Widespread Self-Medication and Unsafe Access to Analgesics and NSAIDs in Urban Conakry, Guinea: Structural Determinants, Epidemiological Patterns, and Health System Implications – A Cross-Sectional Study of 1,032 Participants
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Background
Self-medication with analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) is common in low- and middle-income countries and may expose users to preventable adverse outcomes. Evidence from Guinea remains scarce. This study aimed to estimate the prevalence of self-medication with analgesics and NSAIDs among pharmacy clients in urban Conakry, identify associated factors, and describe clinical risk situations.
Methods
We conducted a pharmacy-based analytical cross-sectional study in 30 private pharmacies across Conakry, Guinea. A total of 1,032 participants seeking analgesics or NSAIDs were enrolled between November 3, 2012, and April 5, 2013. Self-medication was defined as acquisition or use without a valid medical prescription. Factors associated with self-medication were analysed using multivariable logistic regression.
Results
Among 1,032 participants, 603 reported self-medication (prevalence 58.4%). Previous unsupervised use was reported by 78.7%. The most frequently used medicines were paracetamol (56.9%, n=587), diclofenac (21.3%, n=220), ibuprofen (17.9%, n=185), and aspirin (3.9%, n=40). Overall, 68.0% (n=702) reported no knowledge of potential adverse effects. Clinical risk situations were frequent: gastrointestinal disorders (41.3%, n=426), hypertension (9.2%, n=95), and pregnancy exposure among reproductive-age women (26.0%). In multivariable analysis, self-medication was independently associated with previous analgesic/NSAID use (aOR = 2.8, 95% CI: 2.1–3.6), lack of knowledge of adverse effects (aOR = 1.9, 95% CI: 1.4–2.5), informal occupation (aOR = 1.6, 95% CI: 1.2–2.2), and age 18–59 years (aOR = 1.5, 95% CI: 1.1–2.1).
Conclusions
In this pharmacy-based study conducted in urban Conakry, self-medication with analgesics and NSAIDs was common and frequently associated with limited awareness of potential adverse effects. These findings support the need for strengthened pharmaceutical regulation, pharmacist-led counselling, health literacy interventions, and improved access to primary care.
