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Trans R Soc Trop Med Hyg. 2018 Dec 31. doi: 10.1093/trstmh/try138. [Epub ahead of print]

Self-medication with non-prescribed pharmaceutical agents in an area of low malaria transmission in northern Tanzania: a community-based survey.

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Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, USA.
Department of Medicine, Division of Infectious Disease, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, USA.
Department of Statistical Science, Duke University, Durham, NC, USA.
Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC, USA.
Otago Global Health Institute, University of Otago, Dunedin, New Zealand.



Self-treatment with antimicrobials is common in sub-Saharan Africa. Little is known about the prevalence of this practice where malaria transmission intensity is low, and little is known about the prevalence of self-treatment with other medications such as antihypertensives and antihyperglycemics.


A two-stage randomized population-based cluster survey with selection proportional to population size was performed in northern Tanzania. Self-identified healthcare decision-makers from randomly selected households were asked to report instances of self-medication without a prescription in the preceding year. Associations between self-treatment and sociodemographic characteristics were assessed with Pearson's chi-squared and the Student's t-test.


A total of 718 participants completed the survey, and 344 (47.9%) reported any household member obtaining medication without a prescription. Of these, 85 (11.8%) obtained an antimicrobial and four (0.6%) obtained an antihypertensive or antihyperglycemic. Of respondents reporting self-treatment, 306 (89.0%) selected the medication themselves. Self-treatment with antimicrobials was associated with post-primary education (OR 1.95, 95% CI 1.22-3.16, p=0.005), younger age (43.1 vs 48.7 years, p=0.007) and higher socioeconomic status score (0.42 vs 0.34, p=0.023).


Self-treatment with antimicrobials in an area of low malaria transmission intensity was uncommon and self-treatment with antihypertensives and antihyperglycemics was rare.


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