Open Access Library Journal, 2014, 1, 1-9
Published Online June 2014 in OALib. http://www.oalib.com/journal
http://dx.doi.org/10.4236/oalib.1100651
How to cite this paper: Sado, E. and Gedif, T. (2014) Drug Utilization at Household Level in Nekemte Town and Surrounding
Rural Areas, Western Ethiopia: A Cross-Sectional Study. Open Access Library Journal, 1: e651.
http://dx.doi.org/10.4236/oalib.1100651
Drug Utilization at Household Level
in Nekemte Town and Surrounding
Rural Areas, Western Ethiopia:
A Cross-Sectional Study
Edao Sado1*, Teferi Gedif2
1Department of Pharmacy, College of Medical and Health Science, Wollega University, Nekemte, Ethiopia
2Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Science,
Addis Ababa University, Addis Ababa, Ethiopia
Received 5 May 2014; revised 7 June 2014; accepted 15 June 2014
Copyright © 2014 by authors and OALib.
This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/
Abstract
Background : At household levels drug may be hoarded and re-utilized inappropriately, shared
within families and/or outside family and unnecessarily utilized in self-medication. Therefore this
study was conducted to assess drug utilization at household level in Nekemte town and surround-
ing rural areas western Ethiop ia. Methods: It was conducted on 844 households’ head through in-
terviewing where households were stratified into urban and rural; a household was selected by
using systematic random and cluster sampling in the town and rural areas respectively. Results: It
was found that prevalence of drug hoarding was 49.9% where urban areas were 1.4 times more
likely to hoard drug than rural areas (Adjusted OR = 1.4; 95% CI = 1.02 - 1.8) and it was also found
that drug hoarding was associated with level of households’ education where household heads
who had level of education higher than or equal primary were 1.5 times more likely to hoard drug
(Adjusted OR = 1.5; 95% CI = 1.04 - 2.3). The prevalence of drug sharing was found to be 24.9%
where urban areas were 0.4 times less likely to share drugs than surrounding rural areas (Crude
OR = 0.4; 95% CI = 0.3 - 0.6). Nineteen point five percent of illness episodes were reported from
total surveyed households where 36.3% of them were sel f-medicated with modern medicines.
Self-medication with modern drugs was significantly associated with age older than fifteen years
old (Crude OR = 0.37; %CI = 0.2, 0.83). Conclusions: Drug hoarding, sharing and self-medication
with modern drugs particularly antibiotics are commonly practiced in the community, so they
should be avoided through educating general public on drug use so as to minimize of risk of using
expired drugs and accidental poisoning; under dose and inappropriate use; and combat antim-
icrobial resistance.
*Corresponding author.

E. Sado, T. Gedif
2
Keywords
Drug Utilization , Drug Hoarding, Nekemte Town and Surrounding Rural Area, Self-Med ic ation,
Western Ethiopia
Subject Areas: Drugs & Devices, Epidemiology, Evidence Based Medicine, Global Health, Health
Policy, Phar macolo gy
1. Introduction
According to World Hea lth Organization drug utilization is defined as “the marketing, distrib ution, prescr ibing,
and use of drugs in society, with special emphasis on the resulting medical, social, and economic consequences”
[1]. Thus drug utilizat ion study focuses on the factors related to the prescribing, dispensing, administering, and
taking of medication, and its associated events, covering the medical and non-medical determinants of drug
utilization [2]; it also evaluates drug use at a population level, according to age, sex, social class, morbidity and
residence areas [2] [3].
Essential medicines are one of the vital tools needed to improve and maintain health. However, for too many
people throughout the world medicines remain unaffordable, unavailable, unsafe and improperly used. When
available, the medicines are often used incorrectly: where medicines are prescribed, dispensed or sold inappro-
priatel y and patients fa il to tak e their medicines ap pr op riately [4]. All prescribing is not nec essaril y based on pa-
tient needs a nd all patient needs are not necessarily met with drug therapy. Consequently, there is much concern
about inappropriate and expensive prescribing [5].
