Healthcare Professionals’ Knowledge of Pharmacogenetics and Attitudes Towards Antimicrobial Utilization in Zambia: Implications for a Precision Medicine Approach to Reducing Antimicrobial Resistance

Abstract

Introduction: Sub-Saharan Africa and other low- and middle-income countries (LMICs) have the highest rates of antimicrobial resistance (AMR) driven by high rates of antimicrobial utilization. This is a concern as AMR appreciably increases morbidity, mortality and costs. Pharmacogenetics (PGx) and precision medicine are emerging approaches to combat AMR. Consequently, as a first step there is a need to assess AMR knowledge and attitudes, and knowledge of PGx, among healthcare professionals and use the findings to guide future interventions.Methodology: We conducted a cross-sectional study involving 304 healthcare professionals at tertiary hospitals in Lusaka, Zambia. Structural Equation Modeling (SEM) was used to analyze relationships among latent variables.Results: Overall correctness of answers concerning AMR among healthcare professionals was 60.4% (7/11). Knowledge of pharmacogenetics was low (38%). SEM showed that high AMR knowledge score correlated with a positive attitude toward combating AMR (p < 0.001). Pharmacists had relatively higher AMR knowledge scores (mean = 7.67, SD = 1.1), whereas nurses had lower scores (mean = 5.57, SD = 1.9). A minority of respondents [31.5% (n = 95)] indicated that poor access to local antibiogram data promoted AMR, with the majority [56.5% (n = 190)] responding that poor adherence to prescribed antimicrobials can lead to AMR. Pharmacists had the highest scores for attitude (mean = 5.60, SD = 1.6) whereas nurses had the lowest scores (mean = 4.02, SD = 1.4).Conclusion: AMR knowledge and attitudes, as well as knowledge on PGx among healthcare professionals in Zambia, is sub-optimal and has the potential to affect the uptake of precision medicine approaches to reduce AMR rates. Educational and positive behavioral change interventions are required to address this and in future, we will be seeking to introduce these to improve the use of antimicrobials.

Nation-Wide Survey Assessing the Knowledge and Attitudes of Romanian Pharmacists Concerning Pharmacogenetics

“…Most pharmacists knew that PGx studies the influence of genetic variability over efficacy and safety of drugs. Similar results were observed in other studies performed in high-income countries (Haga et al, 2021), but in middle-and low-income countries pharmacists' knowledge concerning PGx was lower, with fewer professionals being familiar with this field (Nagy et al, 2020;Albitar and Alchamat, 2021;Mufwambi et al, 2021). However, when asked more specific questions, Romanian pharmacists displayed lower knowledge, not being aware of the mechanisms behind drug-response variability or regarding the influence of genetic variability over the efficacy and safety of drugs such as clopidogrel, codeine or carbamazepine.…”

Antibiotic resistance in Sudan: assessing the knowledge and practices of healthcare workers in Khartoum

“…The limited use of microbiological diagnostics in Sudan, plus the reliance on the patient and their families to send the specimen to the microbiology lab and subsequently retrieve the results, certainly impacts the availability of robust and accurate data. The results of this study are consistent with studies conducted in other LMICs (Ethiopia, 8 Zambia, 13 Peru 10 and Egypt 9 ), highlighting the poor link between different hospital wards and CMLs, lack of clinical specimens being sent for microbiological culture and susceptibility, and starting antibiotic treatment based on clinical findings, not being confirmed microbiologically (species and antibiogram). In a previous study, 14 we noted a surge in private laboratory diagnostic services that are replacing the hospital microbiology laboratories.…”

Knowledge, attitude and practice towards cervical cancer screening among women living with human immunodeficiency virus: Implication for prevention strategy uptake

“…Structural Equation Modelling (SEM) was used as knowledge, attitude, and practices (KAP) cover several facets, and SEM can model several explanatory variables and multiple outcome variables. As previously demonstrated (Mufwambi et al, 2021), we fitted direct and indirect pathways to KAP. We used direct variables (questions on cervical cancer screening knowledge, practices and attitude) to estimate the latent variables (knowledge, attitude and practices).…”