Access to and utilisation of antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia: a pilot cross-sectional survey

DK Hesari, S Aljadeeah, P Brhlikova, D Hyzam, H Komakech, JSP Rueda, JO Canas, C Ching, S Orubu, OB Acevedo, H Basaleem, Christopher Garimoi Orach, Muhammad H Zaman, CP da Costa

Research output: Contribution to journalA1: Web of Science-articlepeer-review

Abstract

Objectives
Identifying key barriers to accessing quality-assured and affordable antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia and investigating their (1) utilisation patterns of antibiotics, (2) knowledge about antimicrobial resistance (AMR) and (3) perception of the quality of antimicrobials received.

Design
Pilot cross-sectional survey.

Setting
Data were collected from five health facilities in the Kiryandongo refugee settlement (Bweyale, Uganda), three camps for internally displaced persons (IDPs) in the Dar Sad district (Aden, Yemen) and a district with a high population of Venezuelan migrants (Kennedy district, Bogotá, Colombia). Data collection took place between February and May 2021. The three countries were selected due to their high number of displaced people in their respective continents.

Participants
South Sudanese refugees in Uganda, IDPs in Yemen and Venezuelan migrants in Colombia.

Outcome measure
The most common barriers to access to quality-assured and affordable antimicrobials.

Results
A total of 136 participants were enrolled in this study. Obtaining antimicrobials through informal pathways, either without a doctor’s prescription or through family and friends, was common in Yemen (27/50, 54.0%) and Colombia (34/50, 68.0%). In Yemen and Uganda, respondents used antibiotics to treat (58/86, 67.4%) and prevent (39/86, 45.3%) a cold. Knowledge of AMR was generally low (24/136, 17.6%). Barriers to access included financial constraints in Colombia and Uganda, prescription requirements in Yemen and Colombia, and non-availability of drugs in Uganda and Yemen.

Conclusion
Our multicentred research identified common barriers to accessing quality antimicrobials among refugees/IDPs/migrants and common use of informal pathways. The results suggest that knowledge gaps about AMR may lead to potential misuse of antimicrobials. Due to the study’s small sample size and use of non-probability sampling, the results should be interpreted with caution, and larger-scale assessments on this topic are needed. Future interventions designed for similar humanitarian settings should consider the interlinked barriers identified.
Original languageEnglish
JournalBMJ Open
Volume14
Issue number7
Pages (from-to)1-11
Number of pages11
ISSN2044-6055
DOIs
Publication statusPublished - 2024

Keywords

  • Cross-Sectional Studies
  • Health Services Accessibility
  • INFECTIOUS DISEASES
  • MICROBIOLOGY
  • PUBLIC HEALTH
  • Pharmacology

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