Knowledge, attitude, and practices (KAP) of University students regarding antimicrobial use (AMU) and antimicrobial resistance (AMR) in Ethiopia

A cross-sectional questionnaire-based study on 1252 University students was conducted in Ethiopia to assess their knowledge, attitude,  and practices (KAP) towards antimicrobial usage (AMU) and antimicrobial resistance (AMR). Verbal consent was obtained from randomly  selected students to participate in this study. A logistic regression analysis was used to assess the association between the socio- demographic profiles of the students against their knowledge, attitude, and practices toward antimicrobial resistance and antimicrobial  usage. The Kruskal-Wallis and chi-square tests were used to examine how the median scores in each of the knowledge, attitude, and  practice categories varied across study participants. A p-value of less than 0.05 was considered significant. The overall median AMR and  AMU knowledge score was 13 (IQR=11, 14). The median AMR and AMU attitude score was 15 (IQR: 13, 15). The median score of AMU and  AMR practice was 10 (IQR: 10, 11). Logistic regression analysis revealed that the students’ birthplace was found to be a significant factor  (p <0.01) regarding the knowledge of students. The analysis further revealed that students’ birthplace, field of studies, and good  knowledge were significant factors (p<0.01) affecting their attitudes. Students with good knowledge had 3.9 times more positive attitudes  than those with poor knowledge (OR = 3.9, CI = 3.0 -5.2, p < 0.01). Students from VM had 1.6 times better attitudes than  students from HS and NHS (OR = 1.6, CI=1.2- 2.1, p = 0.002). Finally, students in the field of veterinary medicine and those having good  knowledge had 1.4 and 0.5 times better practice than their counterparts (OR=1.4; CI=1.2, 2.1, p<0.01 and OR= 0.5, CI=0.4, 0.6, p<0.01,  respectively). In conclusion, there were critical gaps in knowledge, attitudes, and practices among University students regarding  antimicrobial usage and antimicrobial resistance. Hence, students are encouraged to exhaustively utilize the digital era to advance their  knowledge. Interventions to raise awareness should also target students majoring in fields other than health sciences.