Rational use of medicines is a crucial part of the national health policy and access to medicines is a tool to
improve and maintain health. Rational use of medicine has been defined as patients receive medications appro-
priately to their clinical needs, in doses that meet their individual requirements, for an adequate period of time,
and at the lowest cost to them and their co mmunit y while irratio nal or non-rational use is the use of medicines in
a way that is not c ompliant with rational use [6] [7]. Irrational use of medicines is a worldwide proble m, which
has a serious impact on health and economy [6] [8].
The op timal benefits o f drug ther apy in patient care i n every community may not be achi eved because of in-
app r opr ia te d rugs use [4]. One of the inappropriate drug uses is prematurely discontinued treatment course when
they felt that the symptoms had abated and kept the rest of the medicines for future use [9]-[14].
Other forms of inappropriate drug use are drug sharing and sel f-medication. Sharing of drugs can be within
and across households for friends, neighbors and relatives [14] [15]. Se l f-medicatio n with antibiotics in co mmu-
nity i s common i n third world countrie s [16]. Hence people are willing to pay high prices for antibiotics, and if
they cannot afford a full course, they will purchase them in smaller quantities [14] [17]-[21]. Self-medication
may also be influenced by low severity of illness [22] and easy acce ssibi lit y o f d rug s fro m i nfor mal sect or s suc h
as open mar kets and village ki osks [23].
Drug utilization can be influenced by socio-demographic factors such as age, sex, social status; education,
morbidity, cultural heritage, individual attitudes, and personality are among the factors that have been associated
with the use of medicines [24]. But o ver a ll, morbidit y is the str ongest pred ic tor of drug utilization [25].
Pat terns o f drugs p resc ribin g and d rugs use on the inst itutio nal le vels have be en exte nsive ly st udied in de vel-
oping country [26]. However, there has not yet been any systematic research conducted on the utilization of
drugs at the ho usehold le vel, little is k nown about patterns of dr ug utilization a t household le vel in Ethiop ia [27].
At household level drug may be utilized in different ways such as being hoarded and re-utilized, shared with
household and/or outside households for neighbors and might be used for self-medication inappropriately. In-
for matio n on t hese for ms o f d rug ut iliza ti on at hou seho ld l eve ls in N eke mte to wn and sur ro undi ng rur al ar ea s is
scarce and anecdotal. Nekemte town is selected because it is the most populous and oldest city in the western
part of Oro mia National Re gional state. So we supposed that information obtained from this study may be used
to improve rational use of drugs by policy makers. The aim of this study is therefore to assess prevalence of drug
hoar ding, self-medi cation with modern drugs and drug shari ng practice at household level.

E. Sado, T. Gedif
3
2. Methods
The study was conducted in Nekemte town and surrounding areas located at 328 Km west of Addis Ababa, the
capital cit y of Ethio pia. Nekemte i s the largest town in the Western part of t he Oromia Na tional Regional State,
Ethiopia. Oromia National Regional State is one of the nine regions in Ethiopia and it is the largest and most
populous region. The town is surrounded by rural kebeles namely Gari, in the East, Feyinera in the West, Kitesa
in the North, and Alemi in the South. Currently it is a capital city of East Wollega Zone with the total area of
5480 hectares. Administratively, it is divided in to six sub cities with a total of 12 Kebeles and with a total of
20,000 households.
A descriptive cross-sectional study was conducted in August, 2012 among households’ heads to assess the
prevalence of drug hoardi ng, drug shar ing, self-medicatio n and their determinant s. All house holds were included
in the st udy and pr o po rt io nal ly st ra tif ie d into ur b an a nd surr o und i ng r ura l areas. S ystematic and cluster sampling
technique were employed to obtain a single household from urban and surrounding rural areas respectively.
