Self-medication for COVID-19 among urban slum dwellers in Jinja City

Abstract

Introduction: Self-medication, the use of medicine by individuals without a valid prescription, is a serious public health concern globally and has been exacerbated by the current COVID-19 pandemic. The lack of known effective treatment for COVID-19 and poor access to healthcare are drivers of self-medication, which has led to the use of several over-the-counter drugs, herbal medicines, and concoctions. This study sought to assess the prevalence and associated factors for self-medication for COVID-19 among slum dwellers in Jinja City to inform strategies and policies to prevent the irrational sale or use of drugs and improve health care during public health emergencies.

Methods and materials: This was a cross-sectional study among urban slum dwellers randomly selected from slums in Jinja city. Households were proportionately recruited from the slums and enrolled one participant from each household who had confirmed or self-reported COVID-19 during the year 2021. An electronic semi-structured interviewer-administered questionnaire was used to collect demographic and other data on COVID-19 treatment practices. The data was imported into STATA version 14.0 for analysis. The prevalence of self-medication was determined as a proportion of respondents who self-medicated, and practices of COVID-19 treatment were also reported as proportions. A modified Poisson regression was conducted to determine the crude (CPR) and adjusted prevalence ratios (APR) (95% CI) of predisposing factors, enabling factors, and need factors, selected apriori. Using a backward elimination approach, variables with a P≤ 0.05 were included in the final model. Multi-collinearity was checked, and the final model was tested for fitness.

Results: Overall, 517 respondents were involved in the study, 40.4% were aged between 26-35 years, 59% were male, and 53% had attained secondary-level education. The prevalence of self-medication for COVID-19 was 87.23% (451/517), 95% CI: [84.00%-90.00%] and 56% of the respondents agreed that they were aware of the associated danger. Among the respondents, 58.09% (262/451) used herbal concoctions, 52.55% (237/451) conventional medicine, and 41.24% (186/451) herbal medicine. Age [APR: 1.12, 95% CI:1.05, 1.20], sex [APR: 1.07, 95% CI: 1.02, 1.13], symptoms severity: minor symptoms [APR: 1.62, 95% CI: 1.25, 2.11]; severe symptoms [APR: 1.51, 95% CI: 1.16, 1.96], having medical insurance [APR: 0.63, 95% CI: 0.46, 0.87], xvi access to internet [APR: 1.13, 95% CI: 1.07, 1.20], family/friends influence [APR: 1.27, 95% CI: 1.12, 1.42], and anxiety/fear of being quarantined [APR: 1.35, 95% CI: 1.14, 1.60] were associated with higher rates of self-medication for COVID-19. Being aware of laws against self-medication was associated with a lower risk of self-medication [APR: 0.89, 95% CI: 0.81, 0.97].

Conclusion: The majority of urban slum-dwellers engaged in self-medication to prevent and treat COVID-19, despite some being aware of its risks. The agents commonly used were concoctions, as well as conventional and herbal medicines. These findings highlight self-medication against COVID-19 is common in impoverished communities. Therefore, there is a need for regulatory frameworks and multi-sectoral public health interventions to control the sale, prescription, and use of medicines during the COVID-19 pandemic.