This research article was published by Springer Nature, 2022
Background: Antibiotic resistance is a global health threat driven partly by self-medication with antibiotics (SMA).
This study aims to assess the prevalence and predictors of SMA in selected rural and urban communities of the
Dodoma region, Central Tanzania.
Methods: This cross-sectional study was conducted in Chemba District Council (rural) and Dodoma City Council
(urban) from August to November 2019 using multistage stratifed random sampling. Data were collected through
face-to-face interviews using structured questionnaires.
Results: A total of 430 respondents were interviewed in Chemba District Council (rural) (161/430) and Dodoma City
Council (urban) (269/430). The prevalence of SMA was 23.6% (38/161) among rural respondents and 23.4% (63/269)
among urban respondents. The median amount of SMA in both settings was 2, while the maximum amounts
were 4 and 5, respectively. SMA among rural and urban participants was associated mostly with perceived cough
(76.3%/82%), body pain (71.1%/41.5%) and fever (63.2%/39.7%), and amoxicillin was the most commonly used
antibiotic in both settings (47.3%/41%). Rural participants who reported a shorter perceived distance to a health care
facility than to a drug outlet were 58.9% less likely to practise SMA (adjusted OR: 0.421; 95% CI: 0.388, 0.458; p<0.001),
whereas SMA decreased by 16.3% among urban participants who reported a shorter perceived distance to a health
care facility than to a drug outlet (adjusted OR: 0.837; 95% CI: 0.755, 0.929; p<0.001). SMA was 17.3% lower among
farmers than among nonfarmers in the urban area (adjusted OR: 0.827; 95% CI: 0.716, 0.955; p=0.01), while farming
had no efect in the rural area.
Conclusions: The prevalence of SMA is similar among participants in rural and urban districts. In both localities,
a shorter perceived distance to a drug outlet is an independent risk factor for SMA, while having health insurance
reduces the risk. Equally weighted interventions to reduce SMA are required in rural and urban communities.