The sample size was determined by using single proportion formula [28]. Since no up to date and no reliable
information was available on the prevalence of drug utilization at household level; 50% prevalence was assumed
with 95% confidence level and 5% sampling error. After considering a design effect of 2% and 10% compensa-
tion for non-response, the sample size was determined to be 844.
A s em i -structured questionnaire consisting of open and closed ended questions was developed from a review
of the literature. The anonymous questionnaire covers socio-demographic factors in addition to drug hoarding,
shari ng and self-medication. The English version of the questionnaire was translated into Afan Oromo, the offi-
cial language of the study area, by a panel of experts fluent in the lan guage. It was then translated back in to
Engl ish b y anot her per son t o ens ure consi ste nc y with t he E ngl ish l ang uage q ue stio nna ire . T he Afan O ro mo ve r-
sion was used to collect data. It was employed after pre-testing on 84 households head outside but close to the
study area and corrections was made thereafter to improve the clarity of some items. Data we re collected by
trained data collectors through intervie wing t he house holds ’ head s. The princip al invest igat or ca rried out on site
supervision to check the completeness, clarity, accuracy, and consistency of the interview administration.
Data was coded, cleaned and entered into Epi-info version 3.5.3 and exported to SPSS for windows version
16.0. Analysis was done by using SPSS version 16 and Microsoft Office Excel 2007. Descriptive statistics were
conducted using frequencies and proportions. Bivariate and multivariate analyses were carried out using logistic
regr essio n to exa mine the r ela tions hip bet ween the d rug ho ardi ng, shari ng and self-medication; and selected de-
terminant factors. Adjusted and unadjusted odds ratios (OR) and their 95% confidence intervals (CI) were used
as indicators of strength of association. A P value o f 0.05 or less wa s used as t he cut -off level for statistica l sig-
nificance.
For the sake of clarity the follo wings are operationalized: Drug hoarding―keeping at least one drug at home
for the purpose of preventing, tre a ting or alleviating diseases or left over drugs. Drug sharing-refers to sharing of
drugs for therapeutic or prophylaxis purpose not for recreational purpose. Self-medication-refers to the use of
modern drugs without recommendation of health care professionals regardless of their sources. Drug utilization-
using any modern drug for the purpose of preventing, treating or alleviating disease regardless of its source.
Ethical clearance was obtained from the Ethics Review Committee of the School of Pharmacy, College of
Health Science s, Addis Abab a Univer sity. A letter of coop eration was written fro m Addis Ababa University a nd
further approval was obtained from the zonal health bureau and administration department. The objective of the
study was explained to the study participants. The household heads were briefed about the confidentiality of
their response and the importance of providing correct and accurate information, and that participation was vol-
untary. All parti cipa nts included in the study ha ve pr ovided a verbal conse nt
3. Results
3.1. Socio-Demographic Characteristics of Studied Participants
Out of a total of 844 of households heads interviewed, 820 respondents provided full information and included
in the study this making a response rate of 97.2%. Of these 408 (49.8%) were males and 412 (50.2%) were fe-
male. The mean (SD) age of the respondent s’ was 3 1 (11.3). Five hundred and thirty one (64.8%) of the respon-
dent were married and the rest 289 (35.2%) were single. The mean (SD) household size of the study population
was 4.8 (2.2) persons. Five hundred and for ty (66%) of the surveyed house holds ha d famil y size less t han five,

E. Sado, T. Gedif
4
268 (32.7%) had between 5 and 10, and the rest 12 (1.3%) had more than 11. The majority 678 (82.7%) of the
respondents were Christian and 142 (17.4%) of the respondents were Muslims. Oromo constituted the largest
709 (86.5%) ethnic group followed by Amhara 71 (8.7%) and Guragie 29 (3.5%) (Table 1).
3.2. Drug Hoarding
A total of 409 (49.9%) households head hoarded drugs at their home. Two hundred twenty three (54.5%) of
whom were from urban and 186 (44.5%) were from the surrounding rural areas. In all households which
hoarded drugs, 719 different types of drugs products were encountered. Hence the average number (SD) of
drugs per household was found to be 1.8 (1.2).
