Prevalence and factors associated with self-medication for COVID-19 among slum dwellers in Jinja City, Uganda, in 2021

Introduction: Self-medication is a serious public health concern globally and is more prevalent in underserved populations, especially in resource limited settings. The lack of effective treatment for COVID-19 and poor access to healthcare were drivers of self-medication. We investigated the prevalence and associated factors with self-medication for COVID-19 among slum dwellers in a Ugandan slum. Methods: We conducted a cross-sectional study using randomly selected respondents from slums in Jinja city, Uganda. Households were proportionately selected from the slums and one participant with confirmed or self-reported COVID-19 during 2021 was recruited. Poisson regression with robust standard errors was used to determine the crude (CPR) and adjusted prevalence ratios (APR) (95% CI) of factors associated with self-medication. Variables were selected apriori and backward elimination approach used to fit the final multivariate model in which variables with a P≤0.05 were included. Results: Overall, 517 respondents were recruited, median age (years) was 31 (26-40), and 59% were male. The prevalence of self-medication for COVID-19 was 87.23% (451/517), 95% CI: (84.00%-90.00%) and 56% knew that self-medication was dangerous. Age≥50 years, compared to 20-29 years (APR: 1.12, 95% CI:1.05, 1.20), being female (APR: 1.07, 95% CI: 1.02, 1.13), minor (APR: 1.62, 95% CI: 1.25, 2.11), and severe symptoms (APR: 1.51, 95% CI: 1.16, 1.96), access to internet (APR: 1.13, 95% CI: 1.07, 1.20). Having medical insurance (APR: 0.63, 95% CI: 0.46, 0.87) and awareness about laws against self-medication (APR: 0.89, 95% CI: 0.81, 0.97) were associated with a lower risk of self-medication. Conclusion: The prevalence of self-medication in slum dwellers in Uganda was high despite high awareness about its dangers. Self-medication was common in those with severe symptoms and those access to internet. There is need to control infodemia and improve health insurance cover in informal settlements within Uganda.