2 Drug-resistant infectious “superbugs” are increasing, 3– 5 and global efforts to curtail the emergence of resistance are gaining priority. Both are widely acknowledged as a public health concern and global problem. 1 Antibiotic use relates to “ABR” and is a subset of “antimicrobial resistance” (AMR).
The problem of antibiotic resistance (ABR).Īntibiotic effectiveness has decreased in recent years because of overuse and misuse, resulting in increasing bacterial resistance and threatening modern medicine. Therefore, context-specific educational campaigns, drawing on people’s understandings of antibiotics and informed by the experiences of other diseases, may be an important and deployable means of promoting the safe use of antibiotics. Safer use of antibiotics and why resistance is necessary to understand need to be instilled. Our findings indicate that regulation around the sale of antibiotics is enforced. The concept of “ABR” was understood by some community members when translated into related Xitsonga words because of knowledge tuberculosis and HIV/AIDS treatment regimens. Some people kept antibiotics for future episodes of infection. There was a mix of people who finished their prescription according to the instructions and those who did not. No account of the illegal purchasing of antibiotics was described. Respondents reported accessing antibiotics prescribed from legal sources: by nurses at the government primary healthcare clinics or by private doctors dispensed by private pharmacists. We used the five abilities of seek, reach, pay, perceive, and engage in access to healthcare as proposed by Levesque’s “Access to Healthcare” framework. A sample of 60 community members was recruited from the Agincourt Health and Demographic Surveillance System, situated in Mpumalanga Province, from April to August, 2017. Embedded within the multicountry ABACUS project, this qualitative study uses interviews and focus group discussions. To achieve this, we investigated where community members (village residents) were accessing and sourcing medication, and what they understood antibiotics and antibiotic resistance (ABR) to be.
By using the case of four villages in the north east of the country, our aim was to investigate popular notions and social practices related to antibiotics to inform patient-level social interventions for appropriate antibiotic use. Authors’ addresses: Jocelyn Anstey Watkins, Social Science and Systems in Health, Division of Health Sciences, Warwick Medical School, Gibbet Hill, The University of Warwick, Coventry, United Kingdom, E-mail: Fezile Wagner and Francesc Xavier Gómez-Olivé, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, E-mails: and Heiman Wertheim, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam, Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom, and Department of Medical Microbiology, Radboudumc Center for Infectious Diseases, Nijmegen, The Netherlands, E-mail: Osman Sankoh, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone, and Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, E-mail: John Kinsman, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health (Umeå Centre for Global Health Research), Umeå University, Umeå, Sweden, and Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden, E-mail: and practices of rural South African populations with regard to antibiotic access and use (ABACUS) remain understudied.
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