Knowledge, perceptions and practices on antimicrobial resistance in humans and animals in Wakiso district, Uganda: A cross sectional study

David Musoke; Grace Biyinzika Lubega; Michael Brown Obeng; Claire Brandish; Jody Winter; Filimin Niyongabo; Kate Russell-Hobbs; Bee Yean Ng; Lawrence Mugisha; Saba Amir; Freddy Eric Kitutu; Linda Gibson

doi:10.1371/journal.pgph.0002701

Knowledge, perceptions and practices on antimicrobial resistance in humans and animals in Wakiso district, Uganda: A cross sectional study

PLOS Glob Public Health. 2023 Dec 13;3(12):e0002701. doi: 10.1371/journal.pgph.0002701. eCollection 2023.

Authors

Affiliations

¹ Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
² Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom.
³ Pharmacy Department, Buckinghamshire Healthcare NHS Trust, Aylesbury, United Kingdom.
⁴ Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.
⁵ Department of Pharmacy, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
⁶ Department for Livestock and Industrial Resources, School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, Kampala, Uganda.
⁷ School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Nottingham, United Kingdom.
⁸ Department of Pharmacy, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Abstract

Despite increasing evidence on antimicrobial resistance (AMR), there is limited literature on antimicrobial access and use in humans and animals in community settings globally. This study assessed knowledge and perceptions of AMR, as well as practices relating to the use of antimicrobials in humans and animals in Wakiso district, Uganda. This was a cross-sectional study among 418 participants that employed quantitative data collection methods. A structured questionnaire that included questions on knowledge, perceptions, practices related to AMR, and perceptions on access to antimicrobials in humans and animals was used. Data was analysed in STATA version 10. The majority of participants 63.6% (266/418) had heard about AMR mainly from family and friends 57.5% (153/266), and most 70.8% (296/418) were aware that resistant microorganisms cause infections that are difficult to treat. Most participants 62.7% (262/418) thought that they should complete the full dose of antimicrobials when on treatment. However, on the last occasion of antimicrobial use, 13.0% (44/338) revealed that they did not complete the full course of treatment. Participants who were single (APR = 1.12, C.I = 1.03-1.12, p-value = 0.01) and earning between 91 and 290 USD on average per month (APR = 1.12, C.I = 1.02-1.23, p-value = 0.02) were more likely to have completed a given antimicrobial course as compared to those who were married/cohabiting and earned less than 15 USD respectively. The majority of participants 60% (251/418) owned animals, and 81.3% (204/251) reported using antimicrobials mainly for prevention 61.3% (125/204) or treatment of sick animals 70.6% (144/204). Among the participants, 57.4% (117/204) reported not having sold or consumed animal products within a week after exposure to antimicrobials. Interventions to prevent AMR should adopt a One Health approach to address the gap in knowledge and practices relating to the use of antimicrobials in humans and animals.

Copyright: © 2023 Musoke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This study was funded as part of the Commonwealth Partnerships on Antimicrobial Stewardship (CwPAMS) supported by Tropical Health and Education Trust (THET) and Commonwealth Pharmacists Association (CPA) using Official Development Assistance (ODA) funding, through the Department of Health and Social Care’s Fleming Fund to LG and DM. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the Fleming Fund, the Department of Health and Social Care, THET or CPA.