Knowledge, Attitudes, and Practices Regarding Antimicrobial Resistance and Associated Factors Among Healthcare Workers in Addis Ababa, Ethiopia: A Cross-Sectional Study.

Abstract

Background: Antimicrobial resistance (AMR) is a growing public health concern in Ethiopia, marked by high resistance rates among common pathogens and widespread misuse of antimicrobials, particularly among healthcare providers. This study aimed to assess the knowledge, attitudes, practices (KAP), and influencing factors related to AMR among healthcare workers (HCWs) in health centers of Addis Ababa. Methods: A cross-sectional study design was conducted among 485 HCWs in Addis Ababa from July 1, 2023, to November 25, 2023. Participants were HCWs involved in antimicrobial prescribing at randomly selected health centers in three subcities. Data were collected using structured questionnaires and analyzed using SPSS Version 26. Multivariable logistic regression was performed to identify significant associations at p < 0.05, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported. Results: A total of 473 HCWs participated, yielding a response rate of 97.5%. While 66.8% of HCWs demonstrated good knowledge about AMR, 61.3% exhibited unfavorable attitudes, and only 43.3% had satisfactory practice scores. Factors significantly associated with poor AMR practices included age (30-39 years; AOR = 0.29, 95% CI: 0.12-0.70), being a general practitioner (AOR = 4.26, 95% CI: 1.52-11.90), holding a degree (AOR = 0.47, 95% CI: 0.26-0.88), working in the outpatient department (AOR = 3.78, 95% CI: 1.82-7.86), lack of training (AOR = 0.16, 95% CI: 0.09-0.29), good knowledge (AOR = 0.45, 95% CI: 0.28-0.72), unfavorable attitudes (AOR = 1.79, 95% CI: 1.17-2.85), and lack of guideline consultation (AOR = 0.34, 95% CI: 0.22-0.52). Conclusions: The study found that younger HCWs, general practitioners, and those working in outpatient departments were more likely to exhibit better AMR practices. Conversely, lack of training and guideline consultation negatively impacted practices. Addressing knowledge gaps, improving attitudes, and reinforcing practices through targeted interventions are essential for effective AMR management in health centers.