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EURASIAN EXPERIMENT JOURNAL OF PUBLIC HEALTH (EEJPH)

ISSN: 2992-4081 ©EEJPH Publications
Volume 5 Issue 1 2024

Page | 1
Prevalence and Factors Associated with Self-
Medication among Health Sciences Students at
Kampala International University - Western
Campus
Nakabiri Maria Gorret

Faculty of Clinical Medicine and Dentistry Kampala International University Western Uganda

ABSTRACT
The rising issue of self-medication among university students in Kampala necessitates a deeper understanding of its
prevalence and determinants. This study aims to investigate the extent and correlates of self-medication among
students enrolled in health sciences programs at Kampala International University - Western Campus. A total of
294 participants from various health-related disciplines were surveyed using a structured questionnaire. Data
analysis involved univariate and multivariate logistic regression. Results indicate a high prevalence of self-
medication (78.6%) among the sampled students. Factors associated with increased likelihood of self-medication
include age range of 20-25 years, monthly expenditure of 100,000 – 180,000 Shs, previous experience-based
knowledge, anticipation of doctor prescribing a familiar drug, use of opioid analgesics, pursuit of pharmacy
programs, obtaining drugs from community pharmacies, and self-medication with antibiotics. These findings
underscore the urgent need for targeted interventions to address self-medication practices and promote responsible
healthcare behavior among university students
Keywords: Self-medication, University students, Health sciences, Drugs. Pharmacy.

INTRODUCTION
Self-medication is defined as the acquisition and use of one or more medicines without a physician’s opinion or
diagnosis as well as without prescription of therapeutic monitoring including the use of herbal or synthetic medicines
[1]. In most illness episodes, self-medication is the first option which makes it a common practice worldwide [2].
In the treatment of minor illness, when problems are self-limited, self-medication can be used [3]. Self-medication
in Uganda is becoming alarming [4]. It is imperative to assess the associated factors as a study was done by Ademola
[5] to determine the prevalence and factors associated with self-medication among University students in Kampala.
The results reveal that the prevalence of self-medication was found to be 69.4%, which indicated that 7 out of every
10 Uganda students practice self-medication of antibiotics [5]. Self-medication can delay accurate diagnosis and
appropriate treatment, and can cause toxicity, side-effects, drug interaction and unnecessary expenditure [6].
Improper self- medication practice may lead to serious adverse drug reactions and possibly fatal consequences.
Moreover, currently, there is a worldwide concern about the emergence of antibiotic resistant strains of micro-
organisms which might have been highly augmented by self-medication [7]. Abay and Amelo [8] studied self-
medication practices among medical, pharmacy, and health science students and found out that a remarkable amount
of students had practiced self-medication. However, in Uganda, there is very minimal information about self-
medication behaviour and patterns among university students hence this study amongst students at Kampala
International University – Western campus. Thus, this study was designed to determine the prevalence and factors

