Prevalence of Antibiotic Use and Disposal at Household Level in Informal Settlements of Kisumu, Kenya

Kellen J Karimi; Aijaz Ahmad; Adriano Duse; Mutuku Mwanthi; Richard Ayah

doi:10.3390/ijerph20010287

Prevalence of Antibiotic Use and Disposal at Household Level in Informal Settlements of Kisumu, Kenya

Int J Environ Res Public Health. 2022 Dec 24;20(1):287. doi: 10.3390/ijerph20010287.

Authors

Kellen J Karimi^{1

2}, Aijaz Ahmad^{1

3}, Adriano Duse^{1

3}, Mutuku Mwanthi², Richard Ayah²

Affiliations

¹ Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa.
² Department of Public and Global Health, Faculty of Health Sciences, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya.
³ Infection Control, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory Service, Johannesburg 2193, South Africa.

Abstract

The use and abuse of antibiotics are directly related to the development of drug resistance, a global public health problem. Whereas the majority of research focus is on the use and misuse of antibiotics in drug resistance development, little is known about improper disposal, as a source of contamination in the environment that includes groundwater, especially in informal settlements. This study sought to determine antibiotic use and disposal in informal settlements in Kisumu, Kenya. A random cross-sectional sample of 447 households in selected informal settlements of Kisumu, Kenya was studied. A structured questionnaire was issued to persons heading households. The prevalence of antibiotic use was 43% (n = 193). Among these people, 74% (n = 144) had consulted a health worker in a healthcare facility for a prescription. Respondents did not always complete doses but kept the remainder for the next time they would become ill (54%). About 32% disposed of the remainder of the antibiotics in pit latrines and compost pits (10%) while 4% disposed through burning. Antibiotic use was fairly high despite a low level of awareness of the health effects of consuming water contaminated with antibiotics (35%) (n = 156); p = 0.03. Misuse and inappropriate disposal of antibiotics as identified may lead to a higher risk of antibiotic resistance, increasing the disease burden in the informal settlements.

Keywords: antibiotic disposal; antibiotic resistance; antibiotic use; environment; human health effect; informal settlements.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Family Characteristics*
Humans
Kenya / epidemiology
Prevalence
Public Health*

Grants and funding

This research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No. G-19-57145), Sida (Grant No: 54100113), Uppsala Monitoring Center, Norwegian Agency for Development Cooperation (Norad), and by the Wellcome Trust (reference no. 107768/Z/15/Z) and the UK Foreign, Commonwealth and Development Office, with support from the Developing Excellence in Leadership, Training and Science in Africa (DELTAS Africa) programme. The statements made and views expressed are solely the responsibility of the Fellow. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.