Self-medication practices against COVID-19 infection and awareness among residents of Mogadishu, Somalia: A cross-sectional analysis.

The novel coronavirus disease (COVID-19) pandemic has affected several countries worldwide, resulting in a considerable strain on healthcare systems and increased trend of self-medication practices. This study aims to evaluate the awareness of COVID-19 and the prevalence of self-medication during the pandemic among residents in Mogadishu, Somalia. A cross-sectional study was conducted using a structured and pretested questionnaire between May 2020 and January 2021. Participants from various disciplines were randomly recruited within the study location and interviewed about their self-medication practices during the pandemic. Descriptive statistics were used to summarise the respondents' information and responses to the questionnaire items. Associations between participants' demographic characteristics and specific items relating to self-medication practices were analysed using the Chi-square test. A total of 350 residents participated in the study. Approximately 63% of the participants reported having practised COVID-19 related self-medication with the main reasons being pharmacists' advice (21.4%) and having an old prescription (13.1%), whereas 37.1% did not report their reasons for self-medication. Most participants (60.4%) engaged in self-medication despite not having any symptoms and 62.9% had taken antibiotics in the last three months. Most participants were aware that no medication has been approved for COVID-19 (81.1%), the negative effects of self-medication (66.6%), and the transmission routes of the virus. Meanwhile, more than 40% of the participants have not worn a mask while outside their homes, and do not follow the international COVID-19 guidelines. The most prevalent drug used by participants for self-medication against COVID-19 was paracetamol (81.1%) and antibiotics (78%). The factors associated with awareness of COVID-19 and self-medication practices included age, gender, educational qualification, and occupation. This study revealed considerable high self-medication practices among Mogadishu residents, thus highlighting the need to promote awareness regarding the adverse effects of self-medication and sanitisation guidelines in addressing COVID-19 at the community level.

Knowledge, attitudes and practices concerning breast cancer, cervical cancer and screening among healthcare professionals and students in Mogadishu, Somalia: a cross-sectional study.

Introduction: Somali women face exceptionally high mortality and incidence rates from both breast cancer (BC) and cervical cancer (CC). They experience the highest age-standardised BC mortality rate in Africa and an age-standardised BC incidence rate of 41.7 per 100,000 women. Somalia's second-highest cancer-related mortality and incidence rates are due to CC, both behind BC. It is critical to identify the underlying factors that may influence healthcare workers' management of both cancers. At present, there is a lack of evidence regarding providers' knowledge of these two cancers and their screening in Somalia. Methods: A cross-sectional questionnaire was administered with a purposive sampling strategy to 469 healthcare professionals and students and was completed by 405 (86%). Healthcare workers were recruited from Mogadishu-based hospitals. Results: One hundred and ninety-seven healthcare professionals and 207 students completed the survey and were included in the analysis. 89% and 73% of respondents demonstrated good knowledge of BC and CC, respectively. Only 46% knew that a vaccine could prevent CC, and 89% of healthcare professionals disagreed that human papillomavirus (HPV) vaccines were available to their patients. Attitudes towards cancer screening, in addition to breast self-examination (BSE), were overwhelmingly positive. For both BC and CC, 24% reported having treated a patient and 30% reported having conducted a screen for either disease. Conclusion: Overall, while knowledge of both diseases and screening was good, there remain areas for clear educational targeting such as HPV vaccine availability and BC preventability. Attitudes to screening for both diseases were exceedingly positive but, with the exception of BSE, failed to translate into practice due to inadequate resources and patient refusal. Future investments into Somalia's chronic care management should prioritise technology necessary to conduct screenings for both diseases, expanding HPV vaccine access and understanding patients' potential motivations for refusing screening.

Occurrence and Phenotypic Characterization of Multidrug-Resistant Bacterial Pathogens Isolated from Patients in a Public Hospital in Mogadishu, Somalia.

