Evidence map›Paper›PMID 37651424›Full record

ArticlePloS one2023

Practices and motives behind antibiotics provision in drug outlets in Tanzania: A qualitative study.

Pendo M Ndaki, Joseph R Mwanga, Martha F Mushi, Eveline T Konje, Kathryn Jean Fredricks, Mike Kesby, Alison Sandeman, Stella Mugassa, Msilikale W Manyiri, Olga Loza and 4 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 2 countries.

Pendo M NdakiDepartment of Biostatistics, Epidemiology and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.ORCID 0000-0002-2238-7627
Joseph R MwangaDepartment of Biostatistics, Epidemiology and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Martha F MushiDepartment of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Eveline T KonjeDepartment of Biostatistics, Epidemiology and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Kathryn Jean FredricksDepartment of Geography and Sustainable Development, University of St Andrews, St Andrews, United Kingdom.
Mike KesbyDepartment of Geography and Sustainable Development, University of St Andrews, St Andrews, United Kingdom.
Alison SandemanDepartment of Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom.
Stella MugassaDepartment of Biostatistics, Epidemiology and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Msilikale W ManyiriDepartment of Biostatistics, Epidemiology and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Olga LozaDepartment of Geography and Sustainable Development, University of St Andrews, St Andrews, United Kingdom.
Katherine KeenanDepartment of Geography and Sustainable Development, University of St Andrews, St Andrews, United Kingdom.
Stanley M MwitaSchool of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.ORCID 0000-0003-0563-6705
Matthew T G HoldenSchool of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Stephen E MshanaDepartment of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Catholic University of Health and Allied Sciences · TZUniversity of St Andrews · GB

Funding

Medical Research Council MR/S004785/1
6 · The paper itself

Abstract

Dispensing antibiotics without prescription is among the major factors leading to antimicrobial resistance. Dispensing of antibiotics without prescription has negative impact at the individual and societal level leading to poor patient outcomes, and increased risks of resistant bacteria facilitated by inappropriate choice of antibiotics doses/courses. Antimicrobial resistance is a global public health threat which is projected to cause 10 million deaths by 2050 if no significant actions are taken to address this problem This study explored the practices and motives behind dispensing of antibiotics without prescription among community drug outlets in Tanzania. Finding of this study provides more strategies to antibiotics stewardship intervention. In-depth interviews with 28 drug dispensers were conducted for three months consecutively between November 2019 and January 2020 in 12 community pharmacies and 16 Accredited Drug Dispensing Outlets (ADDOs) in the Mwanza, Kilimanjaro and Mbeya regions of Tanzania. Transcripts were coded and analyzed thematically using NVivo12 software. Majority of dispensers admitted to providing antibiotics without prescriptions, selling incomplete courses of antibiotics and not giving detailed instructions to customers on how to use the drugs. These practices were motivated by several factors including customers' pressure/customers' demands, business orientation-financial gain of drug dispensers, and low purchasing power of patients/customers. It is important to address the motives behind the unauthorized dispensing antibiotics. On top of the existing regulation and enforcement, we recommend the government to empower customers with education and purchasing power of drugs which can enhance the dispensers adherence to the dispensing regulations. Furthermore, we recommend ethnographic research to inform antibiotic stewardship interventions going beyond awareness raising, education and advocacy campaigns. This will address structural drivers of AMR such as poverty and inadequate government health services, and the disconnect between public messaging and/or policy and the public itself.

Indexed as

Anthropology, CulturalMotivationAnti-Bacterial AgentsHumansQualitative ResearchTanzaniaAnti-Bacterial Agents

Identifiers

PMID37651424
PMCPMC10470936
OpenAlexW4386322367

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.