Evidence map›Paper›PMID 42135756›Full record

ArticleBMC public health2026

Exploring confusion with antibiotic identification at the community level in six low-and-middle-income countries across Asia and Africa.

Samuel Afari-Asiedu, Annelie A Monnier, Nga T T Do, Kwaku Poku Asante, Wasif Ali Khan, Mohammad Abdul Matin, Khátia Munguambe, Helena Boene, Esperanca Sevene, Sureeporn Punpuing and 8 more

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Article in BMC public health, 2026. 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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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

18 authors.

Samuel Afari-Asiedu *Kintampo Health Research Centre, Research and Development Division of Ghana Health Service, Kintampo, Ghana.
Annelie A Monnier *Department of Medical Microbiology and Radboudumc Community for Infectious Diseases, Radboudumc, Nijmegen, 6525 GA, The Netherlands.
Nga T T DoOxford University Clinical Research Unit, Hanoi, Vietnam.
Kwaku Poku AsanteKintampo Health Research Centre, Research and Development Division of Ghana Health Service, Kintampo, Ghana.
Wasif Ali KhanInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Mohammad Abdul MatinInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Khátia MunguambeFaculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
Helena BoeneManhiça Health Research Centre, Manhiça, Mozambique.
Esperanca SeveneManhiça Health Research Centre, Manhiça, Mozambique.
Sureeporn PunpuingInstitute for Population and Social Research, Mahidol University, Nakhonpathom, Thailand.
Malee SunpuwanInstitute for Population and Social Research, Mahidol University, Nakhonpathom, Thailand.
Tuyet P AnhDepartment of Family Medicine, Hanoi Medical University, Hanoi, Vietnam.
Toan K TranDepartment of Family Medicine, Hanoi Medical University, Hanoi, Vietnam.
Georgina Pujol-Busquets GuillénMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
F Xavier Gómez-OlivéMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Floidy WafawanakaMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Heiman F L WertheimDepartment of Medical Microbiology and Radboudumc Community for Infectious Diseases, Radboudumc, Nijmegen, 6525 GA, The Netherlands. heiman.wertheim@radboudumc.nl.
ABACUS II consortium

Funding

Wellcome TrustWellcome Trust grant number: 219403/Z/19/Z
6 · The paper itself

Abstract

backgroundAntimicrobial resistance (AMR) is largely attributable to inappropriate antibiotic use particularly in low-and-middle-income countries (LMICs). Misidentification of antibiotics could contribute to inappropriate use, as people may use the wrong drugs for their conditions. Misidentification and inappropriate use are worsened by self medication and easy access to antibiotics that are obtained from unapproved sources, including over-the-counter medicine sellers. This study explored community perceptions of confusion with antibiotics identification and pathways to improve the identification through physical or visual appearance.

methodsA qualitative exploratory study was conducted from June 2021 and December 2022. A total of 140 In-depth interviews (IDIs) with medicine suppliers and 76 focus group discussions (FGDs) with community members were conducted in six countries spanning Africa (Ghana, Mozambique, South Africa) and Asia (Bangladesh, Thailand, Vietnam). Data was thematically analysed, and results presented as narratives with excerpts to support the findings.

resultsIdentification of antibiotics through physical and visual appearance emerged as a complex issue influenced by a variety of factors including colours, shapes, sizes, packaging, local terminologies, and cultural beliefs. Visual cues serve as a primary means of antibiotic identification across all studied countries. This is especially significant in contexts where language barriers or low literacy hinder identification by written labels. While there are common trends across the studied countries, such as the importance of colour in identification, there are also significant regional and local variations that should be considered. DISCUSSION: The study highlights visual cues a primary means of antibiotic identification, providing valuable insights for developing targeted health literacy and antibiotic awareness interventions. Ultimately, enhancing the ability of community members to accurately identify antibiotics is a key step in promoting responsible antibiotic use practices and improving global health outcomes.

Indexed as

Anti-Bacterial AgentsDeveloping CountriesAfricaAsiaFocus GroupsHumansInterviews as TopicQualitative ResearchAnti-Bacterial AgentsAntibiotic identificationAntibioticsAntimicrobial resistanceAppearance of oral antibioticsCommunity-settingMedicine dispensingResponsible antibiotic use

Identifiers

PMID42135756
PMCPMC13625308

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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.