ArticleBMJ open2025
Associations between sociodemographic characteristics and knowledge about antibiotics and antibiotic resistance and usage of antibiotics from a One Health perspective in rural Bangladesh: a descriptive cross-sectional study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesWe explored how key sociodemographic characteristics were associated with correct knowledge about antibiotics and antibiotic resistance (ABR) and appropriate usage of antibiotics from a One Health perspective among rural community members in Bangladesh.
designCross-sectional single-period survey.
settingRural villages in Cumilla district, Bangladesh.
participantsEligibility criteria: aged ≥18. Across 50 clusters of villages, we approached 2160 community members and 2187 (98.8%) agreed to participate. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes: we collected two knowledge outcomes measuring the number of correctly answered binary/multiple-choice questions about (1) antibiotics and ABR and appropriate usage of antibiotics in relation to human illness and (2) antibiotics and ABR and appropriate usage of antibiotics in relation to animal health and the environment. SECONDARY OUTCOMES: self-reported awareness of (1) antibiotics and (2) ABR.
resultsSeveral sociodemographic characteristics were associated with variation in both knowledge outcomes. Education showed the strongest associations, with higher education levels associated with higher knowledge scores. For example, compared with having no formal/incomplete primary education, having higher education was associated with 10 percentage points (95% CI 8 to 12) and 6 percentage points (95% CI 3 to 8) higher mean knowledge scores for the knowledge outcomes 1 and 2, respectively. Having worked in the last month compared with not having worked was also weakly positively associated with both knowledge outcomes, and being female compared with being male was also weakly negatively associated with both knowledge outcomes.
conclusionsBetter public education is required to tackle ABR in Bangladesh but correct knowledge about antibiotics and ABR and appropriate usage of antibiotics in relation to humans, animals and the environment varies in relation to individuals' education level, sex and working status. To maximise their effectiveness, interventions to tackle ABR must be flexible given recipients' sociodemographic characteristics and pre-existing knowledge levels.
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