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. 2024 Jul 16;14(7):e084734.
doi: 10.1136/bmjopen-2024-084734.

Access to and utilisation of antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia: a pilot cross-sectional survey

David Kamiab Hesari  1   2 , Saleh Aljadeeah  3 , Petra Brhlikova  4 , Dalia Hyzam  5 , Henry Komakech  6 , Jhon Sebastián Patiño Rueda  7 , Jovana Ocampo Cañas  7 , Carly Ching  8 , Samuel Orubu  9   10 , Oscar Bernal Acevedo  11 , Huda Basaleem  12 , Christopher Garimoi Orach  13 , Muhammad Zaman  8 , Clarissa Prazeres da Costa  14   2
Affiliations

Access to and utilisation of antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia: a pilot cross-sectional survey

David Kamiab Hesari et al. BMJ Open. .

Abstract

Objectives: Identifying key barriers to accessing quality-assured and affordable antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia and investigating their (1) utilisation patterns of antibiotics, (2) knowledge about antimicrobial resistance (AMR) and (3) perception of the quality of antimicrobials received.

Design: Pilot cross-sectional survey.

Setting: Data were collected from five health facilities in the Kiryandongo refugee settlement (Bweyale, Uganda), three camps for internally displaced persons (IDPs) in the Dar Sad district (Aden, Yemen) and a district with a high population of Venezuelan migrants (Kennedy district, Bogotá, Colombia). Data collection took place between February and May 2021. The three countries were selected due to their high number of displaced people in their respective continents.

Participants: South Sudanese refugees in Uganda, IDPs in Yemen and Venezuelan migrants in Colombia.

Outcome measure: The most common barriers to access to quality-assured and affordable antimicrobials.

Results: A total of 136 participants were enrolled in this study. Obtaining antimicrobials through informal pathways, either without a doctor's prescription or through family and friends, was common in Yemen (27/50, 54.0%) and Colombia (34/50, 68.0%). In Yemen and Uganda, respondents used antibiotics to treat (58/86, 67.4%) and prevent (39/86, 45.3%) a cold. Knowledge of AMR was generally low (24/136, 17.6%). Barriers to access included financial constraints in Colombia and Uganda, prescription requirements in Yemen and Colombia, and non-availability of drugs in Uganda and Yemen.

Conclusion: Our multicentred research identified common barriers to accessing quality antimicrobials among refugees/IDPs/migrants and common use of informal pathways. The results suggest that knowledge gaps about AMR may lead to potential misuse of antimicrobials. Due to the study's small sample size and use of non-probability sampling, the results should be interpreted with caution, and larger-scale assessments on this topic are needed. Future interventions designed for similar humanitarian settings should consider the interlinked barriers identified.

Keywords: Cross-Sectional Studies; Health Services Accessibility; INFECTIOUS DISEASES; MICROBIOLOGY; PUBLIC HEALTH; Pharmacology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. (A) Response distribution (in per cent) among participants how antibiotics are obtained, disaggregated by country; (B) Response distribution (in per cent) among participants obtaining antibiotics without a doctors prescription, disaggregated by country.
Figure 2
Figure 2. Response distribution to accessing medicine and healthcare is divided by effect.
Figure 3
Figure 3. (A) Percentage of respondents among participants knowing what AMR is disaggregated by country. (B) Percentage of respondents among participants in agreement with each statement is disaggregated by country. AMR, antimicrobial resistance.
See this image and copyright information in PMC

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