Access, use and disposal of antimicrobials among humans and animals in Wakiso district, Uganda: a qualitative study

Musoke, D, Namata, C, Lubega, GB, Kitutu, FE, Mugisha, L, Amir, S ORCID: https://orcid.org/0000-0001-5518-9750, Brandish, C, Gonza, J, Ikhile, D ORCID: https://orcid.org/0000-0002-4343-1674, Niyongabo, F, Ng, BY, O’Driscoll, J, Russell-Hobbs, K, Winter, J ORCID: https://orcid.org/0000-0003-3582-7596 and Gibson, L ORCID: https://orcid.org/0000-0002-1220-8680, 2021. Access, use and disposal of antimicrobials among humans and animals in Wakiso district, Uganda: a qualitative study. Journal of Pharmaceutical Policy and Practice, 14: 69.

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Abstract

Background: Inappropriate use of antimicrobials in both humans and animals is a key driver of antimicrobial resistance (AMR). In addition, human behaviours such as poor disposal of antimicrobials in the environment can increase their exposure to microbes which can impact on humans and animals. However, evidence on access, use and disposal of antimicrobials for humans and animals at community level in Uganda is limited. This study therefore explored access, use and disposal of antimicrobials among humans and animals in Wakiso district, Uganda.

Methods: A qualitative study was conducted that involved focus group discussions (FGDs) and key informant interviews (KIIs). Participants of the FGDs were community health workers (CHWs) and farmers involved in animal husbandry, while key informants included: officials from the Ministry of Health; Ministry of Agriculture, Animal Industry and Fisheries; human and animal health professionals; district health officials; and members of the national AMR surveillance committee. Twelve FGDs were held (8 for CHWs and 4 for farmers) while 15 KIIs were conducted. Thematic analysis in NVivo (version 12) was performed.

Results: Five main themes emerged from the study: access to antimicrobials in humans; access to antimicrobials in animals; use of antimicrobials in humans; use of antimicrobials in animals; and disposal of antimicrobials. Community members mainly accessed antimicrobials for humans from public health facilities such as government health centres, as well as private facilities, including drug shops and clinics. Antimicrobials for animals were obtained from veterinary practitioners and drug shops (both for humans and veterinary). Examples of inappropriate use of antimicrobials in both humans and animals was evident, such as sharing antibiotics among household members, and giving human-prescribed antimicrobials to food-producing animals as growth promoters. While some CHWs returned unused antimicrobials to public health facilities for proper disposal, community members mainly disposed of antimicrobials with general household waste including dumping in rubbish pits.

Conclusions: There is a need to increase awareness among the population on proper access, use and disposal of antimicrobials for both humans and animals. Development of a drug disposal system at community level would facilitate improved waste management of antimicrobials. Together, these measures would help prevent the rate of progression of AMR in communities.

Item Type:	Journal article
Publication Title:	Journal of Pharmaceutical Policy and Practice
Creators:	Musoke, D., Namata, C., Lubega, G.B., Kitutu, F.E., Mugisha, L., Amir, S., Brandish, C., Gonza, J., Ikhile, D., Niyongabo, F., Ng, B.Y., O’Driscoll, J., Russell-Hobbs, K., Winter, J. and Gibson, L.
Publisher:	BMC
Date:	2021
Volume:	14
Identifiers:	Number Type 10.1186/s40545-021-00361-4 DOI 1465774 Other
Rights:	© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Divisions:	Schools > School of Animal, Rural and Environmental Sciences Schools > School of Science and Technology Schools > School of Social Sciences
Record created by:	Laura Ward
Date Added:	02 Sep 2021 15:13
Last Modified:	02 Sep 2021 15:24
URI:	https://irep.ntu.ac.uk/id/eprint/44106

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