{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:14:13Z","timestamp":1782782053324,"version":"3.54.5"},"reference-count":40,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"European Joint Programme Initiative on AMR","award":["JPIAMR2021-053"],"award-info":[{"award-number":["JPIAMR2021-053"]}]},{"DOI":"10.13039\/501100005027","name":"Belgian Development Cooperation","doi-asserted-by":"crossref","award":["ITM-CRUN Framework Agreement 5"],"award-info":[{"award-number":["ITM-CRUN Framework Agreement 5"]}],"id":[{"id":"10.13039\/501100005027","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,11,12]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to understand the knowledge possessed by informal medicine vendors regarding antibiotics and antibiotic resistance, identify the perceptions held by informal medicine vendors about antibiotics and their uses and examine the practices employed by informal medicine vendors in the sale and distribution of antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Exploratory qualitative study using semi-structured interviews and direct observations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Markets and shops across 11 villages in the Nanoro health district, Burkina Faso.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>23 informal medicine vendors, aged between 25 and 55 years and with 8\u201330 years of experience, were recruited through snowball sampling in the Nanoro health district of Burkina Faso.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Informal medicine vendors exhibited a limited understanding of antibiotics, often confusing them with other treatments and referring to them using local terminologies based on perceived use and effectiveness. Antibiotics were perceived as universal remedies, supported by therapeutic belief, empirical reasoning and community solidarity, with empirical diagnosis, approximate dosing and informal preparation techniques passed on through imitation. These findings emerged across themes including perceptions, symbolic attributes and sales practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Informal medicine vendors in rural Burkina Faso demonstrated limited understanding of antibiotics and antimicrobial resistance, with practices shaped by local beliefs and empirical experience. These findings underscore the need for context-sensitive interventions that include tailored education and regulatory engagement to improve antibiotic stewardship and mitigate the spread of resistance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105394","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T10:10:40Z","timestamp":1764843040000},"page":"e105394","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Knowledge, perceptions and practices of informal medicine vendors regarding over-the-counter distribution of antibiotics and antibiotic resistance in Nanoro District, Burkina Faso: an exploratory qualitative study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0096-3099","authenticated-orcid":false,"given":"Juste St\u00e9phane","family":"Kouanda","sequence":"first","affiliation":[{"name":"Unit\u00e9 de Recherche 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Vente illicite d\u2019antibiotiques et d\u2019antipaludiques \u00e0 Bamako: concept gnosologique des vendeurs [Th\u00e8se d\u2019exercice]. Bamako: Universit\u00e9 des Sciences, des Techniques et des Technologies de Bamako, Facult\u00e9 de M\u00e9decine et d\u2019Odontostomatologie, 2013. Available: https:\/\/bibliosante.ml\/handle\/123456789\/1792"},{"key":"2026010703463671000_15.12.e105394.14","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-023-07856-2","article-title":"Evaluating the effect of a behavioural intervention bundle on antibiotic use, quality of care, and household transmission of resistant Enterobacteriaceae in intervention versus control clusters in rural Burkina Faso and DR Congo (CABU-EICO)","volume":"25","author":"van der Sande","year":"2024","journal-title":"Trials"},{"key":"2026010703463671000_15.12.e105394.15","unstructured":"Whyte SR , van der Geest S , Hardon A . Social Lives of Medicines. 10. 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La divination comme lieu de rencontre entre maladie et religion en pays mossi (burkina faso). Classiques Des Sciences Sociales; 2005. Available: https:\/\/classiques.uqam.ca\/contemporains\/egrot_marc\/"},{"key":"2026010703463671000_15.12.e105394.33","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)90652-6"},{"key":"2026010703463671000_15.12.e105394.34","doi-asserted-by":"crossref","first-page":"203","DOI":"10.63931\/ijchr.v7iSI2.185","article-title":"Near or far? Exploring Clinic Proximity and Antimicrobial Cultural Beliefs","volume":"7","author":"Castillano","year":"2025","journal-title":"IJCHR"},{"key":"2026010703463671000_15.12.e105394.35","unstructured":"Ba AO . \u00c9tude socio-anthropologique des usages et perceptions des antibiotiques en sant\u00e9 humaine et animale (\u00e9levage et m\u00e9decine v\u00e9t\u00e9rinaire) dans le d\u00e9partement V\u00e9lingara, 2023. 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