Availability and Use of Antibiotics in the Dormaa Municipal District of the Bono Region in Ghana. Report for Fleming Fund Fellowship Programme

The rise observed in antimicrobial resistance over the past decades has been linked to the dramatic increase in use of antibiotics in humans and animals. Few studies have prospectively examined the availability and use of antibiotics in humans and animals at the residential level in Ghana. This study was conducted to gather data on the availability and use of antibiotics among residents in a suburban municipality in Ghana. Data from such studies may aid policy makers to devise strategies to help consumers to minimise inappropriate use of antibiotics at the community level. This study is a cross-sectional study during which the study team assessed the availability and use of antibiotics in humans at the community level in the Dormaa municipality of the Bono Region in Ghana. Structured questionnaires and the Drug Bag’ method were employed to quantify antibiotic types available at the community level, frequently used antibiotics in the community as well as the disease conditions these antibiotics are used to treat. A total of 100 households, 6 retail community pharmacy outlets and 11 out-patient health facilities were visited. Questionnaires were administered to participants in the pharmacies and out-patient facilities whilst the ‘Drug Bag’ method was combined with questionnaires to gather data in the households. The study results revealed that the top four antibiotics used by respondents in the households in the communities surveyed often without prescription were Amoxicillin Capsules, Metronidazole Tablets, Phenoxymethylpenicillin Tablets and Tetracycline Capsules. These antibiotics are normally obtained from Over-the-Counter Medicines Sellers facilities and peddlers although such outlets are not permitted by law to stock and dispense these antibiotics. The top three disease conditions given by respondents in the study communities for which antibiotics are used are gastrointestinal diseases, followed by fever with body pains and cough and cold conditions. Antibiotics known and used by respondents in the community was compared with the WHO AWaRe classification tool. The study revealed that 50% and 47% respectively of antibiotics known and used by respondents fell within the “Access” list while 11% and 8% respectively of antibiotics known and used by respondents fell within the “Watch” list. None of the antibiotics in the “Reserve” list was known to or had been used by respondents. The research found that 85% of households had used antibiotics three months prior to the study in the vicinity. The study has revealed common antibiotic use among residents in the Dormaa municipality, including for diseases which are preventable. This paper therefore suggests that preventive approaches including improving access to water and sanitation facilities may improve infection prevention and control, leading to decreased incidence of infections such as gastrointestinal disturbances and a decrease in the perceived need for frequent antibiotic use. Awareness creation is also key in sensitising communities about the dangers of excessive use of antibiotics, including the emergence of AMR