Abstract
Background: Antimicrobial resistance (AMR) is a major global health threat, yet awareness among adolescents remains low, especially in low-resource settings. Novel educational approaches are needed to appropriately inform and sustain the interest of young people to encourage behavioral change in the use of antimicrobials. This study aimed to evaluate the impact of a comic-based intervention in improving AMR knowledge and perceptions regarding the responsible use of antimicrobials among junior high school students in Ghana. Methods: We conducted a before-and-after educational intervention at the Kwame Nkrumah University of Science and Technology (KNUST) Basic Schools in Kumasi, Ghana, during the 2023 World AMR Awareness Week. All junior high students (JHS 1–3) present were exposed to a comic storyline illustrating appropriate antibiotic use and the risks of AMR, delivered via PowerPoint presentation and print, as an intervention. Questionnaires were administered pre- and post-intervention to assess changes in AMR knowledge and perceptions. Results: The median age of the student participants was 13 years. Out of the 1068 students involved, 611 matched responses were analyzed. Knowledge of AMR increased significantly after the comic intervention (p < 0.001). Correct responses increased across all items, and the proportion of students with a knowledge score increased substantially (33% to 70%). Attitudinal perceptions also shifted positively: 85.1% acknowledged their personal role in tackling AMR after the intervention, up from 67.4% before the intervention (p < 0.001). Conclusions: The educational intervention resulted in increased AMR knowledge and positive perceptions among the adolescents. The study findings suggest that comics and their deployment are viable tools for enhancing AMR awareness in school settings. Therefore, integrating and engaging visual storytelling in health education programs can increase awareness and promote responsible behavior towards the use of antimicrobials and support the global and national efforts for the containment of AMR.
| Original language | English |
|---|---|
| Article number | 646 |
| Pages (from-to) | 1-16 |
| Number of pages | 16 |
| Journal | Antibiotics |
| Volume | 15 |
| Issue number | 7 |
| Early online date | 29 Jun 2026 |
| DOIs | |
| Publication status | Published (in print/issue) - 30 Jul 2026 |
Bibliographical note
©2026 by the authors. Licensee MDPI, Basel, Switzerland.Data Availability Statement
The data presented in this study are available on request from the corresponding author. (data are not made public due to the privacy of the study participants who are adolescents).Funding
This study was supported by the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) (grant reference A11) programs supported by Global Health Partnerships (GHP, formerly THET) and Commonwealth Pharmacists Association (CPA) using Official Development Assistance (ODA) funding through the Department of Health and Social Care’s Fleming Fund. UK partners involved were volunteers supported by their host NHS organizations.
| Funders |
|---|
| Department of Health and Social Care |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 3 Good Health and Well-being
Keywords
- antimicrobial resistance
- AMR educaton
- adolescents
- comics
- Ghana
- school-based intervention visual storytelling
- antimicrobial stewardship
- AMR education
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