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Table 1 Summary of included studies

From: The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis

Author/Date

Country

Objective

Sample Size

Prevalence

CI

Sources NPA

Main findings

Abdulraheem, et al., 2016 [33]

Nigeria - Rural

To estimate the prevalence and identify factors associated with to SMA

150

63%

95%

Drug stores

Pharmacy

Friends/family

Remnant stock

Easy access to information from drug indices, medical literature and colleagues gives the sense of control. Misplaced lead to inappropriate self-medication.

Aditya, et al., 2013 [34]

India – Urban

To compare features of SMA among undergraduate dental students.

1150

82.2%

95%

Pharmacy

Home cabinet

Level of education significantly influenced. Males more prone to self-medication than females. Economic factors – SMA is cheaper and affordable.

Albawani, et al., 2016 [41]

Sana City - Yemen Rural/urban

To determine the prevalence of SMA and its associated risk factors.

363

87.1%

95%

Community drug dispensers

Friends/family

Remnant stock

Poor medication knowledge lack of awareness, Poor dispensing control

Bilal, et al.,2016 [30]

Sindh City - Paquistan Rural

To evaluate the prevalence and practice of self-medication with antibiotics

400

81.25%

95%

Pharmacies

Corner stores

Home cabinet

Population, self-medicating had low level of education, with almost half of them uneducated, and mostly belonging to the low socioeconomic class.

Ramay, et al., 2015 [48]

Guatemala-Rural/Urban

To compare the magnitude of SMA and the characteristics of Those who self-medicate with antibiotics in four pharmacies

418

78%

95%

Pharmacy

left over from previous prescriptions

Family member Friend

Publicity, Internet

Differences in socio-economic characteristics have been cited as a determinant for self-medication practices

Motives for SMA were centered on the cost of medical visits.

Ramay, et al., 2017 [31]

Guatemala City Urban

To understand the practice of SMA in four Guatemalan private pharmacies by comparing the characteristics of SMA in Guatemala, sources of information used, perceived effects of SMA and motives

230

79%

80%

Pharmacies

Supermarket

Corner stores

From home (previously purchased)

Pharmacy employee

Family, Friend

High proportions of self-medication were similar in both

pharmacies, despite the differences in monthly income and educational

level.

Israel, et al., 2015 [42, 49]

Nigeria Urban

To estimate the prevalence of SMA and evaluating the socio-demographic factors associated with the practice

471

93.9%

NS

family and friend’s leftovers

Community Pharmacy Hospital pharmacy

Respondents with higher educational level showed higher prevalence of SMA than those with lower educational qualification. SMA because of lack of funds to purchase drugs or pay hospital bills. Familiarity of the population to Beta lactam class this class of antibiotics could contribute to their misuse and abuse.

The high consultation of patent medicine dealers for drug and health information is appalling and should be discouraged.

Senadheera, G. et al., 2017 [45]

Sri lanka - Rural

To determine the period prevalence of SMA in the Colombo District and to describe the reasons for SMA, its utilization pattern and socio-economical determinants

431

80.4%.

95%

Pharmacy

Left over

previous prescription

Given to another person

Left over from previous prescription

Contact in hospital

Friend

The study has provided data about the practice of SMA in Colombo district and identified an important area to be addressed in antibiotic stewardship programmes.

Sah, A. et al. 2016 [50]

Nepal- Urban

To estimate the prevalence of SMA among nursing students and evaluate factors associated.

500

91%

95%

Previous experience of same illness

Seen previously doctor prescription

Advice from colleagues and seniors

It was reported using antibiotics for an inappropriate duration of time, and few of them knew the dosage of drugs used.

Shah, S. et al., 2014 [46]

Pakistan – Urban

To provide the prevalence of self-medication with antibiotics amongst the university students of Karachi.

431

80.4%

NS

NS

The prevalence of self-medication with antibiotics among the non-medical university students was high despite the awareness of adverse effects. Antibiotic resistance was a relatively unknown terminology.

Shiavong, A. et al., 2017 [51]

Laos- Urban/Rural

To describe antimicrobial self-medication for reproductive tract infections (RTI) including sexually transmitted infections (STI), and to explore the understanding and use of health information among the adult population

500

91%

NS

Pharmacies,

Following previous treatment

Nurse

Drug seller

Friend

Parents/relative

More than three quarters of respondents, self-medicating for RTI/STI with antimicrobials, used inappropriate drugs bought from private pharmacies. There is a need to improve RTI/STI

management, including health promotion, through interventions at community level, and to health providers, including private drug sellers.

  1. NS Not specified
  2. Risk of bias assessment