Prevalence of Commonly Consumed Drugs in Mbarara City, Uganda

Abstract

Pharmaceutical consumption is rising globally, with significant implications for environmental pollution and antimicrobial resistance (AMR). In sub-Saharan Africa, weak prescription control, widespread self-medication, and insufficient wastewater treatment amplify risks of pharmaceutical residues entering aquatic systems. Studies in Uganda have detected active pharmaceutical ingredients in urban waters, including River Rwizi, a critical domestic and agricultural water source for Mbarara City. However, systematic data linking patterns of drug consumption to environmental risks in Mbarara City remain scarce. Through a descriptive cross-sectional survey, drug use prevalence across public and private healthcare outlets in Mbarara City was assessed, focusing on 30 essential medicines listed in the Uganda Clinical Guidelines (2023). Data was collected from 81 drug outlets in strategically selected clusters adjacent to the River Rwizi and analysed using descriptive statistics. Results show extremely high prevalence of paracetamol (97.5%), amoxicillin (96.3%), ibuprofen (93.8%), azithromycin (86.4%), ciprofloxacin (82.7%), metronidazole (84.0%), coartem (80.2%), ceftriaxone (77.8%), and doxycycline (76.5%), indicating a narrow subset of medicines that dominate urban consumption. These drugs address the city’s burden of febrile illnesses, malaria, and bacterial infections, but their widespread and unregulated use heightens risks of AMR development and pharmaceutical pollution. The findings indicate an urgent need for integrated pharmaceutical stewardship, improved wastewater treatment, and environmental monitoring of the River Rwizi. By establishing a baseline of commonly consumed drugs in Mbarara City, this study provides essential evidence for guiding rational drug use policies, waste management strategies, and interventions to safeguard both public health and aquatic ecosystems.