Drugs used for the treatment of infectious diseases were the second most hoarded types of drugs at household
level 180 (25%), next to Analgesics such as Paracetamol, Diclofenac, Ibuprofen and Aspirin which were the
leading drugs 294 (41%) and the other significant categories of drugs kept in the households were GIT drugs
100 (13.9%), CVS drugs and drugs used for endocrine disorders 28 (3.8%) and respiratory drugs account 29
(4%). Twenty four (3.3%) of all the drugs found in the households, were unidentified because they were either
not labeled or their label was removed and 64 (9%) others (Figure 1).
Factors Independently Associated with Drug Hoarding
The study showed that place of residence (X2 = 5.9, P < 0.05) and levels of education (X2 = 4.2, P < 0.05) were
significantly associated with drug ho arding at households’ level. In ord e r to determine the str e ngth of associa tion,
multivariate logistic regression analysis was run and it showed that the odds of drug hoarding were 1.4 times
higher with urban household heads compared to surrounding rural areas households head (Adjusted OR = 1.4;
95% CI = 1.0, 1.8). Households head who had level of education higher than primary education were 1.5 times
higher odds compared to those who had level education less than primary education (Adjusted OR = 1.5; 95%
CI = 1.0, 2.3) (Table 2).
Table 1 . Socio -demographic characteristics of respondents surveyed from households in Nekemte town and surrounding ru-
ral areas western Ethiopia August, 2012 (N = 820).
Var iables Frequency Percentage
Sex Male
Fema le 408 412 49. 8 50.2
Age
18 - 30
31 - 43
44 - 56
≥57
487
223
85
25
59.4
27.2
10.4
3
Marital status Married
Sin g le# 5 31 289 64. 8 35.2
Religion Christian*
Mu s lim 6 78 142 82. 7 17.3
Ethnicity
Oromo
Amhara
Guragie
Tigre
709
71
29
11
86.5
8.7
3.5
1.3
Educati on al status <Primary
≥Prima ry 350 470 42. 7 57.3
Occupation Employed Unem ployed @
Farmers
195
439
186
23.8
53.5
22.7
Household size Less than 5
≥5 540 280 65. 9 34.1
Christian*: Orthodox, Prot estant, Catholic; Unemp loyed @: includes jobless, housewife, daily labours. Single#: Unmarried, widow, divorced.

E. Sado, T. Gedif
5
Table 2. Factors determining drugs hoarding at household level in Nekemte town and surrounding rural areas western Ethio-
pia, August 2012.
Variable Drug hoarding Crude OR Adjuste d OR 95% CI
Yes No
Sex Male
Fema le 207 202 201 210 1 .3 1.0 1.1 (0.8, 1.6) 1 (-)
Marital status Married
Sin g le# 2 67 142 264 147 1 .2 1.0 1.2 (0.6, 2.6) 1 (-)
Place of residence Urban
Rural 223 186 189 222 1 .5 1.0 1.4 (1.02, 1. 8)* 1 (-)
Religion Christian
Mu s lim 3 31 78 347 63 0.9 1.0 0.9 (0.6, 1.3) 1 (-)
Level of education <primary
≥pri mary 61 177 79 153 1 .0 1.5 1 (-) 1.5 (1.04, 2.3)*
Household size ≤5
>5 272 137 270 141 1 .0 1.02 1 (-) 1.02 (0.8, 1.4)
*P < 0.05; Single #: Unmarried, widow, divorced.
Figure 1. Frequency of the pharmacological category of drugs hoarded in surveyed households in
Nekemte town and surrounding rural areas western Ethiopia August, 2012.
3.3. Drugs Sharing and Its Influencing Factors
It was found that prevalence of drug sharing wit hin the household and outside househol d including friends and
neighbors was 24.9%. It was also found that drug sharing was significantly associated with place of residence
(X2 = 7.9, P < 0.05). Binary logistic regression showed that the odds of drug sharing were 0.4 times less with
those liv in g i n urb a n as c o mp a re d to tho se li vin g in s ur ro un d ing r ura l a r ea s (C rud e OR = 0. 4 ; 95 % CI = 0.3, 0.6)
(Table 3).
