DOI: 10.11648/j.cajph.20261205.12 ISSN: 2575-5781

Antibiotic Use, Antimicrobial Resistance Awareness and Knowledge–Practice Gaps in Magharibi A, Zanzibar: A Bayesian Estimation and Posterior Predictive Analysis

Ochieng Anthony, Sultan Muki
Show PDF Cite
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.

More from our Archive