statistical analysesThe information from the returned questionnaire were coded and entered using SPSS edition 12 statistical software. Results were expressed as counts and percentages while 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 purpose 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 according to level of medical education is shown in Table 1. In respons e to the questionwhether 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, sore throat, fever, 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 universe mild while 24 (35.3%) were involved in it because of their past experience with the particular antibiotic. Regarding the source of the antibiotics used for self-medication, majority of the respondents (57.4%) patronized unvarnished 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 remainder from a previous prescription in this study. Majority of the medical undergraduates (89.6%) knew that the natural duration of treatment was supposed to be at least a minimum of 5 days however only 34 (49.3%) of the respondents rattling completed the course of treatment. This study also found out that sexual practice of the respondents did not influence significantly the practice of antibiotic self-medication (p = 0.07). DISCUSSION smack population and self-medicationThe frequency of antibiotic self- medication observed in our study is slightly lower than that reported in equal studies in Africa (Awad and Eltayeb, 2007b) and walk-to(prenominal) to that found in population-based studies in Jordan and Lithuania (Al-A zzam et al., 2007 Berzanskyte et al., 2006). This goes to show that there might 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. statistical distribution of respondents by level of medical education and practice of self-medication. University level Self-medication (Y) Self-medication (N) natural number of respondent 200 10 31 41 three hundred 20 26 46 400 27 43 70 500 12 9 21 Missing 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 Frequency (Percentage) ampicillin/cloxacillin 15 (22.1) A moxicillin 12 (17.6) Metronidazole 12 (17.6) Co-trimoxazole 8 (11.8) ciprofloxacin 6 (8.8) Tetracycline 6 (8.8) Amoxicillin/Clavulanic acid 3 (4.4) Penicillin G 1 (1.5) health care workers of a tertiary healthcare instalment 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 note that such levels of antibiotic self-medication even exists in some countries with more stringent 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 some(prenominal) other university and community-based studies (Zafar et al., 2008 Shankar et al., 2002 James et al., 2006). These findings emphasize the fact that self-medication is usually resorted to by individuals for comprehend mild clinical conditions. The problem with this practice is that fever and other similar symptoms which could be due to viral conditions are usually wrongly handle 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 pickaxe 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 interest reasons 1. They are cheap, easily accessible, have a good safety visibility and somehow broad spectrum of antimicrobial activity. The relatively low patronage of antibiotics uniform 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 apposite to note that at the moment, there are no restrictions to how and where antibiotics can be sold in Nigeria hence the easy accessibility. to the highest degree 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 James 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 result of similar research in 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 either before the clinical training or at its initial stage and there is no significant reinforce- ment during the latter stages. Also too much 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 revaluation of educational programs especially the teaching of clinical pharmaco- logy to include modules on self- medication and rational use of medicines. At thepolicy-making level, there is an urgent need to legislate and enforce laws restricting access to antibiotics in Nigeria. Most importantly, there is a need fo r a robust 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 Training Course on the Promoting Rational Drug Use in the Community, Jaipur, India where the idea 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). 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