3.4. Self-Medication Practice
A total of 160 households head reported illness episodes in four weeks recall period, where 51 (36.7%) of them

E. Sado, T. Gedif
6
Table 3. Factors associated with drug sharing in Nekemte town and surrounding rural areas western Ethiopia August, 2012.
Variables Drug sharing Cru de OR 95% CI
Yes No
Residence area Urba n
Rural 72 132 340 276 0.4 (0.3, 0.6)*
1 (-)
Sex Male
Fema le 108 96 300 316 1 (-) 1.1 (0.8, 1.6)
Age
18 - 30
31 - 43
44 - 56
≥57
126
54
19
5
361
169
66
20
1.4 (0.5, 3.7)
1.2 (0.4 - 3.6)
0.38 (0.38, 3.4)
1 (-)
Marital status Married
Sin g le* 1 27 77 404 212 1 (-) 1.3 (0.5, 3.4)
Religion Christian#
Mu s lim 1 78 26 500 116 1.5 (0.9, 2.4) 1 (-)
Level of education <primary
≥primary 126 78 364 252 1 (-) 0.9 (0.4, 1.5)
Household size ≤5
>5 142 62 400 216 1 (-) 1.4 (0.9, 1.9)
*P < 0.05; Single*: includes unmarried, divorced and widowed; Christian#: includes Orthodox, Protestant and Catholic .
were self-medicated with modern drugs; 5 (8.6%) of them were self-medicated with traditional medicine and the
rest 104 (65% ) of the m consulted health care professionals. A total of 82 modern drugs were used for self-medi-
cation. Among the modern drugs used for self-medication, the most leading drugs category were antibiotics 27
(33%) and anti-inflammatory analgesics 26 (32%), followed by GIT drugs category 14 (17%), unidentified 4
(5%) drugs because they did not remember drugs but obtained from drug outlets, cough preparations 2 (2%) and
others 9 (11%) which comprises of different categories of drugs (Figure 2).
4. Discussions
Though the drugs were not offered free of charges from both public (except for fee waiver & exempted health
services) and private health care facilities, the study revealed that almost half of the surveyed households head
hoarded drugs at their home. This finding is similar to reports from studies conducted in New Guinea, Spain,
Pakistan and European countries [13] [17] [29] [30]. However it is less than those reported from study con-
ducte d in I ran, Iraq, Tanzania and Sudan where the rates were 82%, 94% ,73% and 97.1% respectively [11] [14]
[15] [31] . And it is great er t han thos e re por ted from st ud y conduc ted in Vietna m and Turke y [18] [32] . T he high
prevalence of drug hoarding in our study might be attributed to less controlled distribution of drugs and the
presence of a large number of drug outlets dispensing drugs without prescriptions.
The average number of drugs hoarded per household was 1.8, which may be considered very low in compari-
son with other study conducted Iraq which was 14.26 per households but comparable with the studies conducted
in Vietna m, Paki stan a nd Turkey [17] [18] [31] [32]. T he variation in numbers of hoarded drugs may be related
to socioec onomic factors, cu ltural attit udes, inappr opriate drug use, treatmen t modificatio ns after hosp italizatio n
and drug advert ising [4] [11] [31] [33].
