Knowledge and use of antibiotics in six ethnic groups: the HELIUS study

Schuts, Emelie C.; van Dulm, Eline; Boyd, Anders; Snijder, Marieke B.; Geerlings, Suzanne E.; Prins, Maria; Prins, Jan M.

doi:10.1186/s13756-019-0636-x

Antimicrobial Resistance & Infection Control

Table 1 Characteristics of the HELIUS study population (N = 21,617) by ethnicity

From: Knowledge and use of antibiotics in six ethnic groups: the HELIUS study

Variables^a	Ethnicity
Variables^a	Dutch (N = 4564)		South-Asian Surinamese (N = 3043)		African Surinamese (N = 4151)		Ghanaian (N = 2339)		Turkish (N = 3614)		Moroccan (N = 3906)
Sociodemographics
Female sex	2475	54%	1672	55%	2535	61%	1434	61%	1980	55%	2392	61%
Age in years, median (IQR)	47	(34–58)	48	(35–56)	50	(40–57)	47	(38–53)	42	(31–50)	40	(30–50)
Migration generation
1st generation	N.A.	N.A.	2328	77%	3468	84%	2231	95%	2544	70%	2680	69%
2nd generation	N.A.	N.A.	715	23%	683	16%	108	4.6%	1080	30%	1226	31%
Educational level
Unknown	25	0.6%	16	0.5%	36	0.9%	42	1.8%	38	1.1%	38	1.0%
No school/elementary school	150	3.3%	437	14%	231	6%	660	28%	1135	31%	1205	31%
Lower vocational/lower secondary school	646	14%	1010	33%	1477	36%	917	39%	889	25%	694	18%
Intermediate vocational/ intermediate secondary school	994	22%	885	29%	1464	35%	578	25%	1020	28%	1294	33%
Higher vocational/university	2749	60%	695	23%	943	23%	142	6%	532	15%	675	17%
Marital status
Married/registered partnership	1724	38%	1043	34%	766	19%	420	18%	2208	61%	2285	59%
Cohabiting	914	20%	311	10%	441	11%	427	19%	132	3.7%	110	2.8%
Unmarried/never married	1474	32%	1001	33%	2231	54%	779	34%	761	21%	1010	26%
Divorced/separated	356	8%	580	19%	617	15%	656	28%	407	11%	414	11%
Widow/widower	87	1.9%	92	3.0%	65	1.6%	23	1.0%	90	2.5%	69	1.8%
Health status
Self-reported medical conditions (previous 12 months)
Diabetes mellitus	102	2.2%	521	17%	419	10%	185	8%	336	9%	389	10%
CVA/one-sided loss of bodily function ≤1 day	160	3.5%	212	7%	261	6%	95	4.1%	196	5%	195	5%
MI incl. ≥half hour chest pain or dotter/bypass operation	233	5%	491	16%	440	11%	225	10%	591	16%	476	12%
Severe heart condition	67	1.5%	120	4.0%	105	2.5%	75	3.2%	153	4.3%	58	1.5%
Malignant disorder	103	2.3%	70	2.3%	85	2.1%	33	1.4%	73	2.0%	46	1.2%
Severe or chronic fatigue	633	14%	1032	34%	956	23%	186	8%	1602	45%	1465	38%
High blood pressure	534	12%	720	24%	1230	30%	770	33%	610	17%	546	14%
Artery stenosis	85	1.9%	193	6%	181	4.4%	115	5%	348	10%	200	5%
Respiratory diseases	345	8%	433	14%	354	9%	117	5%	556	15%	446	11%
Serious/persistent intestinal disorders	249	5%	248	8%	308	7%	70	3.0%	433	12%	391	10%
Psoriasis	136	3.0%	168	6%	128	3.1%	71	3.1%	154	4.3%	121	3.1%
(Chronic) eczema	420	9%	406	13%	370	9%	71	3.1%	471	13%	423	11%
Incontinence	309	7%	326	11%	342	8%	108	4.7%	464	13%	300	8%
Body Mass Index (kg/m²), median (IQR)	24.1	(21.9–26.7)	25.7	(23.2–28.8)	27.0	(23.9–30.8)	27.9	(25.0–31.2)	27.9	(24.6–31.7)	27.0	(23.9–30.7)
Smoking
Yes	1129	25%	861	28%	1309	32%	104	4.5%	1240	35%	525	13%
No, never	1689	37%	1758	58%	2016	49%	2027	87%	1700	47%	2874	74%
No, but ever	1737	38%	413	14%	805	19%	191	8%	648	18%	492	13%
Alcohol consumption
Never	297	7%	1072	35%	1002	24%	806	35%	2414	67%	3265	84%
Not in previous 12 months	110	2.4%	251	8%	292	7%	408	18%	358	10%	338	9%
Monthly or less	436	10%	758	25%	1242	30%	508	22%	367	10%	127	3.3%
2–4 times per month	894	20%	541	18%	873	21%	291	13%	257	7%	87	2.2%
2–3 times per week	1413	31%	262	9%	439	11%	193	8%	132	3.7%	56	1.4%
≥ 4 times per week	1408	31%	147	5%	272	7%	109	4.7%	57	1.6%	16	0.4%
Difficulty with Dutch language
Yes	N.A.	N.A.	711	23%	520	13%	1926	83%	2136	60%	1774	46%
Perceived health
Excellent	541	12%	162	5%	303	7%	226	10%	117	3.3%	166	4.3%
Very good	1381	30%	310	10%	571	14%	458	20%	383	11%	384	10%
Good	2205	48%	1623	53%	2335	56%	1180	51%	1871	52%	1871	48%
Mediocre	402	9%	811	27%	834	20%	383	16%	921	26%	1223	31%
Bad	28	0.6%	131	4.3%	101	2.4%	88	3.8%	307	9%	241	6%
Antibiotics
Knowledge concerning antibiotics^b
Antibiotics effective for influenza	324	7%	554	19%	592	15%	658	29%	744	21%	648	18%
Antibiotics effective for pneumonia	4166	92%	2304	77%	3114	77%	1312	58%	2587	73%	2741	73%
Antibiotics effective for fever^c	689	15%	552	19%	679	17%	586	26%	898	26%	614	17%
Antibiotics effective for sore throat^c	672	15%	760	26%	1089	27%	720	32%	1203	34%	978	26%
Antibiotics effective for bronchitis	2246	50%	1385	50%	1862	46%	919	41%	1235	35%	1485	40%
Higher level of antibiotic knowledge^d	3638	80%	1996	68%	2737	69%	1248	57%	2128	62%	2528	70%
Did not finish antibiotic treatment
Yes, regularly	5	0.1%	49	1.6%	44	1.1%	48	2.1%	41	1.2%	44	1.1%
Yes, occasionally	332	7%	312	10%	527	13%	174	8%	424	12%	445	12%
Always finished or no antibiotics	4203	93%	2646	88%	3524	86%	2053	90%	3104	87%	3361	87%
Saved antibiotics for later
Yes, regularly	2	0.0%	7	0.2%	9	0.2%	5	0.2%	10	0.3%	6	0.2%
Yes, occasionally	37	0.8%	45	1.5%	68	1.7%	62	2.7%	60	1.7%	46	1.2%
No, never	297	7%	304	10%	492	12%	146	6%	387	11%	430	11%
Not applicable (no antibiotics)	4203	93%	2646	88%	3524	86%	2053	91%	3104	87%	3361	87%
Ever asked GP for antibiotics
Yes, regularly	38	0.8%	34	1.1%	26	0.6%	36	1.6%	67	1.9%	71	1.9%
Yes, occasionally	824	18%	491	16%	607	15%	401	18%	734	21%	634	17%
No, never	3674	81%	2482	83%	3441	84%	1835	81%	2744	77%	3074	81%

