Antibiotic Use, Antimicrobial Resistance Awareness and Knowledge–Practice Gaps in Magharibi A, Zanzibar: A Bayesian Estimation and Posterior Predictive Analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Antimicrobial resistance (AMR) is driven partly by inappropriate antibiotic use, including premature treatment discontinuation, antibiotic sharing, and inappropriate treatment decisions. This study assessed antibiotic-use practices, AMR awareness, and the knowledge–practice gap among community inhabitants and community health workers in Magharibi A District, Zanzibar, while applying Bayesian analysis to project the persistence of inappropriate antibiotic-use behaviours under comparable conditions. A cross-sectional study was conducted from 16 December 2025 to 24 June 2026 among 60 respondents, comprising 44 community inhabitants and 16 community health workers. Data were collected using a structured questionnaire and analysed using descriptive statistics, Bayesian estimation, and posterior predictive analysis to quantify uncertainty and estimate the likely occurrence of selected antibiotic-use behaviours in comparable populations. All community inhabitants (44/44, 100%) reported previous antibiotic use, and none reported obtaining antibiotics without a prescription. However, all (44/44, 100%) reported discontinuing antibiotic treatment before completing the prescribed course. Economic constraints were the leading reported reason for discontinuation (22/44, 50.0%), while 7/22 (31.8%) of those reporting economic constraints also reported antibiotic sharing. Traditional or herbal remedies were subsequently used by 25/44 (56.8%) inhabitants, including 7/44 (15.9%) following hospital discharge. AMR awareness was lower among community inhabitants (29/44, 65.0%) than among community health workers (16/16, 100%), highlighting a substantial knowledge–practice gap. Bayesian posterior predictive analysis indicated that inappropriate antibiotic-use behaviours may remain prevalent in comparable communities if underlying social, economic, and behavioural conditions remain unchanged. These findings highlight the need to strengthen community-based AMR education, antibiotic-use counselling, and socioeconomic support, with active involvement of community health workers, to promote rational antibiotic use and strengthen antimicrobial stewardship in Zanzibar.
Authors: Ochieng Anthony, Sultan Muki
Institution: Zanzibar University
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7214067775