Prescribers' adherence to world health organisation antimalarial treatment guideline in a University Medical Centre in Lagos, Nigeria: An intervention study

Abstract

Background: In Nigeria, presumptive treatment had been the norm. In 2010, WHO guideline advocated use of artemether based combination therapy and positive parasitological test.
Objective: Evaluation of prescribers' adherence to WHO malaria treatment guideline and standard prescribing indicators.
Methods: All prescriptions and laboratory records of malaria parasitological tests within the three months pre- and three months post-intervention study period were used. Face-to-face and provision of educational information leaflets intervention was done for the
prescribers. Data was analysed using Statistical Package for Social Sciences Systems (SPSS) software version 20.0. Chi square statistical analysis test employed to determine the effect of intervention at p≤0.05 level of significance.
Results: Most (81.7%) patients were adult. Most prescribed antimalarial pre- and post- intervention were Artemether + lumefantrin (71.6% and 59.0%). Only 24.1% and 32.6% patients underwent parasitological testing for malaria pre- and postintervention respectively. Prescriptions contained average of 3.83±1.28 drugs/prescription, 22.84% antibiotics, 1.76% generic prescription and 7.2% injections.
Conclusion: More effective educational interventions for prescribers to stop presumptive treatment of malaria needs to be developed.

Keywords: Malaria, presumptive treatment, parasitological test, adherence, ACT.