186254 Self-prescribed use of antimicrobials for menstrual symptoms among Nigerian university students

Tuesday, October 28, 2008

Shauna Jayne Sweet , College Park, University of Maryland, College Park, MD
Erinna L. Kinney , School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, College Park, MD
Cecilia Oreoluwa Sopeju , Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
Elizabeth Otivhia , Department of Biological Sciences, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
Modupe T. Ojo , Department of Biological Sciences, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
Yemi Ayepola , Convenant University, Ogun State, Nigeria
Olufunmiso O. Olajuyigbe , Babcock University, OgunState, Nigeria
Morenike E. Coker , Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
Kayode K. Ojo, PhD , Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA
Amy R. Sapkota, PhD, MPH , Maryland Institute for Applied Environmental Health, University of Maryland, College Park, MD
Previous studies have shown that antimicrobial resistance is greatly influenced by human behavior. In developing countries where access to antimicrobials is largely unregulated misinformation and misperceptions exacerbate the improper and excessive use of antibiotics. In this study we present the preliminary results of a survey designed to evaluate the prevalence of self-prescribed antimicrobial usage among Nigerian women of child-bearing age, and examine the sociocultural beliefs supporting this usage. The survey was administered to a probability sample of women at four universities in Southwest Nigeria. Results suggest widespread and unorthodox use of antimicrobials to 1) treat menstrual symptoms, including cramps and heavy flow; and 2) prevent infections from feminine sanitary products. Ampicillin, metronizadole and tetracycline were among the antimicrobials that were heavily used. This misuse of antimicrobials during menstruation cannot be explained by low social status, educational attainment or access to health care. We propose instead that underlying this behavior is a form of information poverty perpetuated and validated by an association of any infection of the female urogenital area to promiscuity. The results of this survey underscore the need to educate young Nigerian women about the appropriate use of antimicrobials and sanitary products, as well as dispel inaccurate perceptions and beliefs associated with infections of the urogenital system. We explore how these data could help in the design of targeted educational outreach efforts in Southwest Nigeria aimed at reducing unorthodox antimicrobial use and ultimately stemming rises in antimicrobial resistance.

Learning Objectives:
1. Identify antibiotics being used among young women of child-bearing age in Nigeria to treat menstrual symptoms. 2. Understand potential local public health impact associated with unorthodox antimicrobial use. 3. Understand the potential global impact associated with unorthodox antimicrobial use. 4. Understand and describe the socio-cultural dynamics perpetuating unorthodox antimicrobial use among young women in Nigeria. 5. Identify necessary features of educational interventions designed to reduce unorthodox antimicrobial use among Nigerian women.

Keywords: Women's Health, Antimicrobial Drugs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am primarily responsible for the sample and survey design for this project; I am primarily responsible for the administration of preliminary focus groups and for the analysis of the pre-test and survey data. Although this would be my first time presenting at a Public Health Conference, I have experience presenting at regional and national conferences. To date I have presented at the Eastern Sociological Society meetings; I have attended and presented at conferences hosted by the Higher Education Data Sharing Consortium; most recently I presented work at the AAC&U Conference in January and was invited to present at an NITLE conference this June. I will be presenting at the 2008 AAPOR Conference.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.