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associated with self-medication among students pursuing health sciences programmes at Kampala International
University - Western Campus in Bushenyi, Uganda.
METHODOLOGY
Study Design
A facility-based cross-sectional study design was used to assess self-medication practice among health sciences
students at KIU – WC, Bushenyi, Uganda. It was a quantitative study because it sought to measure self-medication
Page | 2 practices among students through the use of a questionnaire. On the other hand, it is also described as a cross-
sectional survey since the study involved the administration of the research instrument (questionnaires) once only
to the sample and the data generated on the measured characteristics are limited only to the specific period of the
study.
Area of Study
Kampala International University - Western Campus located in Ishaka town in Ishaka – Bushenyi municipality is
the Medical school section of the bigger Kampala International University family headquartered in Kansanga,
Kampala. The campus hosts a Medical teaching hospital and a fully-fledged academic campus comprised of schools
and faculties dedicated to Clinical medicine, Pharmacy, Nursing Sciences, Allied health sciences and biomedical
sciences.
Study Population
The study population was comprised of all students pursuing undergraduate health sciences related programmes.
Inclusion criteria
Undergraduate students pursuing health sciences related programmes.
Exclusion Criteria
i. Post graduate students.
ii. Students not in the health sciences faculties and schools.
Sampling Size Determination
The sample size was determined using single population proportion formula for cross sectional survey (Kish, [9])
as follows:
n= (zα/2)2pq
d2
Assuming that:
Proportion of self-medication practice among health care professionals P=77.6% (Ali et al. [10]).
q= (1-p) =22.4%
Confidence level = 95% = 1.96
Desired precision (d) = 0.05
Non-response rate= 10%
The total required sample size was 294.
Sampling procedure
Convenient sampling technique was used were all willing students that met the inclusion criteria who were present
at the time of data collection were considered in the population from the sample was drawn.
Data collection methods
The data was collected from study participants by using pre-tested, structured, self-administered questionnaire
adapted and modified from previous researches on similar topic (Ali et al. [10]). It was designed in such a way that
to includes all the relevant variables that met the study objectives which consist of 14 questions divided into two
sections that cover questions to assess socio-demographic characteristics and self-medication practice of respondents
including questions which are helpful to identify their reasons for practice and the type and pattern of drugs self-
prescribed among themselves. Data collection tools were distributed and later on collected by the principal
investigator. Respondents were approached at their respective class.
Data Processing and analysis
Questionnaire tools were checked for their accuracy and data completeness, then data was coded and entered into
Epi info version 7, then exported into SPSS version 22.0 for analysis. Descriptive statistics was used to summarize
the variables. Figures and tables were used to summarize frequencies and percentages of the variables. Univariate
and multivariate logistic regression analysis were computed to determine factors associated with self-medication.
Variables with a p - value of < 0.2 during a univariate analysis were incorporated in a multivariate logistic regression
model to control for confounding. Adjusted odds ratio (AOR) with corresponding 95% confidence interval (CI) were

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computed to see the strength of the association and a p-value of < 0.05 was considered statistically significant.
Hosmer and Leme show test was utilized to test the goodness-of-fit of the final logistic regression model.
Quality control
The questionnaire was pretested amongst willing students from the same schools and faculties whose data was not
included in the final reporting. The collected data was checked immediately after finalizing the questionnaire for
completeness and consistency of information collected.
Page | 3 Ethical considerations
Ethical approval was sought from Kampala international university western campus Faculty of clinical medicine and
dentistry and an introduction letter was given after to seek permission for data collection. A written and verbal
consent was sought from all the students whore selected to take part in the study before they were requested to
respond to the questions in the data collection tool.
RESULTS
Socio demographic characteristics of health sciences students at KIU – WC
A total of 294 students offering health sciences programmes at KIU – WC were recruited for the study. Majority of
the students were aged between 20 – 25 years, 174 (59.2%) with an average age of 23±3.5, mostly female 169
(57.5%), Single by marital status 248 (84.4%), spending averagely <100,000, 163 (55.4%) and offering Bachelors of
Medicine and Surgery (BMS) 134 (45.6%) as shown in Table 1 and Figure 1.
Table 1: Socio demographic characteristics of health sciences students at KIU – WC
Variable Category Frequency (N=294) Percentage (%)

Age (Years) <20 68 23.1

20 – 25 174 59.2
>25 52 17.7

Sex Female 169 57.5

Male 125 42.5

Marital Status Single 248 84.4

Married 34 11.6
Cohabiting 12 4.0

Average Monthly Expenditure <100,000 (Shs) 163 55.4

100,000 – 180,000 84 28.6
>180,000 47 16.0

Programme offered Nursing sciences 53 18.0

Clinical Medicine 26 8.8
Pharmacy 81 27.6
BMS 134 45.6

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Figure 1: Column graph showing demographic characteristics of health sciences students at KIU – WC

Page | 4

Prevalence of self-medication amongst health sciences students at KIU – WC

Of the 294 students recruited in the study, 231 representing 78.6% reported practicing self-medication. Majority of
the self-medicating students were aged 20 – 25 accounting for 54.1%, were female 46.3%, single 66.7%, spending a
monthly average of <100,000 shillings 39.1% and offering the BMS programme BMS 36.7% as shown in Table 2, 3
and Figure 2 & 3.

