Knowledge and utilization of the acts in two major Nigerian cities

Abstract

This study examined the knowledge and utilization of the artemisinin-based combination therapies (ACTs) for the treatment of acute uncomplicated malaria, in Nigeria. From March 2006 to December 2008, 2004 randomly selected outpatients presenting at hospitals and community pharmacies in Abuja (central Nigeria) and Port Harcourt (South-south, Nigeria) with acute uncomplicated malaria were used in a cross-sectional survey that employed self-administered questionnaires. Some 53 healthcare givers (15 doctors, 25 pharmacists and 13 nurses) were interviewed using structured questionnaires. Data generated were entered into SPSS 10.0 for Windows for statistical analysis. Seven hundred and sixty two (762) or 38% outpatients indulged in self-medication of the ACTs, with amodiaquine combinations being the most prescribed ACT despite the adverse drug events (ADEs) encountered. Factors influencing the prescription of the ACTs by healthcare givers were biased and 1343 (67%) outpatients and 23 (35.9%) healthcare givers were ignorant of the rationales for using them. Some 441 (22%) outpatients did not complete treatment and most malaria diagnosis, 1824 or 91% was not validated in the laboratory. Only 4(6.25%) of the healthcare givers discussed the non-pharmacological malaria control methods and about 2% documented ADEs. There were 1042 (52%) cases of mal dosing of the ACTs, occurring more in the public sector and higher in Port Harcourt. Some 601(30%) of the respondents with severe malaria received AL. The knowledge and utilization of the ACTs should be improved using diagnostic and educational tools. Improvement of drug information services should be the government’s top priority, as progressive mismanagement of the ACTs would hasten relapse, recrudescence and drug resistance amongst the populace.

Keywords:  Artemisinin, malaria, outpatients, healthcare givers, drug resistance

International Journal of Natural and Applied Sciences, 5(4): 344-350, 2009