Healthcare professionals' knowledge of pharmacogenetics and attitudes towards antimicrobial utilization in Zambia: implications for a precision medicine approach to reducing antimicrobial resistance

Webrod Mufwambi, Julia Stingl, Colleen Masimirembwa, Justen Manasa, Charles Nhachi, Nadina Stadler, Chiluba Mwila, Aubrey Chichonyi Kalungia, Moses Mukosha, Chenai S. Mutiti, Alfred Kamoto, Patrick Kaonga, Brian Godman, Derick Munkombwe

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Abstract

Introduction: Sub-Saharan Africa (SSA) and other low- and middle- income countries (LMICs) have the highest rates of antimicrobial resistance (AMR) driven by high rates of antimicrobial utilisation. This is a concern as AMR appreciably increases morbidity, mortality and costs. Pharmacogenetics (PGx) and precision medicine are emerging approaches to combat AMR. Consequently, as a first step there is a need to assess AMR knowledge and attitudes, and knowledge of PGx, among healthcare professionals and use the findings to guide future interventions. Methodology: We conducted a cross-sectional study involving 304 healthcare professionals at tertiary hospitals in Lusaka, Zambia. Structural Equation Modelling (SEM) was used to analyse relationships among latent variables. Results: Overall correctness of answers concerning AMR among healthcare professionals was 60.4% (7/11). Knowledge of pharmacogenetics was low (38%). SEM showed that high AMR knowledge score correlated with a positive attitude towards combating AMR (p<0.001). Pharmacists had relatively higher AMR knowledge scores (mea=7.67, SD=1.1), whereas nurses had lower scores (mean=5.57, SD=1.9). A minority of respondents [31.5% (n=95)] indicated that poor access to local antibiogram data promoted AMR, with the majority [56.5% (n = 190)] responding that poor adherence to prescribed antimicrobials can lead to AMR. Pharmacists had the highest scores for attitude (mean=5.60, SD= 1.6) whereas nurses had the lowest scores (mean=4.02, SD=1.4). Conclusion: AMR knowledge and attitudes, as well as knowledge on PGx among healthcare professionals in Zambia, is sub-optimal and has the potential to affect the uptake of precision medicine approaches to reduce AMR rates. Educational and positive behavioural change interventions are required to address this and in future, we will be seeking to introduce these to improve the use of antimicrobials.
Original languageEnglish
Article number551522
Number of pages10
JournalFrontiers in Pharmacology
Volume11
DOIs
Publication statusPublished - 12 Jan 2021

Keywords

  • antimicrobial resistance
  • knowledge
  • attitudes
  • pharmacogenetics
  • precision medicine
  • Zambia

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