A systematic Review and Meta-analysis of Antimicrobial Prescriptions in East Africa
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Date
2021-06
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Addis Abeba University
Abstract
Background: Antimicrobial resistance is one of the major global health problems that has been
worsened due to poor antibiotic stewardship by health workers and improper use of
antimicrobial by the patients among other factors. Quality data representative of the extent of
poor antimicrobial stewardship in low- and middle-income countries is scanty, but high
incidences of antimicrobial resistance are increasingly reported in many settings across the
globe. The objective of the present study was, therefore, to evaluate prescriptions for
antimicrobials in East Africa.
Methods: A comprehensive literature search strategy that includes text words and medical
subject headings was developed and applied to predefined electronic databases. Two
researchers independently screened the titles and abstracts of the outputs of the literature
search. Full texts were then independently reviewed by the two researchers. Extracted data
from included studies were pooled using meta-analysis.
Results: Majority of the included studies (30.8%) were retrieved from Ethiopia, followed by
Sudan, Kenya and Tanzania each contributing 19.2%. The overall proportion of encounter with
antimicrobials reported was 57% (95%CI 42%; 73%). Ethiopia had an overall patient encounter
with antimicrobials of 63% [95%CI: 50%, 76%] followed by Sudan with an overall encounter
with antimicrobials of 62% [95%CI: 34%, 85%]. Studies included from Kenya reported the
overall encounter with antimicrobials of 54% [95%CI: 15%, 90%], whereas studies from
Tanzania reported an overall patient encounter with antimicrobials of 40% [95%CI: 21%,
60%].
Conclusion: Prescription patterns demonstrated in this review significantly deviate from WHO
recommendations suggesting inappropriate antimicrobial use in the East African countries.
Considering the global threat posed by antimicrobial resistance, perhaps countries with few
research being carried out on antimicrobial use patterns and resistance should focus more
resources on this important research agenda as a matter of public health priority.
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Keywords
Antimicrobial Prescriptions