PURPOSE: This study reports a cross-sectional investigation to determine the antimicrobial resistance pattern of the common bacterial contaminants isolated from hospitalized patients in Mogadishu, Somalia. MATERIALS AND METHODS: A total of 328 clinical samples comprising urine, blood, vaginal swab, pus aspirates, and stool were collected from a public hospital located in Mogadishu the capital city of Somalia between October 2019 to March 2020. The isolation and biochemical characterization of the bacterial isolates were performed using the conventional culture and biochemical assay tests. Similarly, antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion. RESULTS: A total of 275 pathogenic bacteria that include Staphylococcus aureus, Escherichia coli, Pseudomonas aeroginosa, Proteus vulgare, Klebsiella pneumonia, and Salmonella spp. were detected with an overall detection rate of 78.4% (257/328). Among the bacterial pathogens isolated from clinical specimens, 152 (46.3%) were Staphylococcus aureus, 60 (18.3%) were E. coli, 10 (3.1%) Proteus vulgaris, 6 (1.8%) Klebsiella pneumonia, and 1 (0.3%) isolate was found to be Salmonella sp. The antimicrobial susceptibility assay revealed variable resistance pattern with clindamycin (40%), ampicillin (27%), vancomycin (26%), levofloxacin (23%), amoxicillin (20%), ciprofloxacin (18%) and nitrofurantoin (12%) showing the highest rate of resistance. Moreover, evaluation of multidrug resistance showed that Staphylococcus aureus had the highest multidrug resistance rate, with 19 isolates showing resistance to more than two drugs, followed by E. coli with three isolates. In contrast, each of Proteus vulgare, Salmonella sp. and Klebsiella pneumonia had one isolate each that exhibited multidrug resistance characteristics. CONCLUSION: The findings of this study showed the occurrence of a number antimicrobial-resistant bacterial pathogens whose prevalence varies with age and sex. Therefore, there is a need for comprehensive antimicrobial profiling of bacterial isolates during the management of patients in the hospital.

High Level Aminoglycoside Resistance And Distribution Of The Resistance Genes In Enterococcus faecalis And Enterococcus faecium From Teaching Hospital In Malaysia.

BACKGROUND: Enterococcus faecium and Enterococcus faecalis are among the predominant species causing hospital-acquired infections. Currently, enterococcal infections are treated using combination therapy of an aminoglycoside with cell-wall active agents, which led to high level aminoglycoside resistance (HLAR) and vancomycin resistance (VRE) among enterococci. The aim of this study was to determine the prevalence of HLAR and the distribution of the resistance genes among clinical E. faecalis and E. faecium isolates in Malaysia. MATERIALS AND METHODS: Seventy-five enterococci isolates recovered from different clinical sources were re-identified by subculturing on selective medium, Gram staining, biochemical profiling (API 20 Strep), and 16s rRNA sequencing. Antimicrobial susceptibility testing (AST) was performed using Kirby-Bauer disc diffusion, E-test, and broth microdilution methods. PCR amplification was used to detect the presence of aminoglycoside modifying enzyme (AME) genes [aac(6')-Ie-aph(2")-Ia, aph(2")-Ib, aph(2")-Ic, aph(2")-Id, aph(3')-IIIa]. Descriptive data analysis was used to analyze the antibiotic susceptibility profiles and the distribution of HLAR genes. RESULTS: The majority of the isolates recovered from the clinical samples are E. faecalis (66.7%), with the highest recovery from the pus. The prevalence of HLGR (51%) is higher when compared to HLSR (45-49%). Analysis of the resistance genes showed that bifunctional genes aac(6')-Ie-aph(2")-Ia and aph(3')-IIIa contributed to the HLAR E. faecalis and E. faecium. The other AME genes [aph(2")-Ib, aph(2")-Ic, aph(2")-Id] were not detected in this study. CONCLUSION: This study provides the first prevalence data on HLAR and the distribution of the AME genes among E. faecalis and E. faecium isolates from Malaysia. These highlight the need for continued antibiotic surveillance to minimize its emergence and further dissemination.