Nepalese parents' knowledge and self reported use of antimicrobial medicine in the children of 0-12 years

Abstract

Antimicrobials treatment enables us to prevent and to treat ailments caused by bacteria, virus, fungi and parasites. Discovery of antimicrobials has played a major role in the increasing life span of human being. Along with the discovery of the antibiotic, antimicrobial resistance (AMR) has been inevitable phenomena ever since. Furthermore, inadequate knowledge about antimicrobial use and misuse is contributing in speeding up AMR. Therefore, the main objective of the survey is to find out any practice or knowledge that is potentially detrimental from the aspect of AMR. This study aimed to assess Nepalese parents' knowledge and self-reported use of antimicrobial medicine in the children from 0-12years. A cross-sectional survey was carried out in Nepal among 101 respondents. For the data collection, a previously validated Lebanese instrument was used. It was further modified according to the cultural and contextual setting of the survey location. Data was collected by face to face method with the assistance of structured questionnaire. Questionnaire was pre-tested with 5 respondents for assessing readability and validity. Data was analyzed using SPSS version 23. Mean, standard deviation, percentage and frequency were used to analyze data. For the scale constructed by summated variables the reliability tests by Cronbach Alpha coefficient was used. In order to find out differences in knowledge and self-reported antibiotic use according to demographic characteristics, Kruskal Wallis H test, Mann Whitney U test and Chi square test were used. P value <0.05 is considered as statistically significant. Among the respondents, 86.1% were young parents between 20-40 years, while female (69.3%) remained the highest respondents. Most of the respondents i.e. 71.3% had either secondary or university education. Almost all (97%) reported having 1-2 children under 12 years. Most of parents (92.1%) bought antibiotic according to doctor’s prescription and 82.2% of parents followed instruction of health care personnel. On the other hand, 30% of parents would stop giving antibiotic when their children feel better. Only, 4% would share antibiotic with another sick children suffering from the same symptoms and 9% would keep antibiotic stock at home for later use. Fever was reported (47.5%) to be the most common reason for giving antibiotics and most parents (68%) thought that antibiotic reduce fever. More than half of the parents acknowledged that antibiotic kills bacteria. However, almost half (45.5%) reported that antibiotic also treats viral infection. Most of parents (74.3%) were unsure if Amoxicillin is an antibiotic. More than half (59%) knew that antibiotic overuse leads to antibiotic resistance and 73% of parents knew that antibiotic effectiveness is reduced if full course is not completed. Significant differences were found between “age of respondent” and purchasing antibiotics on doctors’ prescription (p=0.009); and in between sharing antibiotics and “healthcare worker in the family” (p= 0.034). Also, significance differences in knowledge score were found with “education of parents” (p= 0.017) and “number of children” (p=0.031). Although the parental knowledge regarding antibiotic was reported inadequate, the self-reported use of antibiotic was better. It was reported that most parents trust health care worker and follow their instruction. Therefore, recommendations should focus on training health care personnel on judicial antimicrobial use and educating parents in their doctor’s visit. Further studies with adequate sample population are recommended to generalize results. Keywords: antibiotic, antimicrobial medication, knowledge, practice, parents, children