Missing data, n: marital status 128; diabetes 78; stroke 55; myocardial infarction 33; heart condition 83; malignant disorders 137; fatigue 145; high blood pressure 101; artery stenosis 140; respiratory diseases 115; bowel diseases 115; psoriasis 98; eczema 117; incontinence 126; BMI 23; smoking 107; alcohol 127; perceived health 61; AB effective for influenza 614; AB effective for pneumonia 477; AB effective for fever 685; AB effective for sore throat 625; AB effective for bronchitis 663; asked GP for AB 414; did not finish treatment 292; saved AB 325
Abbreviations: IQR Inter Quartile Range, CVA Cerebro Vascular Accident, MI Myocardial infarction, N.A. Not Applicable, GP General Practitioner
N.A. Not applicable (categories not applicable due to Dutch ethnicity)
^aAll variables are reported as n (%), unless otherwise indicated
^bAnswered “yes” to the statements below
^cThe Dutch General Practitioners guidelines (and those of other European countries) advise against the use of antibiotics for fever in general or sore throat, as they usually constitute viral infections, with only a few exceptions in both cases. Therefore, antibiotics are in general not appropriate for these conditions
^dBased on a summed score with cutoff determined by an Item Response Theory model (≥4 out of 5 antibiotic knowledge questions correctly answered was considered as having a higher level of knowledge)

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