Antibiotic resistance among the Lahu hill tribe people in northern Thailand: a cross-sectional study

Abstract Background Antibiotic resistance is often reported and is of major concern as a public health problem. The hill tribe people in Thailand are considered populations vulnerable to antibiotic resistance due to their poor economic and educational status. The study aimed to estimate the prevalence of, the factors associated with, and the major species of bacteria involved in antibiotic drug resistance among the Lahu hill tribe people in northern Thailand. Methods A cross-sectional study was conducted to gather information from participants between March and September 2019. A validated questionnaire was used for data collection. Participants who presented an illness related to infectious diseases were eligible to participate in the study and were asked to obtain specific specimens. Antibiotic susceptibility was tested by the Kirbey-Bauer disk diffusion test. Chi-square tests and logistic regression were used to detect the associations between variables at the significance level of α = 0.05. Results A total of 240 participants were recruited into the study; 70.4% were females, 25.4% were aged 30–40 years. More than half worked in the agricultural sector (55.4%) and had an education level of less than primary school (45.8%). The majority had urinary tract infections (67.9%) with two major pathogenic species of the infection: Escherichia coli (12.8%) and Enterobacter cloacae (8.0%). The prevalence of antibiotic resistance was 16.0%. Escherichia coli and Klebsiella pneumoniae species were found to have multidrug resistance that was greater than that of other species, while ampicillin was found to have the greatest drug resistance. In the multivariate model, it was found that those who had poor knowledge of antibiotic use had a 2.56-fold greater chance (95% CI = 1.09–5.32) of having antibiotic resistance than did those who had good knowledge of antibiotic use, and those who had poor antibiotic use behaviors had a 1.79-fold greater chance (95% CI = 1.06–4.80) of having antibiotic resistance than did those who had good antibiotic use behaviors. Conclusion Effective public health interventions are urgently needed to reduce antibiotic drug resistance among the Lahu people by improving their knowledge and skills regarding the proper use of antibiotics and eventually minimizing antibiotic resistance.</jats:p

Antibiotic resistance among the Lahu hill tribe people, northern Thailand: a cross-sectional study

Abstract Background Antibiotic resistance is often reported and great concerned as one of public health problems especially people living with poverty in developing countries including Thailand. The hill tribe people is defined as vulnerable population for antibiotic resistance in Thailand due to poor economic and education status particularly the Lahu people who is the second greatest group of the hill tribe people in Thailand. The study aimed to estimate the prevalence, factors associated with, and typing major species of bacteria with antibiotic drugs resistance among the Lahu hill tribe people in northern Thailand. Methods A cross-sectional study was conducted to gather the information from the participants. A validated questionnaire was used for data collection. Participants who presented an illness related to infectious diseases were eligible to participate the study and were asked to obtain specific specimen; sputum, urine or stool. Antibiotic susceptibility was tested by Kirbey Bauer’s disc diffusion test. Chi-square and logistic regression were used to detect the associations between variables at the significant level of α = 0.05. Results A total of 240 participants were recruited into the study. The majority had urinary tract infection (67.9%) with two major pathogenic species of the infection; Escherichia coli (12.8%), and Enterobacter cloacae (8.0%). The prevalence of antibiotic resistance was 16.0%. Escherichia coli and Klebsiella pneumoniae species were found to have multidrug resistance that was greater than that of other species, while ampicillin was found to have the greatest drug resistance. It was found that those who had poor knowledge of antibiotic use had a 2.56-fold greater chance (95% CI = 1.09–5.32) of having antibiotic resistance than did those who had good knowledge of antibiotic use, and those who had poor antibiotic use behaviors had a 1.79-fold greater chance (95% CI = 1.06–4.80) of having antibiotic resistance than did those who had good antibiotic use behaviors. Conclusion Effective public health interventions are urgently needed to reduce antibiotic drug resistance among the Lahu people by improving their knowledge and skills regarding the proper use of antibiotics and eventually minimizing antibiotic resistance. Moreover, health care professionals should strictly follow the standard guideline to prescribe antibiotics. </jats:sec

Community Health Nurses’ Perspective on the Introduced Rational Drug Use Policy in Primary Care Settings in Thailand: A Descriptive Qualitative Study

Background: To address the problems related to drug resistance and medication safety, the rational drug use (RDU) policy has been implemented in Thailand since 2014. Theoretically, the policy was supposed to bring drastic changes to the way clinicians prescribe medications and its impacts on clinical practice, however, it has not yet been investigated. The study aimed to describe the experience of community health nurses with regard to the impact of RDU policy implementation on their practices. Methods: Focus group interviews and in-depth interviews with community nurses were conducted. Thematic analysis was performed. Results: Five themes emerged from the analysis, namely, (1) a welcome opportunity, (2) RDU as the quality of healthcare, (3) multidisciplinary collaboration, (4) reinventing productive interactions between nurses and patients, and (5) challenges over control of medications prescribed or purchased elsewhere. Conclusions: Implementing RDU in primary care provides opportunities for protecting individual patients and public health as well as safeguarding against professional prescription error. This can be made possible by adopting a systemic approach to changes. Additional educational and organizational support will optimize health professionals’ contribution to the implementation and hence optimal outcomes of this important policy