Evaluation of Doctors’ Knowledge, Attitudes, Behaviors, Awareness and Practices on Rational Antimicrobial Stewardship in a Training and Research Hospital in Mogadishu-Somalia

Kazım Kıratlı,1 Murat Aysin,2 Mukhtar Abdullahi Ali,1 Ahmed Mohamed Ali,1 Hakan Zeybek,3 Şükran Köse4 1Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Mogadishu, Somalia; 2Balikesir University Faculty of Medicine, Department of Public Health, Balikesir, Turkey; 3Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Orthopedics and Traumatology, Mogadishu, Somalia; 4Dokuz Eylul University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, TurkeyCorrespondence: Kazım Kıratlı, Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Mogadishu, Somalia, Tel +252611522947, Email drkazimkiratli@gmail.comIntroduction: Historically, antimicrobials have been used to treat microbial illnesses in humans and animals. But throughout this time, antibiotics that had been successful against particular microorganisms started to lose their effectiveness due to rising inappropriate use brought on by ignorance, negligent attitudes, and improper methods. Our goal in conducting this study was to ascertain the knowledge, attitudes, and practices of doctors with relation to the use of antibiotics in light of the growing global and Sub-Saharan African problem of antimicrobial resistance.Methods: In a tertiary hospital in Mogadishu, Somalia, a cross-sectional survey study was carried out to assess experts’ and research assistants’ knowledge, attitudes, behavior, awareness, and practices regarding the use of antibiotics and antibiotic resistance. A questionnaire consisting of 2 sections and 22 questions was applied to the participants on a voluntary basis.Results: Among the 202 doctors that participated in the study, 49 (24.3%) were specialists, and 153 (75.7%) were assistants. Prescriptions for one to ten antibiotic boxes per week on average were reported by 146 respondents (72.3%). Of the physicians, just 27 (13.4%) did not require assistance when prescribing an antibiotic. The most often accessed sources of support were experts in infectious diseases (43.1%) and national/international antimicrobial guidelines (32.2%). The top three factors contributing to antibiotic resistance in Somalia include misuse of antibiotics (61.4%), unnecessary prescriptions written by doctors (44.6%), and an absence of infectious disease specialists in most institutions (44.1%).Conclusion: As an alarming level of antimicrobial resistance has been observed globally in recent years, the results of our survey will help educate our doctors by gauging their perceptions, attitudes, and knowledge about rational antibiotic use in Sub-Saharan Africa. This will provide better patient outcomes.Keywords: antimicrobial resistance, Sub-Saharan Africa, microorganism, prescription, Infectious disease, knowledge