Assessment of self-medication practices involving antibiotics among children under 5 years of age in the Likasi health zone (Democratic Republic of Congo): a cross-sectional study on the prevalence and socio-cultural and economic determinants

Abstract

Introduction: Self-medication with antibiotics among children under five years of age poses a major threat to public health, contributing to the emergence of bacterial resistance and exposing children to the risks of adverse effects and treatment failure. In the Democratic Republic of the Congo (DRC), this phenomenon is exacerbated by economic hardship, a weak healthcare system and the proliferation of the informal medicines market. This study aimed to assess the prevalence of self-medication with antibiotics among children under five years of age and to identify the associated sociocultural and economic factors in the Likasi health zone.

Methods: A descriptive and analytical cross-sectional study was conducted among 420 mothers or carers of children under five years of age, selected using a multi-stage probability cluster sampling method. Data were collected using a structured questionnaire administered face-to-face and subsequently analysed using SPSS. Bivariate and multivariate logistic regressions were performed to identify associated factors.

Results: The prevalence of self-medication with antibiotics was 61.7 per cent (n = 259). Amoxicillin (22.8 per cent) was the most commonly used drug, mainly to treat coughs, and syrup (65.2 per cent) was the predominant dosage form. The factors significantly associated were: low monthly income (ORa = 5.2; 95% CI: 3.0–9.1; p < 0.001), a university-level education (ORa = 2.8; p = 0.007), and a distance to the health centre of > 5 km (ORa = 1.9; p = 0.021). The mistaken belief in the universal effectiveness of antibiotics was also a major factor (80.0 per cent of self-medication among mothers holding this belief).

Conclusion: Self-medication with antibiotics is an alarming practice in Likasi, driven primarily by economic hardship and popular beliefs. Targeted interventions are urgently needed: strengthening pharmaceutical regulation, policies providing free paediatric care, community-based health education, and the expansion of universal health coverage.

Keywords: Self-medication, antibiotics, children under 5 years of age, sociocultural factors, economic factors, Likasi, Democratic Republic of the Congo, bacterial resistance.

Received Date: August 17, 2026

Accepted Date: September 09, 2026

Published Date: October 01, 2026

Available Online at: https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/969