Besides aforementioned factors influencing drug hoarding at household level, in present study it was also
found that drugs hoarding are significantly associated with residence area and level of education. These associa-
tions revealed that peoples who live in urban areas were 1.4 times more likely to store drugs at their home than
those who live in rural areas and a higher proportions of peoples who had level of education higher than or equal
to primary educations were 1.5 times more likely to hoard drugs at their home than those who had level of edu-
cation less than primary education. The urban population was relatively more educated and education increases
knowledge of a drug, as they read leaflet and understa nd its merit and d emerits. So those who had level of ed u-
cation higher than primary may cease taking drugs prematurely to fear of side effects once symptoms abated or

E. Sado, T. Gedif
7
Figure 2. Pharmacological category of drugs used for self-medication by sur-
veyed households’ head in Nekemte town and surrounding rural areas western
Ethiopia August, 2012.
they may obtain drugs without advice of health care professionals. But the previous study conducted in Addis
Ababa showed that drugs hoarding was associated with gender and education [9]. This discrepancy may be re-
sulted from the difference in socio-cultural factors of studied population and geographic areas.
The study also revealed that 24.9% of households were found to practice drugs sharing within the households
or outside households for friends and neighbors. But the previous study conducted in Addis Ababa community
showed lower percent (17%) of drug sharing practice [9]. This discrepancy may be associated with relative ac-
cessibility of healt h facilities, ti me when the study was conducted, and difference in socio-economical factors of
two areas [34]. Similar study conducted in Tanzania showed that drug sharing within family or outside family
was practiced by 12% of surveyed households [15] but the study conducted in Sudan showed higher percent
(59.3%) of drug exchange among surveyed households [14]. It was found that drug sharing was significantly
associated with place of residence. This showed that a higher numbers of households who live in urban areas
were 0.31 times less likely to share drugs than those who live in rural areas. This association was in contrast to
the pr evious st udy which r eported t hat drug shar ing was assoc iated with sex, age, edu cation and marital status of
the households [9].
The prevalence of self-medication with modern medicine was found to be thirty six and this finding is com-
parable with the study done in Western Nepal which reported 34.8% self-medication with modern drugs [24].
But it was higher than the reports from studies conducted in Jimma (27.6%) and Pakistan (15%) [17] [27].
The most common reasons why respondents practiced self-medication were the previous experience with the
drugs and relatively less cost. Similarly Andualem & Gebre-meriam (2004) in a study conducted in Addis Ababa
noted that most of the people who practiced self-diagnosis and self-medication were due to prior experience on
drug. Cost as a reason to practice self-medication was also identified in Jima’s study [24]. But the study con-
ducted in India showed the main reasons why people practice self-medication i s d ue to easily accessibility [19].
This study also revealed that self-medication with modern drug was significantly associated with age. Ac-
cordingly, respondents whose age greater than fifteen were more likely to self-medicate tha n those less t han fi f-
teen. This was comparable with study conducted in Nigeria which showed the extent of self-medication with
modern drug was associated with age [35].
5. Conclusion
In co ncl us io n s, d r ug hoa r di ng and sha ri ng were p re val e nt amon g house ho l ds in t he st ud ie d a re as. D rug ho a rd in g
was significantly associated with residence place and education while drug sharing was significantly associated
only with residence place. Self-medication with modern drug was also prevalent in the study areas. These find-
ings ind icated that there is a need fo r avoid ing drug hoar ding, dr ug sharing a nd self-medicatio n with antibiotics
to minimize of risk of using expired drugs and accidental poisoning; under dose and inappropriate use; and
combat antimicrobial resistance respectively.

E. Sado, T. Gedif
8
Acknowledgements
Our special than ks go to all the stud y participants for their willin gness to participate, data collector s, Zonal and
town administration official s who provide us valuable cooperation during data collection. We would like to ex-
tend our acknowledgement to the School of Pharmacy, Addis Ababa University for sponsoring the research.
References
[1] World Health Organization (2003) What Is Drug Utilization Research and Why Is It Needed: Introduction to Drug
Utilization Research. Oslo Press, Oslo .
[2] Gama , H. (2008) Drug Utilization Studies. Arq ui v os de Medicina, 22, 69-74.
[3] Mishra, P., Dubey, A., Rana, M., Shankar, P., Subish, P., et al. (2005) Drug Utilization with Special Referenc e to An-
timicrobials in a Sub Health Post in Western Nepal. Journal of Nepal Health Research Council, 3, 65-69.
