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Open Access Research article

Self-medication with antibiotics for the treatment of menstrual symptoms in southwest Nigeria: a cross-sectional study

Amy R Sapkota1*, Morenike E Coker2, Rachel E Rosenberg Goldstein1, Nancy L Atkinson3, Shauna J Sweet1, Priscilla O Sopeju2, Modupe T Ojo4, Elizabeth Otivhia4, Olayemi O Ayepola5, Olufunmiso O Olajuyigbe6, Laura Shireman7, Paul S Pottinger7 and Kayode K Ojo7

Author Affiliations

1 Maryland Institute for Applied Environmental Health, University of Maryland College Park, School of Public Health, College Park, MD, USA

2 University of Ibadan, Ibadan, Oyo State, Nigeria

3 Department of Public and Community Health, University of Maryland College Park, School of Public Health, College Park, MD, USA

4 Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria

5 Covenant University, Ota, Ogun State, Nigeria

6 Babcock University, Ikeja, Ogun State, Nigeria

7 University of Washington, Seattle, WA, USA

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BMC Public Health 2010, 10:610  doi:10.1186/1471-2458-10-610

Published: 15 October 2010

Abstract

Background

Self-medication with antibiotics is an important factor contributing to the development of bacterial antibiotic resistance. The purpose of this study was to evaluate the prevalence of self-medication with antibiotics for the treatment of menstrual symptoms among university women in Southwest Nigeria.

Methods

A cross-sectional survey was administered to female undergraduate and graduate students (n = 706) at four universities in Southwest Nigeria in 2008. The universities were selected by convenience and the study samples within each university were randomly selected cluster samples. The survey was self-administered and included questions pertaining to menstrual symptoms, analgesic and antibiotic use patterns, and demographics. Data were analyzed using descriptive statistics and logistic regression.

Results

The response rate was 95.4%. Eighty-six percent (95% CI: 83-88%) of participants experienced menstrual symptoms, and 39% (95% CI: 36-43%) reported using analgesics to treat them. Overall, 24% (95% CI: 21-27%) of participants reported self-medicated use of antibiotics to treat the following menstrual symptoms: cramps, bloating, heavy bleeding, headaches, pimples/acne, moodiness, tender breasts, backache, joint and muscle pain. Factors associated with this usage were: lower levels of education (Odds Ratio (OR): 2.8, 95% CI: 1.1-7.1, p-value: 0.03); non-science major (OR: 1.58, 95% CI: 1.03-2.50, p-value: 0.04); usage of analgesics (OR: 3.17, 95% CI: 2.07-4.86, p-value: <0.001); and mild to extreme heavy bleeding (OR: 1.64, 95% CI: 1.01-2.67, p-value: 0.05) and pimples/acne (OR: 1.57, 95% CI: 0.98-2.54, p-value: 0.06). Ampicillin, tetracycline, ciprofloxacin and metronidazole were used to treat the most symptoms. Doctors or nurses (6%, 95% CI: 4-7%), friends (6%, 95% CI: 4-7%) and family members (7%, 95% CI: 5-8%) were most likely to recommend the use of antibiotics for menstrual symptoms, while these drugs were most often obtained from local chemists or pharmacists (10.2%, 95% CI: 8-12%).

Conclusions

This is the first formal study to report that approximately 1 out of 4 university women surveyed in Southwest Nigeria self-medicate with antibiotics to treat menstrual symptoms. This practice could provide monthly, low-dose exposures to antibiotics among users. Further studies are necessary to evaluate the impacts of self-medication on student health.