Health literacy, knowledge, household disposal, and misuse practices of antibiotics among UAE residents: a nationwide cross-sectional study

Figures & data

Table 1. Sociodemographic characteristics of the study population (n = 1074).

Variable	Frequency (percentage)
Gender
Female	809 (75.33%)
Male	265 (24.67%)
Age group
18–29	469 (43.67%)
30–39	309 (28.77%)
40–49	207 (19.27%)
50–59	77 (7.17%)
60–69	12 (1.12%)
Work or study field
Medical sector (health related job)	250 (23.28%)
Non-medical sector (non-health related job)	824 (76.72%)
City of residence
Al Fujairah	19 (1.77%)
Abu Dhabi	483 (44.97%)
Ras Al Khaimah	37 (3.45%)
Um Quwain	14 (1.30%)
Sharjah	224 (20.86%)
Dubai	167 (15.55%)
Ajman	130 (12.10%)
Marital status
Widowed	6 (0.56%)
Single	427 (39.76%)
Married	626 (58.29%)
Divorced	15 (1.40%)
Educational level
No schooling completed	14 (1.30%)
12th grade or less, no diploma/qualifications	69 (6.42%)
Some college credit, no degree	134 (12.48%)
Technical/Vocational training or Associate degree	69 (6.42%)
High school graduate with diploma/qualifications	150 (13.97%)
Bachelor’s degree	541 (50.37%)
Master’s/Professional degree	86 (8.01%)
Doctorate degree	11 (1.02%)

Figure 1. Responses to the Single Item literacy Screener (SILS) (a) and levels of health literacy among participants (b).

Table 2. Predictors of participants’ adequate health literacy regarding antibiotics.

	OR	P value*	95% CI
Involvement in the medical field	1.98	<001	1.45–2.69
Male gender	0.83	0.195	0.62–1.1
Marital status (Married vs single)	1.03	0.847	0.75–1.43
Education**
1	0.84	0.370	0.57–1.23
2	1.32	0.092	0.95–1.84
3	1.86	0.019	1.11–3.11
Age (years)
30.39	1.44	0.041	1.02–2.03
40–49	1.61	0.021	1.07–2.41
50–69	1.55	0.096	0.93–2.59

OR: Odds Ratio and CI: Confidence interval.

*Adjusted analysis (Multivariable logistic regression).

**the scores for education are the following: 0: No schooling completed, some college credit, no degree, or 12th grade or less, no diploma/qualifications, 1: Technical/Vocational training or Associate degree, or High school graduate with diploma/qualifications, 2: Bachelor’s degree, and 3: Doctorate degree, or Master’s/Professional degree.

Number of observations = 1,074.

Table 3. Participants` knowledge and practice regarding the use and disposal of antibiotics (n = 1074).

Question	Frequency (percentage)
When did you last take antibiotics?
Never	28 (2.61%)
In the last month	260 (24.21%)
In the last 6 months	274 (25.51%)
In the last year	143 (13.31%)
More than a year ago	206 (19.18%)
Can’t remember	163 (15.18%)
On that occasion, did you get advice from a doctor on how to take them?
I have never taken antibiotic	28 (2.61%)
Can’t remember	172 (16.01%)
Yes, I received advice on how to take them (e.g. with food, for 7 days)	874 (81.38%)
On that occasion, did you get advice from a pharmacist on how to take them?
I have never taken antibiotic	28 (2.61%)
Can’t remember	121 (11.27%)
Yes, I received advice on how to take them (e.g. with food, for 7 days)	925 (86.13%)
On that occasion, do you know what type of infection your antibiotics were used for, (respiratory tract infection, urinary tract infection, skin infection or others)?
I have never taken antibiotic	28 (2.61%)
No	276 (25.70%)
Yes	770 (71.69%)
How often do you ask someone for help reading instructions and leaflets from a doctor or pharmacy?
Always	86 (8.01%)
Often	116 (10.80%)
Sometimes	292 (27.19%)
Rarely	315 (29.33%)
Never	265 (24.67%)
How do you dispose unused antibiotics?
Dispose them in the toilet	53 (4.93%)
Dispose them in the bin	800 (74.49%)
Return them to Pharmacy	114 (10.61%)
Others	107 (9.96%)

Figure 2. Number of participants with symptoms and diseases that are thought to be treated with antibiotics.