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Table 2: Prevalence and reasons for self-medication among health sciences students at KIU - WC
Self-medication variable Frequency Percentage (%)

Prevalence
Self-medication 231 78.6
No self-medication 63 21.4
Page | 5
Causes of self-medication (231)
No need to visit the doctor for a minor disease 77 33.3
Knowledge from previous experience 182 78.8
The doctor will prescribe me the same drug 164 37.9
Time and money saving 218 93.4
Fast relief 201 87.0

Causes for not self-medicating (63)

Fear of adverse/ side effects 63 100.0
Lack of knowledge & experience 16 25.4
Lack of confidence 19 30.2
Prior bad experience with self-medication 41 65.1

Sources for self-medication (231)

Public health facility 17 7.4
Community pharmacy 231 100.0
Friends & classroom colleagues 83 35.9
Old prescription 52 22.5

Classes of drugs commonly self-medicated (231)

Anti-Ulcers 59 25.5
Antibiotics 72 31.2
Anti-allergens 46 19.9
Hypnotics 24 10.4
Opioid analgesics 106 45.9
NSAID analgesics 182 78.8

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Table 3: Self-medication of KIU – WC health sciences students by socio demographic stratification
Variable Category Frequency (N=231) Percentage (%)
Age (Years) <20 24 8.1
20 – 25 159 54.1
>25 48 16.3
Page | 6
Sex Female 136 46.3
Male 95 32.3

Marital Status Single 196 66.7

Married 27 9.2
Cohabiting 8 2.7

Average Monthly Expenditure <100,000 115 39.1

100,000 – 180,000 74 25.2
>180,000 42 14.3

Programme offered Nursing sciences 35 11.9

Clinical Medicine 11 3.7
Pharmacy 77 26.2
BMS 108 36.7

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Figure 2: Line graph showing Self-medication of KIW – WC health sciences students by socio demographic
stratification

Page | 7

Figure 3: Column bar graph showing prevalence of self-medication amongst KIU – WC health sciences
students

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Drugs commonly used for self-medication by health sciences students at KIU - WC
The most commonly used drugs for self-medication by health sciences students at KIU – WC are NSAID analgesics
78.8%, Opioid analgesics 45.9%, Antibiotics 31.2%, Anti-Ulcers 25.5%, Anti-allergy drugs 19.9%, and Hypnotics
10.4% as shown in Table 2 and Figure 4.
Reasons for and against self-medication health sciences students at KIU - WC
Of the 231 students that reported practicing self-medication, 93.4% did it as a way of saving time, 87.0% did it as
Page | 8 they perceived it as a way of fast relief, 78.8% did so because they had knowledge from previous experience, 37.9%
expected the doctor to prescribe the same drug while 33.3 did so because they perceived their condition as minor as
shown in Table 2 and Figure 5. Of the 63 that reported non self-medication, 100.0% feared side effects, 65.1% had a
bad experience with self-medication before, 30.2% lacked confidence to do so while 25.4% lacked the knowledge &
experience as shown in Table 2 and Figure 6.
Figure 4: 3-D Pie chart showing commonly used drugs for self-medication by health sciences students of
KIU – WC

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Figure 5: Line and column bar combo graph showing for reasons self-medication by health sciences students
of KIU – WC

Page | 9

Figure 6: Horizontal Bar graph showing for reasons non self-medication by health sciences students of KIU
– WC

Factors associated with self-medication among health sciences students at KIU - WC

