Prevalence of Antibiotic Use and Disposal at Household Level in Informal Settlements of Kisumu, Kenya

Abstract

The use and abuse of antibiotics are directly related to the development of drug resistance, a global public health problem. Whereas the majority of research focus is on the use and misuse of antibiotics in drug resistance development, little is known about improper disposal, as a source of contamination in the environment that includes groundwater, especially in informal settlements. This study sought to determine antibiotic use and disposal in informal settlements in Kisumu, Kenya. A random cross-sectional sample of 447 households in selected informal settlements of Kisumu, Kenya was studied. A structured questionnaire was issued to persons heading households. The prevalence of antibiotic use was 43% (n = 193). Among these people, 74% (n = 144) had consulted a health worker in a healthcare facility for a prescription. Respondents did not always complete doses but kept the remainder for the next time they would become ill (54%). About 32% disposed of the remainder of the antibiotics in pit latrines and compost pits (10%) while 4% disposed through burning. Antibiotic use was fairly high despite a low level of awareness of the health effects of consuming water contaminated with antibiotics (35%) (n = 156); p = 0.03. Misuse and inappropriate disposal of antibiotics as identified may lead to a higher risk of antibiotic resistance, increasing the disease burden in the informal settlements.

Environmental reservoirs of multidrug-resistant pseudomonads in a geographical location in Kenya with high community-acquired infections

“…All pseudomonad isolates had a MARI greater than 0.43, suggesting a high selective pressure in the current study environments, probably due to widespread antibiotic use and abuse, as reported in a previous study on the use and disposal of antibiotics in households in Kisumu, Kenya. 46 To prevent dissemination of MDR-pseudomonads, protecting water systems from contamination, thus incorporating the principle of one-health where environmental health translates directly to human health remains a top priority.…”

Environmental and Human Health Impact of Antibiotics Waste Mismanagement: A Review

“…It has been reported that more than 80 active pharmaceutical ingredients and metabolites have been found in underground and surface water in Europe and the US [64]. In 2015 and 2018, the European Union (EU) established a watch list that included antibiotics such as amoxicillin, erythromycin, ciprofloxacin, and clarithromycin perceived to negatively affect aquatic lives and the environment in general [70]. A call to world experts and world leaders by the World Health Organization (WHO) has been made to reduce the antimicrobial pollution of our environment [71].…”

Contamination of groundwater with sulfamethoxazole and antibiotic resistant Escherichia coli in informal settlements in Kisumu, Kenya

“…Higher prevalence of infectious diseases in informal settlements is s major driver for increased antibiotic use, leading to increased demand for antibiotics due to low capacity to access information to make informed health choices particularly in developing nations [5]. Antibiotic use in the informal settlement was found to be 43%, with the majority acquiring antibiotics without a prescription for a qualified health practitioner, choosing to self-medicate, which may accelerate selection and spread of antibiotic resistant microbes [6]. Access to antibiotics in informal settlements without a prescription is easy, where the health practitioners are not necessarily qualified or are not competent [7].…”