This was a community based cross-sectional study.

The study was carried out at Down beach and Newtown-Limbe Cameroon. Limbe (known as Victoria from 1858 to 1982) is a seaside city in the South-West Region of Cameroon. Limbe was founded in 1858 on the southern slopes of Mount Cameroon by the British missionary Alfred Saker. At the 2005 Census, the population was 84,223.

This study was conducted from January to August 2021.

The target population included adults residing in Down beach and New-Town quarters in the Limbe municipality

We used the probability convenience sampling method to recruit our study participants’ population. Adults that gave their consent to participate in the study were included. The sample size was estimated using Lorenz’s formula.

Sample size, n = ( z 2 p q ) / d 2

where, q = 1 − p;

z = standard normal variate, 1.96;

p = expected proportion in population based on previous studies (prevalence). The prevalence of 75% was used in this study which was obtained from a study conducted by Omolase et al. to “assess the self-medication amongst general outpatients in a Nigerian community hospital”;

d = absolute error or precision, 5%.

From the above formula, the sample size was 284 adults.

Inclusion criteria

r All adults that had lived for at least six months at down beach and Newtown Limbe.

Exclusion criteria

r We excluded all adults who were morbidly ill and those with hearing and visual disorders.

r Individuals who were busy at the time and couldn’t provide adequate time to answer questionnaires till the end.

Data was collected using a well structured questionnaire. The questionnaire was structured from reviewing existing literature. Pretesting of the questionnaire was done in some 20 adults in the New Town community to ensure its feasibility. Ambiguities were modified based on the pretest findings. The finalised questionnaire was used to collect data by face-to-face interview with eligible participants. The variables in this research study consisted of use of self-medication (dependent variable) and knowledge, attitude and practice of self-medication (Independent variable). The technique of the data collection was through a self-administered questionnaire with the participant to elicit responses if eligibility for the study were met within the period of data collection. Individuals who were unable to read and write were assisted by the investigator to fill their questionnaire. The questionnaire was made up of 5 sections. Section one (1) was on the socio-demographic factors of the respondent and made of seven (7) questions with options for the respondent to choose one option. These questions include; Name, age, Gender, marital status, educational level, income level, employer of respondent. Section two (2) is on self-medication habits with nine (9) questions. The first six (6) questions were made of short statements for the respondent to mark a cross (X) on either always, most of the time, often, sometime or rarely as appropriate to them. The next 3 questions (question 7 - 9) were made of short questions and options for the respondent to select more than one choice. Section three (3) was on the knowledge of self-medication and made of seven (7) statements (questions) for the respondent to place a cross (X) in the box on either right, wrong or uncertain as appropriate to them. Section four (4) was on attitude towards self-medication and made of six (6) questions (statements) for the respondent to place a cross (X) in the box on either strongly agree, agree, uncertain, disagree, or strongly disagree. Section five (5) was on the practice of self-medication and made up of eight (8) questions (statements) for the respondent to place a cross (X) in the box on either right, wrong or uncertain as appropriate to them.

Ethical clearance was obtained from the Faculty of Health Sciences, University of Buea. Administrative authorization was obtained from the Regional Delegation of Public Health for the South West Region. A written consent form was signed by each participant willing to partake after going through the participant’s information sheet. All the information was recorded anonymously and confidentiality was assured throughout the study.

After signing an informed consent form, participants were administered a pre-tested survey questionnaire and any ambiguity was modified based on pre-test findings.

Data was entered and analysed using Statistical Package for Social Science (SPSS) version 17. Descriptive statistics such as frequencies and percentages were presented using tables, graphs, and texts. P-value less than 0.05 was used to determine variables significantly associated with Self-medication practice. The prevalence of self-medication was obtained from the answer provided in the questionnaire by all the participants that answered “yes” to having given medication to anyone that fell ill at home. Knowledge of self-medication was obtained from answers provided on the questionnaire. All participants who ticked “right” with the statement, were considered to have “good knowledge”, those who ticked “wrong” were considered to have “poor knowledge” while participants who ticked uncertain with the statement were considered to be “uncertain” with self-medication practice. Attitude was analysed based on the option made by participants against the statement. Those who agreed or strongly agreed were considered to have “negative attitude”, participants that disagreed or strongly disagreed were considered to have “positive attitude” while those who said to be uncertain were considered to be “indifferent” on the practice of self-medication. The practice of self-medication was based on the options ticked by participants against the statements in the questionnaire. Those who agreed or strongly agreed were considered to have “good practice”, participants that disagreed or strongly disagreed were considered to have “poor practice” while those who said to be uncertain were considered to be “uncertain” on the practice of self-medication. All this data was printed and kept safe in a clean dry cupboard and accessibility was restricted from all except the investigator. The softcopy of the document was converted to a pdf file and backed up on a google drive and into a USB flash disk.