[4] World Health Organization (2004) How to Investigate the Use of Medicines by Consumers. Universi ty of Amsterdam,
Royal Tropical Institute, Amsterdam.
[5] Truter, I. (2008) A Review of Drug Utilization Studies and Methodologies. Jordan Journal of Pharmaceutical Sciences,
1, 91-104.
[6] Abdulrasool, B., Fahmy, S., Abu-Gharbieh, E. and Ali, H. (2010) Professional Practices and Perception to wards Ra-
tional Use of Medici nes Accordi ng to WHO Methodology in United Arab Emirates.
http://www.pharmacypractice.org/vol08/pdf/070-076.pdf
[7] World Health Organization (1985) The Rational Use of Drugs: Report of the Conference of E xperts. In Promoting Ra-
tional Use of Medicines. WHO, Gene va. http://apps.who.int/medicinedocs/documents/s16221e/s16221e.pdf
[8] Bhartiy, S., Shinde, M., Nandeshwar, S. and Ti wari, S. (2008) Pattern of Prescr ibing Pr actices in the Madh ya Pradesh,
India. Kathmandu University Medical Journal, 6, 55-59.
[9] Amare, G., Alemayehu, T., Gedif, T. and Tesfahun, B. (1997) Pattern of Drug Use in Addis Ababa Community. East
Africa Medical Journal, 74, 362-367.
[10] World Health Organization/DAP (1992) People’s Perceptions and Use of Drugs in Zimbabwe: A Socio-Cultural Re-
search Projects. http://whqlibdoc.who.int/hq/1992/WHO_DAP_92.7.pdf
[11] Asefzadeh, S. and Nassiri-Asl, M. (2009) Drugs at Home in Qazvin, Iran: Community Based Participatory Research.
Europea n Journal o f Scientific Research, 32, 42-46.
[12] Asefzadeh, S., Asefzadeh, M. and Javadi, H. (2005) Care Management: Adherence to Therapies among Patients at
Bu-Alicina Clinic, Qazvin, Iran. Journal of Research in Medical Sciences, 10, 343-348.
[13] Kiyingi, K. and Lauwo, J. ( 19 93) D rugs in Home: Danger and Waste. World Health Forum, 14, 381-384.
http://whqlibdoc.who.int/whf/1993/vol14no4/WHF_1993_14(4)_p381-384.pdf
[14] Yousif, M. (2002) In-Home Drug Storage and Utilization Habits: A Sudanese Study. Eastern Mediterranean Health
Journal, 8, 422-431.
[15] Temu-Justin, M., Ma kwa ya, C., Mlavwasi, Y., Risha, P. and Leshabar i, M. (2002) Availability and Usage of Drugs at
Households Level in Tanzania: Case Stud y in Kinondoni District, Dar es Salaam. The East and Central African Jour-
nal of Pharmac e uti c al Sc i e nc e s , 5, 49-54.
[16] Haak, H. and Radyowijati, A. (2002) Determinants of Antimicrobial Use in the Developing World Manual. Child
Health R esearch Project Special Report Volume 4. http://www.bvsde.paho.org/bvsacd/cd65/amr_vol4.pdf
[17] Hussain, S., Ah mad, S., Ashfaq, K., Hameed, A., Malik, F., et al. (2011) Prevalence of Self-Medication and Health-
Seeking Behavior in a Developing Country. African Journal of Pharmacy and Pharmacology, 5, 972-978.
[18] Okumura, J., Wakai, S. and Umenai, T. (2002) Drug Utilization and Self-Medication in Rural Communities in Vietnam.
Social Science & Medici ne, 54, 1875-1886.
[19] Kadri, R., He gde, S., Kudva, A., Achar, A. and Shenoy, S. (2011) Self-Medication with over the Counter Ophthalmic
Preparations: Is It Safe? International Journal of Biological & Medical Research, 2, 528-530.