Table 4. Participants’ practice and perception of antibiotics self-medication (n = 1074).

Question	Frequency (percentage)
Was the dispensed antibiotic obtained using a medical prescription?
Yes	945 (87.99%)
No	129 (12%)
Why did you choose self-medication with the above-mentioned medicine(s) instead of going to Doctor for your complaint(s)? (You may choose more than one option)
Saves Time	273 (25.42%)
Saves money	208 (19.37%)
To avoid the hassle of going to the doctor	202 (18.81%)
The same medicine successfully resolved my complains previously	351 (32.68%)
The same medicine worked for my friends/family members with similar complaints	101 (9.40%)
Left over medicine was present at home	264 (24.58%)
Other (please specify)	71 (6.61%)
What do you think about self-medication with antibiotics for self-health care?
Good practice	34 (3.17%)
Not acceptable practice	797 (74.21%)
Acceptable practice	243 (22.63%)
Did you ever change the dosage of antibiotics deliberately during the course of self-treatment?
Never	846 (78.77%)
Yes, sometimes	199 (18.53%)
Yes, always	29 (2.7%)
Why did you change the dosage of antibiotics during the course of self-treatment? (check more than one if applicable)
Improving conditions	129 (12.01%)
Worsening conditions	41 (3.82%)
To reduce adverse reactions	68 (6.33%)
Drug insufficient for complete treatment	21 (1.96%)
Others	6 (0.56%)
It’s okay to buy the same antibiotics, or request these from a doctor, if you’re sick and they helped you get better when you had the same symptoms before
False	557 (51.86%)
True	325 (30.26%)
Don’t know	192 (17.88%)
It’s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness
False	767 (71.42%)
True	170 (15.83%)
Don’t know	137 (12.76%)

Table 5. Participants’ practice of antibiotics misuse (n = 1074).

Question	Frequency (percentage)
When did you normally stop taking antibiotics? (Check more than one if applicable)
After a few days regardless of the outcome	80 (7.45%)
After symptoms disappeared	245 (22.81%)
A few days after the recovery	199 (18.53%)
After antibiotics ran out	143 (13.31%)
At the completion of the course	537 (50%)
After consulting a doctor/pharmacist	172 (16.01%)
Others	23 (2.14%)
The option that best describes why antibiotics are kept at home
I save them just in case my family and friends need them	355 (33.05%)
Save them for next time use	320 (29.80%)
I don’t know what to do with them	193 (17.97%)
I don’t know how to get rid of antibiotics	108 (10.06%)
Others	97 (9.03%)
What do you usually do with unused antibiotics?
Get rid of it at home	407 (37.90%)
Take them back to the pharmacy	53 (4.93%)
Share them with friends/family	83 (7.73%)
Keep it at home	505 (47.02%)
Others	26 (2.42%)
When do you think, you should stop taking antibiotics when you have started one treatment?
When all the antibiotics have been taken according to the instructions	759 (70.67%)
When you feel better	282 (26.26%)
Don’t know	33 (3.07%)

Table 6. Predictors of participants’ self-medication with antibiotics.

	OR	P value*	95% CI
Adequate knowledge of antibiotic resistance	1.10	0.622	0.75–1.62
Involvement in the medical field	1.15	0.542	0.74–1.8
Male gender	1.42	0.094	0.94–2.14
Marital status	0.75	0.261	0.46–1.23
Education**
1	0.89	0.675	0.53–1.5
2	0.46	0.002	0.29–0.75
3	0.82	0.579	0.40–1.66
Age
30–39	1.00	0.994	0.59–1.69
40–49	0.63	0.188	0.31–1.26
50–69	0.92	0.848	0.41–2.1
Adequate health literacy	0.85	0.391	0.58–1.24

OR: Odds Ratio and CI: Confidence interval.

*Adjusted analysis (Multivariable logistic regression).

**the scores for education are the following: 0: No schooling completed, some college credit, no degree, or 12th grade or less, no diploma/qualifications, 1: Technical/Vocational training or Associate degree, or High school graduate with diploma/qualifications, 2: Bachelor’s degree, and 3: Doctorate degree, or Master’s/Professional degree.

Number of observations = 1,074.

Data availability statement

Data available on reasonable request and in line with permission approval processes from the Al-Ain University Research Ethics Committee.