In a univariate logistic regression model, age 20 – 25 years, average monthly expenditure of 100,000 – 180,000 Shs,
knowledge from previous experience, prediction of doctor prescribing a similar drug like before, and taking opioid
analgesics showed odds of a more likelihood to self-medication among the students at [cOR=1.6, 95%CI (1.2 – 2.1),
p=0.001], [cOR=2.1, 95%CI (0.8 – 3.5), p=0.007], [cOR=2.4, 95%CI (0.8 – 6.2), p=0.024], [cOR=2.1, 95%CI (0.5
– 4.0), p=0.040] and [cOR=3.3, 95%CI (1.0 – 7.0), p=0.001] respectively as shown in tables 4 and 5. In a multivariate

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logistic regression model after all confounders had been controlled, age 20 – 25 years p=0.001, average monthly
expenditure of 100,000 – 180,000 Shs p=0.005, knowledge from previous experience p=0.025, prediction of doctor
prescribing a similar drug like before p=0.040, and taking opioid analgesics p=0.001 remained independently
associated to self-medication as shown in tables 4 and 5. Also in a multivariate logistic regression model after all
confounders had been controlled, offering a pharmacy program [aOR = 3.0, 95% CI (1.1 – 1.9), p=0.0016], access
of drugs from a community pharmacy [aOR = 1.5, 95% CI (0.3 – 5.5), p=0.041] and self-medication with antibiotics
Page | 10 [aOR = 2.0, 95% CI ( 0.2 – 5.0), p=0.044] turned out independently associated with self-medication as shown
in tables 4 and 5.
Table 4: Socio demographic factors associated with self-medication of health sciences students at KIU - WC
Variable Frequency cOR, 95% CI p - value aOR, 95% CI p - value
n = 231
0R CI 0R CI
Age (Years)
<20 24 Ref Ref
20 – 25 159 1.6 1.2 – 2.1 0.001* 1.4 1.1 – 2.5 0.001*
>25 48 2.2 0.4 – 4.5 0.118 1.8 0.1 – 5.0 0.115

Sex
Female 136 1.4 0.5 – 8.2 0.441
Male 95 Ref Ref

Marital Status
Single 196 Ref Ref
Married 27 2.0 0.1 – 3.5 0.500
Cohabiting 8 1.5 0.5 – 5.8 0.358

Average Monthly
Expenditure
<100,000 115 Ref Ref
100,000 – 180,000 74 2.1 0.8 – 3.5 0.007* 2.2 1.0 – 3.8 0.005*
>180,000 42 1.0 0.1 – 5.4 0.115 0.8 0.1 – 4.8 0.100

Programme offered
Nursing sciences 35 Ref Ref
Clinical Medicine 11 1.0 0.2 – 5.0 0.402 0.8
Pharmacy 77 3.5 1.5 – 6.2 0.158 3.0 1.1 – 1.9 0.0016
BMS 108 0.5 0.1 – 6.5 0.08 0.7 0.2 – 5.2 0.128

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Table 5: Logistic regression analysis of factors associated with self-medication of health sciences students
at KIU – WC

Variable Frequency cOR, 95% CI p- aOR, 95% CI p-

n = 231 value value
Page | 11 0R CI 0R CI
Causes of self-medication
No need to visit the doctor for a minor 77 1.5 0.2 – 4.8 0.100 2.0 0.5 – 5.2 0.113
disease
Knowledge from previous experience 182 2.4 0.8 – 6.2 0.024 2.0 0.9 – 5.0 0.025*
*
The doctor will prescribe me the same 164 2.1 0.5 – 4.0 0.040 2.0 0.5 – 4.5 0.040*
drug
Time and money saving 218 2.0 0.1 – 5.0 0.505
Fast relief 201 1.5 0.1 – 5.5 0.335

Sources for self-medication

Public health facility 17 3.0 1.2 – 6.8 0.518
Community pharmacy 231 1.2 0.1 – 6.5 0.125 1.5 0.3 – 5.5 0.041*
Friends & classroom colleagues 83 1.5 0.1 – 6.0 0.500
Old prescription 52 1.0 0.1 – 8.2 0.552

