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. 2021 Oct 15;10(10):1249.
doi: 10.3390/antibiotics10101249.

National Antibiotics Utilization Trends for Human Use in Tanzania from 2010 to 2016 Inferred from Tanzania Medicines and Medical Devices Authority Importation Data

Raphael Zozimus Sangeda  1 , Habibu Ally Saburi  1   2 , Faustine Cassian Masatu  2 , Beatrice Godwin Aiko  3 , Erick Alexander Mboya  4 , Sonia Mkumbwa  2 , Adonis Bitegeko  2 , Yonah Hebron Mwalwisi  2 , Emmanuel Alphonse Nkiligi  2 , Mhina Chambuso  5 , Hiiti Baran Sillo  6 , Adam M Fimbo  2 , Pius Gerald Horumpende  7   8   9
Affiliations

National Antibiotics Utilization Trends for Human Use in Tanzania from 2010 to 2016 Inferred from Tanzania Medicines and Medical Devices Authority Importation Data

Raphael Zozimus Sangeda et al. Antibiotics (Basel). .

Abstract

Antimicrobial use (AMU) is one of the major drivers of emerging antimicrobial resistance (AMR). The surveillance of AMU, which is a pillar of AMR stewardship (AMS), helps devise strategies to mitigate AMR. This descriptive, longitudinal retrospective study quantified the trends in human antibiotics utilization between 2010 and 2016 using data on all antibiotics imported for systemic human use into Tanzania's mainland. Regression and time series analyses were used to establish trends in antibiotics use. A total of 12,073 records for antibiotics were retrieved, totaling 154.51 Defined Daily Doses per 1000 inhabitants per day (DID), with a mean (±standard deviation) of 22.07 (±48.85) DID. The private sector contributed 93.76% of utilized antibiotics. The top-ranking antibiotics were amoxicillin, metronidazole, tetracycline, ciprofloxacin, and cefalexin. The DIDs and percentage contribution of these antibiotics were 53.78 (34.81%), 23.86 (15.44), 20.53 (13.29), 9.27 (6.0) and 6.94 (4.49), respectively. The time series model predicted a significant increase in utilization (p-value = 0.002). The model forecasted that by 2022, the total antibiotics consumed would be 89.6 DIDs, which is a 13-fold increase compared to 2010. Government intervention to curb inappropriate antibiotics utilization and mitigate the rising threat of antibiotic resistance should focus on implementing AMS programs in pharmacies and hospitals in Tanzania.

Keywords: Anatomical Therapeutic and Chemical Classification; Defined Daily Dose; Tanzania; antibiotics utilization; antimicrobial; antimicrobial resistance; antimicrobial use.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Contribution of oral (A) and parenteral (B) route of medicine administration for systemic antibiotics utilized over seven years.
Figure 2
Figure 2
Contribution of each class (level 3 ATC classification) of antibiotics utilized in Tanzania from 2010 to 2016.
Figure 3
Figure 3
Contribution of each antibiotic in ATC class level J01C (A) for amoxycillin per year and (B) for the other antibiotics in class J01C utilized over seven years from 2010 to 2016 in Tanzania.
Figure 4
Figure 4
Contribution of each antibiotic in ATC class level J01X for the other antibiotics utilized over seven years from 2010 to 2016 in Tanzania.
Figure 5
Figure 5
Trends of total consumed antibiotics over seven years from 2010 to 2016. Year 1 corresponds to 2010, and year 7 corresponds to 2016. The linear curve estimation for (A) overall consumption of antibiotics shows an increasing trend. (B) The autoregressive integrated moving average (ARIMA, 0, 1, 0) model forecasts utilization between 2010 and 2022.
Figure 6
Figure 6
Top (local) importers of antibiotics utilized in Tanzania between 2010 and 2016. Panel (A) shows the top 10 importers, and panel (B) shows the annual distribution of the top 3 importers.
Figure 7
Figure 7
Top (foreign) suppliers of antibiotics utilized in Tanzania between 2010 and 2016. Panel (A) shows the top 10 importers, and panel (B) shows the annual distribution of the top 3 importers.
See this image and copyright information in PMC

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