Knowledge, attitudes and practices on substandard and falsified medicines for human and animal use in Wakiso district, Uganda.

Background: Substandard and falsified medicines (SFMs) continue to pose a significant threat to public health globally. However, there is limited evidence on use of SFMs for both humans and animals particularly in low- and middle-income countries such as Uganda. The study assessed knowledge, attitudes and practices on SFMs for human and animal use in Wakiso District, Uganda.

Methods: A cross-sectional survey that employed a structured questionnaire among 432 community members was conducted in Wakiso District. The questionnaire assessed knowledge, attitudes and practices on SFMs for human and animal use. Data was collected using the KoboCollect mobile application hosted on tablet computers. Univariate data analysis was conducted in Stata Version 14.

Results: The majority of respondents (83%) stated that they had heard about SFMs although only 31% could correctly define them. Only 7% of the respondents accurately identified a falsified medicine despite 24% stating that they believed they could recognise SFMs. Almost two-thirds (62% and 60%) of the respondents disagreed that most human and animal SFMs respectively were as good as genuine medicines. Most of the respondents strongly agreed or agreed that SFMs could be very dangerous for humans (96%) and for animals (95%). Respondents reported having bought products they suspected were SFMs for use in humans (14%) and animals (24%). Seeking health worker advice on the medicine brand (40%) / getting medicine from a trustworthy pharmacy (34%) for humans; and seeking a veterinary officer's advice for choosing the brand (43%) / getting medicine from a trustworthy veterinary pharmacist (29%) for animals were the most common measures respondents reported taking to ensure the medicine bought was genuine. Only 25% of the respondents mentioned informing a health worker and only 4% had reported suspicions of SFMs to the National Drug Authority.

Conclusion: Despite commendable attitudes, there was generally limited knowledge and related poor practices regarding SFMs for both humans and animals. There is a need for key stakeholder engagement involving health and regulatory authorities in both human and animal medicine to increase awareness on SFMs to minimise the potential risks to health among the community.