Effect of policy change on the prescription pattern of antimalarial drugs of doctors in Benin City

Abstract

This study evaluates the prescriptions of antimalarial medicines before and after the change in the National Antimalarial Policy and ascertain the adherence of prescribers to the change in policy. It's a Retrospective and Descriptive study. The study was carried out in the out-patient department of the University of Benin Teaching Hospital and Central Hospital, both in Benin City, Nigeria. The study examined case records of adult patients (≥ 18yrs) treated for uncomplicated malaria. One in every ten Case cards was sorted via Systematic Sampling.

Results showed that prior to the policy change, Artesunate monotherapy was the most prescribed antimalarial(37.3%), followed by Sulphadoxine Pyrimethamine(SP) and Chloroquine(CQ) monotherapies,19.8% and 19.0% respectively. However three years into the change in policy, Artemether/Lumefantrine (AL) was the most prescribed, recording 25.2% as against 0.8% a year prior to the change in policy (2004).This was followed by Artesunate/Amodiaquine (AA) and Artesunate/Mefloquine (AM), 24.3% and 23.6% respectively. Artemisinin monotherapies and non-ACT combinations made up 10.3% and 5.1% of prescribed antimalarials in 2008 respectively. This study showed good adherence of prescribers to the change in antimalarial policy. This is encouraging, however there is need for stiffer regulations regarding Artemisinin monotherapies if success in malaria control must be achieved and the development of resistance prevented.

Keywords: National Antimalarial Policy, Artemisinin-based Combination therapy, Plasmodium falciparum