This study involved 284 participants of varied age ranges, ≤19 years 23 (8.1%), 20 - 29 years 120 (42.3%), 30 - 39 years 60 (21.1%), 40 - 49 years 58 (20.4%) and ≥50 years were 23 (8.1%). The total number of individuals per household; 1 - 2 persons 73 (25.7%), 3 - 5 persons 109 (38.4%), 6 - 7 persons 68 (23.9%) and ≥8 persons were 34 (12.0%). For educational level, the majority 159 (56.0%) had been to the university as shown on Table 1 below.

Among the participants, 213 (75.0%) said yes to self-medication at home when sonhmeone was sick, while 71 (25.0%) said no to self-medication. Also, 151 (71.4%) of participants said they self-medicated when they have fever and headache, 23 (10.7%) said when they had cough and cold, 8 (3.7%) said acidity, 4 (1.7%) said when they have nausea and vomiting, 4 (1.7%) said when they had diarrhoea and 23 (10.8%) said others (Figure 1).

For self-medicated drug used by the participants, majority 204 (18.9%) said paracetamol and the least was dexamethasone 5 (0.5%) (Figure 2).

Concerning the reason for self-medication, the majority 95 (15.6%) said it saves time and the least 5 (0.8%) response of the participants was that doctors were too busy with many patients (Figure 3).

The various responses of the participants to test their knowledge are represented on Table 2 below.

Overall, 68.9% of the participants had good knowledge, 13.1% of participants had poor Knowledge while 18.2% of participants were uncertain (See Figure 4).

The attitude of the participants towards self-medication varied in this study, as some agreed, others disagreed and others were uncertain. These attitudes were represented on Table 3 below.

Overall, 58.3% of participants had a positive attitude on self-medication, 12.7% were indifferent while 29.0% had a negative attitude (Figure 5).

A chi-square test was done to check for factors that promoted self-medication among households of the Limbe community, there was a statistically significant relationship between age and self-medication (p = 001) the age group < 19 years had the highest case of self-medication (100%). Also, there was a significant association between the total number of family members staying at a house and self-medication (p = 0.001), households with 6 - 7 members had the highest rate of self-medication (100%). There was also a significant association between the highest level of education and self-medication, primary and secondary education

was found to be the greatest (100%) promoter of self-medication. The type of illness also promoted self-medication (p = 0.001) as those with acidity and diarrhoea (100%) were most likely to self-medicate. There was a statistically significant association between all the elements of knowledge on self-medication (p < 0.05) and self-medicating, most of the participants responded that it was right. (Table 4)

The practice of self-medication among the participants varied in this study, as some agreed, others disagreed and others were uncertain. These practices of self-medication are represented on Table 5 below.

The overall practice of self-medication showed that 46.0% of participant had good practice on self-medication, 46.0% were uncertain while 8.0% had poor practice of self-medication (Figure 6).

To the problems identified in this study, the following proposed suggestions have been made:

To health personnel

• Health care providers should educate patients on the dangers of self-medication. Such messages should be extended to the community at large periodically by government health ministries.

To the government

• Government should enforce relevant legislation which limits the sales of drugs without prescription to only a few relatively harmless over the counter ones.

• Create awareness about existing health facilities so that patients will know where to go when the need arises thereby minimising the potential resort to self-medication.

• Further research should be carried out in the rural area of the Limbe community, South West region and Cameroon as a whole assessing the awareness of both modern and traditional medicine in order to be able to make a definitive conclusion.

• This study was conducted in an urban setting which didn’t show the practices of the rural area.

• The study assessed conventional medicine and did not include practices of traditional medicine.

• The study might also prone to recall bias as a result of self-reporting of the participants for their last 6 months experiences.