Management of microbial keratitis by private pharmacies in Uganda: a study of knowledge, attitude, and practice [version 1; peer review: 2 approved]

Purpose: To determine the knowledge, attitude, and practice of pharmacy attendants in the management of microbial keratitis.

Methods: This mixed-methods study was conducted in selected pharmacies and drug shops located in Mbarara City between March and May 2022. We administered questionnaires assessing the knowledge, attitudes, and practices (KAP) related to microbial keratitis (MK) to 140 pharmacy attendants (PAs) in the drug shops and pharmacies. We also conducted 40 in-depth interviews (IDI) and three focus group discussions (FGD) with pharmacy attendants to discuss practices, challenges, and opportunities to improve the management of MK.

Results: Of the 140 pharmacy attendants, almost half (49.29%) reported that they were not confident when making diagnoses in patients with eye problems, and 19.29% were uncertain of which drug to prescribe. In the IDIs and FGDs, the pharmacy attendants reported that they receive and manage patients with MK. Some immediately refer any patients they receive with eye complaints without prescribing any medication while others only refer those who are not responding to medication. The challenges faced in managing patients with MK included inadequate knowledge of managing eye diseases including MK, patients presenting with severe diseases because of delays in seeking healthcare, and the use of traditional eye medicine. The pharmacy attendants suggested ways of improving the management of MK and other eye diseases in the community including community sensitisation on eye diseases and conducting continued professional development lecture sessions on MK in pharmacies, drug shops, and clinics.

Conclusion: The study showed that probable MK was a common presentation among patients seeking to buy drugs from pharmacies and drug shops. Pharmacies are key stakeholders in the health seeking journey of patients and hence need to be supported through capacity building and strengthening the referral network to improve the outcomes of patients with eye diseases and MK.