The Impact Of Community-Directed Administration Of Various Formulations Of Pre-Packaged Chloroquine In Umuahia South Local Government Area Of Abia State Nigeria

Abstract

The high patronage of Patent Medicine Vendors (PMV's) to the detriment of Primary Health Centres (PHCs), the uncontrollable habit of home treatment and self-medication by rural dwellers, have necessitated the need to improve on the knowledge and awareness of malaria exhibited by these target groups. A community-directed intervention programme to effect prompt and adequate treatment of presumptive episodes of clinical malaria in a rural community (Ubakala, population 15,600) in Ummuahia South Local Government Area (L.G.A.) of Abia State, Nigeria has therefore been studied. The instruments of implementation were based on (a) training the rural dwellers, 3 Community Malaria Committees (CMC's) and the Patent Medicines Vendors (PMVs) in the community and (b) supplying the CMCs and PMVs with the essential antimalarial drug, chloroquine (CQ) packaged in various age-specific plastic bottles, compartmentalized polythene bags and blister packs. Of the 3,000 pre-packs delivered in 4 instalments from January to November 1998, 2503 were sold under a subsidized cost-recovery scheme. The progress of 510 patients was followed up 4 days after treatment and 250 mothers/carers of children under 6 years in each of the test and control (Olokoro, population: 11,800) communities were interviewed in-depth. Results showed a significant increase (P<0.001) in knowledge, awareness drug consumption (without misuse) and compliance amongst PMVs and rural dwellers in the test compared with the control community. Analysis of cases of malaria which were recorded as "severe" by the PHCs highlighted a reduction in the test community. These results showed that the strategy is feasible and sustainable and could lead to continued reduction of malaria-specific morbidity and mortality in the community. The protocol could also be extended to other communities in Nigeria.

Nigerian Quarterly Journal of Hospital Medicine Vol. 9, No. 2 (June 1999) pp. 146-152