Sunday, June 13, 2021

Use of antimicrobials and antimicrobial resistance in Nepal: a nationwide survey

Komal Raj Rijal1,6*, Megha Raj Banjara1,6, Binod Dhungel1, Samarpan Kafle1Kedar Gautam1, Bindu Ghimire1, Prabina Ghimire2, Samriddh Dhungel2, Nabaraj Adhikari1Upendra Thapa Shrestha1, Dev Ram Sunuwar3, Bipin Adhikari4,5 & Prakash Ghimire1*

1Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal. 2Nepal Medical College, Jorpati, Kathmandu, Nepal.

3Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal.

4MahidolOxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

5Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.

 

6These authors contributed equally: Komal Raj Rijal and Megha Raj Banjara.

 

*email: komal.rijal@cdmi.tu.edu.np; prakash.ghimire@cdmi.tu.edu.np

 

 

Nepal suffers from high burden of antimicrobial resistance (AMR) due to inappropriate use of antibiotics. The main objective of this study was to explore knowledge, attitude and practices of antibiotics uses among patients, healthcare workers, laboratories, drug sellers and farmers in eight districts of Nepal. A cross-sectional survey was conducted between April and July 2017. A total of 516 individuals participated in a face-to-face interview that included clinicians, private drug dispensers, patients, laboratories, public health centers/hospitals and, livestock and poultry farmers. Out of 516 respondents, 62.8% (324/516) were patients, 16.9% (87/516) were clinicians, 6.4% (33/516) were private drug dispensers. A significant proportion of patients (42.9%; 139/324) thought that fever could be treated with antibiotics. Majority (79%; 256/324) of the patients purchased antibiotics over the counter. The knowledge of antibiotics used among patients increased proportionately with the level of education: literate only [AOR = 1.4 (95% Cl = 0.6–4.4)], versus secondary education (8–10 grade) [AOR = 1.8 (95% Cl = 1.0–3.4)]. Adult patients were more aware of antibiotic resistance. Use of antibiotics over the counter was found high in this study. Knowledge, attitude and practice related to antibiotic among respondents showed significant gaps and need an urgent effort to mitigate such practice.

 

Citation: Scientific Reports (2021);11:11554 DOI: https://doi.org/10.1038/s41598-021-90812-4

www.nature.com/scientificreports

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