■抗菌素耐药性(AMR)的主要驱动因素是抗菌药物的不当使用。在社区层面,人们经常从事在人类内部驱动AMR的行为,动物,和环境(一个健康)影响。这项范围界定审查巩固了研究,以确定(A)社区的知识,态度,基于社区的现有干预措施;以及(c)尼泊尔解决AMR的障碍和促进因素。
■此范围审查遵循JoannaBriggsInstitute范围审查方法。文献在PubMed中索引,Scopus,CINAHL,全球指数Medicus,Hinari-Sumon,Embase(Ovid),全球卫生(Ovid),CAB文摘(Ovid),WebofScience,和谷歌学者在2000年1月至2023年1月期间进行了审查。如果他们考虑了尼泊尔社区一级的AMR问题,则将其纳入审查中;这排除了临床和实验室研究。共有47项研究符合这些标准,被提取,并分析巩固重点主题。
■总共31篇(66%)的文章仅涉及人类健康;5篇(11%)的文章仅集中在动物健康上;没有研究仅关注AMR的环境方面;其余研究共同提出了人类,动物,和环境方面。调查结果显示,在人类和动物卫生部门,知识不足,实践不当。四项社区干预措施改善了社区人群中适当使用抗菌药物的知识和实践。然而,各种社会和经济因素被认为是在社区中适当使用抗菌药物的障碍。
■社区参与和一种健康方法可能是提高对AMR的认识并促进与社区AM使用相关的行为改变的关键工具,因为目前的研究表明,人类和动物卫生部门的知识不足以及不适当的做法。
■DOI:10.17605/OSF。IO/FV326。
A major driver of antimicrobial resistance (AMR) is the inappropriate use of antimicrobials. At the community level, people are often engaged in behaviors that drive AMR within human, animal, and environmental (One Health) impacts. This scoping review consolidates research to determine (a) the community\'s knowledge, attitudes, and practices around AMR; (b) existing community-based interventions; and (c) barriers and enablers to addressing AMR in Nepal.
This scoping review follows the Joanna Briggs Institute scoping review methodology. Literature indexed in PubMed, Scopus, CINAHL, Global Index Medicus, HINARI-SUMMON, Embase (Ovid), Global Health (Ovid), CAB Abstracts (Ovid), Web of Science, and Google Scholar between January 2000 and January 2023 were reviewed for inclusion. Articles were included in the review if they considered the issues of AMR at the community level in Nepal; this excluded clinical and laboratory-based studies. A total of 47 studies met these criteria, were extracted, and analyzed to consolidate the key themes.
A total of 31 (66%) articles exclusively included human health; five (11%) concentrated only on animal health; no studies solely focused on environmental aspects of AMR; and the remaining studies jointly presented human, animal, and environmental aspects. Findings revealed inadequate knowledge accompanied by inappropriate practice in both the human and animal health sectors. Four community interventions improved knowledge and practices on the appropriate use of antimicrobials among community people. However, various social and economic factors were found as barriers to the appropriate use of antimicrobials in the community.
Community engagement and One Health approaches could be key tools to improve awareness of AMR and promote behavioral change related to AM use in communities, as current studies have revealed inadequate knowledge alongside inappropriate practices shared in both human and animal health sectors.
DOI: 10.17605/OSF.IO/FV326.