The effect of community dialogues and sensitization on patient reporting of adverse events in rural Uganda: Uncontrolled before-after study

Helen Byomire Ndagije; Leonard Manirakiza; Dan Kajungu; Edward Galiwango; Donna Kusemererwa; Sten Olsson; Anne Spinewine; Niko Speybroeck

doi:10.1371/journal.pone.0203721

The effect of community dialogues and sensitization on patient reporting of adverse events in rural Uganda: Uncontrolled before-after study

PLoS One. 2019 May 9;14(5):e0203721. doi: 10.1371/journal.pone.0203721. eCollection 2019.

Authors

Helen Byomire Ndagije¹, Leonard Manirakiza¹, Dan Kajungu², Edward Galiwango², Donna Kusemererwa¹, Sten Olsson³, Anne Spinewine⁴, Niko Speybroeck⁴

Affiliations

¹ National Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
² Makerere University Centre for Health and Population Research, Iganga, Uganda.
³ Sten Olsson Pharmacovigilance Consulting, Uppsala, Sweden.
⁴ Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium.

Abstract

Background: Patients experiencing adverse drug events (ADE) in many developing countries are in the best position to report these events to the authorities but need to be empowered to do so. Systematic evaluation of community engagement and patient support especially in rural areas would provide evidence for a program to monitor potential harm from medicines. The aim of this study was to assess the effects of a community dialogue and sensitization (CDS) program on the knowledge, attitude and practises of community members for reporting ADE.

Methods: This an uncontrolled before-after study was conducted in two eastern Ugandan districts between September 2016 and August 2017.

Results: After implementation of the community dialogue and sensitization (CDS) program, there was an overall 20% (95% CI:16% to 25%) increase in knowledge about ADE in the community compared to before the program began. Awareness levels increased by 50% (95% CI: 37% to 63%) among those with little or no education and by41% (95% CI: 31% to 52%) among young people (15-24 years). Furthermore, 5% (95% CI: 3% to 7%) more respondents recognized the need for reporting ADEs compared to before the program. Finally, there was a significant increase of 115% (95% CI:137% to 217%) in respondent recognition and reporting of ADEs compared to the beginning of the CDS program. Overall, this community found the CDS program acceptable and proposed aspects that could be improved for future use.

Conclusion: Our evaluation showed that the CDS program increased knowledge and improved attitudes by catalyzing discussions among community members and healthcare professionals on health issues and monitoring safety of medicines compared to before the program. Successful implementation of the program depends on holistic health systems strengthening and adaptation to the community's way of life.

Publication types

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

MeSH terms

Adverse Drug Reaction Reporting Systems / statistics & numerical data*
Controlled Before-After Studies
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Patient Acceptance of Health Care
Population Surveillance
Public Health* / standards
Public Health* / statistics & numerical data
Rural Population*
Self Report*
Uganda / epidemiology

Grants and funding

The authors received no specific funding for this work. The National Drug Authority provided support in the form of salaries for authors(HBN & DAK) and research materials but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Sten Olsson is affiliated to Sten Olsson Pharmacovigilance Consulting. Sten Olsson Pharmacovigilance Consulting provided support in the form of salary for author SO, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.