Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Aug;26(8):862-881.
doi: 10.1111/tmi.13600. Epub 2021 May 24.

Comparative assessment of the prevalence, practices and factors associated with self-medication with antibiotics in Africa

Eugene Vernyuy Yeika  1 , Brecht Ingelbeen  2 , Ben-Lawrence Kemah  3   4 , Frankline Sevidzem Wirsiy  5 , Joseph Nkeangu Fomengia  6   7 , Marianne A B van der Sande  2   8
Affiliations
Free article
Meta-Analysis

Comparative assessment of the prevalence, practices and factors associated with self-medication with antibiotics in Africa

Eugene Vernyuy Yeika et al. Trop Med Int Health. 2021 Aug.
Free article

Abstract

Objective: To evaluate and compare the prevalence, reasons, sources and factors associated with self-medication with antibiotics (SMA) within Africa.

Methods: Systematic review and meta-analysis. An electronic search of PubMed and Google Scholar databases was performed for observational studies conducted between January 2005 and February 2020. Two reviewers independently screened abstracts and full texts using the PRISMA flowchart and performed quality assessment of eligible studies. Both qualitative and quantitative syntheses were carried out.

Results: Forty studies from 19 countries were eligible for qualitative synthesis. The prevalence of SMA in Africa ranged from 12.1% to 93.9% with a median prevalence of 55.7% (IQR 41-75%). Western Africa was the sub-region with the highest reported prevalence of 70.1% (IQR 48.3-82.1%), followed by Northern Africa with 48.1% (IQR 41.1-64.3%). We identified 27 antibiotics used for self-medication from 13 different antibiotic classes. Most frequently used antibiotics were penicillins (31 studies), tetracyclines (25 studies) and fluoroquinolones (23 studies). 41% of these antibiotics belong to the WHO Watch Group. The most frequent indications for SMA were upper respiratory tract infections (27 studies), gastrointestinal tract symptoms (25 studies) and febrile illnesses (18 studies). Common sources of antibiotics used for self-medication were community pharmacies (31 studies), family/friends (20 studies), leftover antibiotics (19 studies) and patent medicine stores (18 studies). The most frequently reported factor associated with SMA was no education/low educational status (nine studies).

Conclusions: The prevalence of SMA is high in Africa and varies across sub-regions with the highest prevalence reported in Western Africa. Drivers of SMA are complex, comprising of socio-economic factors and insufficient access to health care coupled with poorly implemented policies regulating antibiotic sales.

Keywords: Africa; associated factors; practices; prevalence; self-medication with antibiotics.

PubMed Disclaimer

References

    1. World Health organization. Guidelines for the Regulatory Assessment of Medicinal Products for Use in Self-medication. WHO: Geneva, 2000.
    1. Ayalew MB. Self-medication practice in Ethiopia: a systematic review. Patient Prefer Adher 2017: 11: 401-413.
    1. Bennadi D. Self-medication: a current challenge. J Basic Clin Pharm 2013: 5: 19-23.
    1. Alhomoud F, Aljamea Z, Almahasnah R, Alkhalifah K, Basalelah L, Alhomoud FK. Self-medication and self-prescription with antibiotics in the Middle East-do they really happen? A systematic review of the prevalence, possible reasons, and outcomes. Int J Infect Dis 2017: 57: 3-12.
    1. Torres NF, Chibi B, Middleton LE, Solomon VP, Mashamba-Thompson TP. Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review. Public Health 2019: 168: 92-101.

Substances

LinkOut - more resources