Classes of drugs commonly self-

medicated
Anti-Ulcers 59 2.5 0.5 – 5.8 0.460
Antibiotics 72 1.4 0.1 – 6.4 0.174 2.0 0.2 – 5.0 0.044*
Anti-allergens 46 1.0 0.1– 8.2 0.860 0.8 0.1 – 5.0 0.120
Hypnotics 24 1.8 0.6 – 4.0 0.250
Opioid analgesics 106 3.3 1.0 – 7.0 0.001 3.0 0.5 – 5.5 0.001*
*
NSAID analgesics 182 1.5 0.1 – 6.2 0.416

DISCUSSION
A total of 294 students offering health sciences programmes at KIU – WC were recruited for the study. Majority of
the students were aged between 20 – 25 years, 174 (59.2%) with an average age of 23±3.5, mostly female 169 (57.5%),
single by marital status 248 (84.4%), spending averagely <100,000 Uganda Shillings, 163 (55.4%) and offering BMS
programme 134 (45.6%). By age, gender, marital status and average spending capabilities, this social demographic
pattern is consistent with studies in Nepal, Ethiopia and Kenya. The consistency in the average spending capabilities
might be because all these countries are grouped in the same economic class and their population quite similar in
terms of social characteristics [11-13]. The prevalence of self-medication amongst the study population was 78.6%.
This indicates that over three-quarters of health sciences students at KIU–WC practice self-medication. Other
studies in Pakistan, Jordan, Nigeria and Saudi Arabia have reported a similar prevalence of over 70% university
students self-medicating. In all these previous studies, the perception by students that they know what they are
doing very well is associated to this high prevalence rate. Therefore, even though this study didn’t study the
knowledge of the students in this aspect, still offering a Pharmacy related programme turned out significantly
associated with self-medication among this population [14-17]. The majority of the self-medicating students were
aged 20 – 25 accounting for 54.1% and females 46.3%. studies in Ethiopia and Malaysia have reported a similar
pattern were most female students and those aged between 20 – 25 years practiced the habit more than those in the
opposite groupings. Females practicing self-medication more than male students are attributed to a number of
conditions like light headaches, fevers, GIT disturbances etc. which cause females to respond faster by taking

