Understanding community antibiotic use and antimicrobial resistance in Sub-Saharan Africa: A grassroots perspective from Enugu, Nigeria

What the report says

PLOS One published a study examining how communities in Enugu State, Nigeria, use antibiotics and understand antimicrobial resistance, or AMR. The paper, by W. Maduko, E. Olamijuwon, M. Kesby and J.M. Hale, was published July 23, 2026, and used a mixed-methods design: a baseline survey of 1,281 people, 20 interviews and four focus group discussions involving 24 participants.

According to the study, antibiotic use was common in the surveyed communities, with 57.7% of respondents saying they had taken antibiotics in the previous six months. Many reported using them without a prescription, including for conditions such as malaria, cough and fever, which may not be bacterial illnesses. Among those who used antibiotics, 48% said they self-medicated, often obtaining medicines from chemist shops.

The authors reported low awareness of AMR: only 15.7% of respondents had heard of it, and some participants associated it with fake medicines or allergic reactions rather than drug-resistant infections. The study also identified reported practices such as using antibiotics for pregnancy termination or preventive “cleansing.” Researchers linked misuse not only to knowledge gaps but also to poverty, limited access to formal healthcare, weak regulation and reliance on informal drug vendors.

The study matters because AMR can make infections harder to treat, a risk that is especially serious where health systems and diagnostic services are under-resourced. PLOS One reported that participants suggested locally grounded responses, including radio messages, education through religious leaders and stronger enforcement of drug rules. The authors argue that effective AMR strategies in Sub-Saharan Africa should address both behavior and the structural pressures shaping everyday healthcare decisions.