Knowledge, attitude and practice of health care workers on antibiotic resistance and usage in the Gambia

Introduction: Irrational prescription and use of antibiotics are found to be risk factors to the spread of antibiotic resistance. Studies have shown that more than half of the admitted patients at the Paediatric Department of the Edward Francis Small Teaching Hospital (EFSTH) in The Gambia have been treated with antibiotics in the year 2015 alone. It was also evident that 74.5% of clinical isolates were resistant to ampicillin which was the most prescribed antibiotic among these patients. Therefore, the need to assess  health care workers’ knowledge, attitude and practices on the phenomenon of anti-microbial resistance (AMR) and antibiotic usage in the Gambia.

Materials and Methods: This cross-sectional study was conducted using self-administered questionnaires which were adopted from related studies. The questionnaires were administered at 60 randomly selected health facilities (both public and private) from around the country with a sample size of 225 respondents in 2016. Descriptive analyses were performed for each study variable and rates were reported as percentages. The results are presented in the form of contingency tables with their respective related Chi-squared (χ2) statistics values. The interpretations of the P-values are based on the less than or equal to 0.05 (5%) significance level.

Result: The study revealed that 63.27% of the respondents were nurses, 41.7% of them had a work experience between 0-4 years of service and most of the respondents work in the urban areas. Most of health care workers have knowledge on the right usage of antibiotics and understood that frequent usage of antibiotic could compromise the effectiveness of antibiotics. The study found 94.14% of the health care workers agreed there exists antibiotic abuse in both hospital and community settings. However, 23.08% of the respondents are not aware those antibiotics are not effective against viral infections such as common cold.

Conclusion: Therefore, majority of the health care workers had knowledge about antibiotic resistance and are aware of the frequent and abuse of antibiotic use could contribute to the development of antibiotic resistance in the country. However, they were less informed of the cost involved in the treatment and management of multidrug resistance patients using fewer and expensive antibiotics. Moreover, some of the health care workers had misconception on the treatment of viral infections with antibiotics (such as antibacterial) and there also exists disproportionate distribution of trained health workers in the country. Therefore, refresher training on prudent usage of antibiotics for health care workers especially doctors and nurses must be strengthened.