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medication yet they are considered minor by the males so usually let the body get back to normal order with less
medical interventions [13, 18]. The most commonly used classes of drugs for self-medication by health sciences
students at KIU – WC were NSAID analgesics 78.8%, Opioid analgesics 45.9%, Antibiotics 31.2%, Anti-Ulcers
25.5%, Anti-allergy drugs 19.9%, and Hypnotics 10.4%. Studies in Australia, Iran, Brazil, Uganda and a review of
Gulf States university students reported analgesics, antibiotics and anti – ulcers drugs as the most used by university
communities in those countries for self-medication. This pattern in classes of commonly used drugs is because
Page | 12 naturally individuals will respond to the need to eradicate pain which causes discomfort therefore will swiftly apply
analgesics. Over time the misuse of antibiotics has been reported globally and also GIT conditions like ulcers where
people think of using medication earlier prescribed in case they feel any GIT disturbance like before [19-23]. For
the students that didn’t practice self-medication, 100.0% feared side effects, 65.1% had a bad experience with self-
medication before, 30.2% lacked confidence to do so while 25.4% lacked the knowledge & experience. The fear for
side effects and having an undesirable outcome in an earlier experience have been reported as deterrent factor to
self-medication in previous studies in Serbia, Brazil and Iran. In the Iranian case, students reported experiences of
fatalities of their colleagues due to overindulgence in the practice [24]. Being of age 20 – 25 years, ability to spend
on average 100,000 – 180,000 Shs per month, knowledge from previous experience, prediction of doctor prescribing
a similar drug like before, and taking opioid analgesics showed turned out to be factors related to increased odd of
self-medication among the students at [cOR=1.6, 95%CI (1.2 – 2.1), p=0.001], [cOR=2.1, 95%CI (0.8 – 3.5),
p=0.007], [cOR=2.4, 95%CI (0.8 – 6.2), p=0.024], [cOR=2.1, 95%CI (0.5 – 4.0), p=0.040] and [cOR=3.3, 95%CI
(1.0 – 7.0), p=0.001] respectively in a univariate logistic regression model analysis. A global systematic review on
self-medication by university populations reported a consistent age strata of 20 – 25 years where the odds were
highest for students to self-medicate. This can be attributed to the fact the world over, the 20 – 25 age group makes
up the greatest part of university students’ population by average [11]. Studies in Egypt, Saudi Arabia and the
United Arab Emirates also reported students that who had a better advantage in spending money with resources at
their disposal were more likely to self–medicate. This can be attributed to the fact that the medicines don’t come
cheap, and thus it's even likely that had other students had an advantage to spend, the prevalence rates of the habit
could be higher than what is reported [15, 25, 26]. KIU – WC health sciences students that practise self-medication
are 3.3 more times likely to take opioid analgesics than any other classes of drugs [cOR=3.3, 95%CI (1.0 – 7.0),
p=0.001]. The high likelihood of university students consuming opioids with prescriptions had been reported in
Australia, China, United States, Nigeria, Egypt and other Gulf states and in all studies it was related to drug abuse
rather than intending for a clinical outcome. Even though in this study intention of self-medication was not
investigated, we have no reason not agree with the previous studies that concluded on abuse as the reason [19, 21,
25, 27, 28]. When all confounders had been controlled in a multivariate logistic regression model, offering a
pharmacy program [aOR = 3.0, 95% CI (1.1 – 1.9), p=0.0016], access of drugs from a community pharmacy [aOR
= 1.5, 95% CI (0.3 – 5.5), p=0.041] and self-medication with antibiotics [aOR = 2.0, 95% CI (0.2 – 5.0), p=0.044]
turned out to be factors that increased the odds of self-medication by the students. These results are not surprising
after controlling the confounders. Studies in Iran, Syria, Pakistan and Ethiopia reported students offering Pharmacy
programmes to be most likely to self-medicate than others, those with easy access to community pharmacies which
was attributed to weak regulations of access to drugs without prescription and use of antibiotics which was attributed
to previous use and experience [8, 20, 29, 30]. However, in studies in China and Malaysia, students pursuing human
medicine programmes and nursing sciences respectively were reported to be more likely to practice self-medication
than in Pharmacy and other programmes. This variation could be because of the lower proportion of pharmacy
students in their samples [18, 28].
CONCLUSION
More than three quarters of KIU – WC students are reported to be practicing self-medication indicating a prevalence
of 78.6%. The most commonly self-medicated classes of drugs are NSAID analgesics 78.8%, Opioid analgesics 45.9%,
Antibiotics 31.2%, Anti-Ulcers 25.5%, Anti-allergy drugs 19.9%, and Hypnotics 10.4%. Factors of age 20 – 25 years,
average monthly expenditure of 100,000 – 180,000 Shs, knowledge from previous experience, prediction of doctor
prescribing a similar drug like before, taking opioid analgesics, pursuing a pharmacy program, access of drugs from
a community pharmacy and use antibiotics significantly increased the odds of likelihood to self-medicate by the
students.
RECOMMENDATION
Under the Uganda clinical practice regulations, provision of drugs by drug outlets without a valid prescription is
prohibited. However, the study indicates unacceptable high prevalence of self-medication among the university

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population which in a way points to weak implementation of the clinical practice regulations. We recommend that
relevant authorities strongly enforce the laws so us to curb this high prevalence. Self-medication of opioid analgesics
by the university students’ population is very high in a pattern that points to drug abuse. We recommend that
university authorities picks this up and devises appropriate measures to control this looming problem because the
dangers of opioid addiction especially in young generation is well documented.
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CITE AS: Nakabiri Maria Gorret (2024). Prevalence and Factors Associated
with Self-Medication among Health Sciences Students at Kampala
International University - Western Campus. EURASIAN EXPERIMENT
JOURNAL OF PUBLIC HEALTH 5(1):1-14.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.