[20] Durgawale, P., Phalke, D. and Phalke, V. (2006) Self-Medication Practices in Rural Maharashtra. Indian Journal of
Community Medicine, 31, 34-35. http://dx.doi.org/10.4103/0970-0218.54933
[21] Gupta, P., Bobhate, P. and Shrivastava, S. (2011) Determinants of Self Medication Practices in an Urban Slum Com-
munity. Asian Journal of Pharmaceutical and Clinical Research, 4, 54-57.
[22] Suleman, S., K etsela, A. and Mekonnen, Z. (2009) Assessment of Self-Medicatio n Pract ices in Assend abo Town, Ji m-
ma Zone, Southwestern Ethiopia. Research in Social and Administrative Pharmacy, 5, 76-81.
http://dx.doi.org/10.1016/j.sapharm.2008.04.002

E. Sado, T. Gedif
9
[23] Baruzaig, A. and Bashrahil, K. (20 08) Self-Medicat ion: Concep t, Prevalence & Risks i n Mukalla Ci ty (Yemen). Anda-
lus for studies & Research es Yemen, 2, 1-15.
[24] Kumar, P., Partha, P., Shankar, R., Shenoy, N. and Theodore, A. (2003) A Survey of Drug Use Patterns in Western
Nepal. Singapore Medical Journal , 44, 352-356.
[25] Andualem, T. and Gebremariam, T. (2004) A Prospective Study on Self Medication Practices and Consumers Drug
Knowledge in Addis Ababa, Ethiopia. Ethiop Journal of Health Science, 14, 1-11.
[26] Le Grand , A., Hagerzeil, H. an d Haaijer-Ruskam, F. (199 9) In terventi on Resear ch i n Ration al Us e of Drugs: A Revie w.
Health Policy and Planning Journal, 14, 89-92.
[27] Mariam, A. and Worku, S. (20 03) Practice of Self-Medication in Jimma Town. Ethiop Journal of Health Science, 17,
111-116.
[28] WHO (2001) Sampling Methods and Sample Size. In: Omi, S., Ed., Health Research Methodology: A Guide for Trai-
ning in Research Methods, Manila, 71-84.
[29] Gonzales, J., Orero, A. and P rieto, J. (1997) Antibiotics in Spanish Households, Medical and Socioeconomic Implica-
tions. Medicina Clínica, 109, 782-785.
[30] Burgerhof, J., Gr i g orya n, L., R u s k a mp, F., M echt ler, R., Deschep per, R., Andrasevic, A., et al. (2006 ) Se lf-Medication
with Antimicrobial Drugs in Europe. Emerging Infectious Diseases, 12, 452-459.
http://dx.doi.org/10.3201/eid1203.050992
[31] Jassim, A. (2010) In-Home Drug Storage and Self Medication with Antimicrobial Drugs in Bisrah, Iraq. Oman Medi-
cal Journal, 25, 79-87. http://dx.doi.org/10.5001/omj.2010.25
[32] Aksakal, N., Ilhan, N., Durukan, E., Ilhan, S., Özkan, S. and Bumin, M.A. (2009) Self-Medication with Antibiotics:
Questionnaire Survey among Primary Care Center Attendants. Pharmacoepidemiology and Drug Safety, 18, 1150-
1157. http://dx.doi.org/10.1002/pds.1829
[33] Sachdeva, P. (2010) Drug Utilization Studies—Scope and Futu re Persp ectives. International Journal on Pharmaceuti-
cal and Biological Research, 1, 11-17.
[34] Gedif, T. an d Hahn, H. (2003) The Use of Medicinal Plants in Self-Care in Rural Central E thiopia. Journal of Ethno-
pharmacology, 87, 155-161. http://dx.doi.org/10.1016/S0378-8741(03)00109-0
[35] Afolabi, A. (2008) Factors Influencing the Pattern of Self-Medication in an Adult Nigerian Population. Annals of Afri-
can Medicine Journal, 7, 120-127. http://dx.doi.org/10.4103/1596-3519.55666