PHYSICIANS' COMPLIANCE WITH ANTI-MALARIAL TREATMENT GUIDELINES AMONG UNDER FIVE CHILDREN ATTENDING SECONDARY HEALTH FACILITIES IN SOKOTO METROPOLIS
DOI:
https://doi.org/10.47672/ejhs.802Keywords:
Physicians; Compliance; Anti-malarial; Treatment Guideline; Under five years: SokotoAbstract
Introduction: Rational use of drugs against most common and life"‘threatening tropical diseases such as malaria remains a huge challenge, particularly in sub-Saharan African region. The correct use of antimalarial drugs is the key not only to therapeutic success but also to deterring the spread of drug resistance malaria.
Aims: To assess the physicians' compliance with the national anti'-malaria treatment guidelines among Under five (U-5) years children in secondary health facilities in Sokoto metropolis.
Methods: This was a cross-sectional study conducted as an exit interview among 292 mothers/caregivers of febrile U-5 children with antimalarial prescription, that presented to the out-patient clinics of the selected secondary health facilities in Sokoto metropolis. Simple random sampling technique using balloting option was used to select 2 secondary Health facilities in the metropolis, Proportionate allocation was done to allocate study subjects to the selected Health facilities based on average weekly outpatient attendance. The data was collected using an interviewer-administered questionnaire. Descriptive statistics was used to analysed data using IBM SPSS version 22.
Results: Of the 292 children, only 115(39.4%) had malaria parasite test requested by the physician, out of which 63(54.8) had microscopy, while 52(45.2) of the children had malaria Rapid Diagnostic Test (mRDT). One hundred and eighty-five (65.1%) of the children were treated presumptively with anti-malarial drugs. Artemisinin based Combination Therapy (ACT) was prescribed in 221(77.8%) of the under-fives. The commonest prescribed ACT was Artemether-Lumefantrine in 113(77.4%) of the children. Majority 263(92.6%) of the prescriptions were in brand names.
Recommendation: The physicians' compliance with national malaria treatment guidelines using the proportion of U-5 children was suboptimal. There was over prescription of anti-malarial drugs, as majority of the patients treated for malaria had no laboratory evidence for the treatment. However, compliance with the use of ACT was good. This study shows also suboptimal compliance with WHO prescribing indicators with respect to prescription in generic names. Regular training of the health care providers by the government is recommended to improve adherence to antimalarial treatment guideline.
Downloads
References
Ango UM, Oche MO, Kaoje AU, Bello MM, Umar MT, Adamu A., Kalgo YF, Basakkwace SA, Musa A. Pattern of Prescription of Anti-Malarial Drugs in the Primary Health Care Facilities in Sokoto State, Nigeria. IJTDH 2021;42(2):30-38
Yaya S, Ekholuenetale M, Tudeme G. et al. Prevalence and determinants of childhood mortality in Nigeria. BMC Public Health 17, 485 (2017). https://doi.org/10.1186/s12889-017-4420-7
World Health Organisation: Guidelines for treatment of malaria, April 2015. Third edition. Available at: http://apps.who. int/iris/bitstream/handle/10665/162441/978 9241549127eng.pdf?sequence
Jiya NM, Sani UM, Jiya FB, Ameh B. Prevalence of uncomplicated malaria in a paediatric outpatient department of a Tertiary Health Institution in Sokoto, Nigeria. Afr J Online 2010;13(1)
Nakakana UN, Mohammed IA, Onankpa BO, Jega MR and Jiya NM. A validation of the Malaria Atlas Projectmaps and development of a new map of malaria transmission in Sokoto, Nigeria:a cross"‘sectional study using geographic information systems. Malar 2020;19:40:112.
Arute JE, Ojieabu WA, Patani-Okelosi E, Iwor P. Prescribing trends of anti-malarial drugs in a Primary Health Care facility in Delta State. World j pharm Res 2016; 5(5):1411-1419
WHO, Malaria 2020 accessed at https://www.who.int/news-room/fact-sheets/detail/malaria.
Federal Ministry of Health, Abuja, Nigeria. Progress toward the Implementation of National Malaria. Strategic Plan, 2014-2020 ;2019
World Health Organisation: Guidelines for treatment of malaria, April 2015. Third edition. Available at: http://apps.who. int/iris/bitstream/handle/10665/162441/978 9241549127eng.pdf?sequence
Mady O, David TK, Skou S, Toussaint R, Philippe D, Fati KS. Malaria Case Fatality Rate among Children under Five in Burkina Faso: An Assessment of the of Spatiotemporal Trends Following the Implementation Control Programs. Int. J. Environ. Res. Public Health 2020; 17:1840: doi:10.3390/ijerph17061840 www.mdpi.com/journal/ijerph
. Maryah PS, Denue BA, Ikunaiye NY, Aderemi-Williams RI, Akawu CB. Evaluation of antimalarial drugs usage according to WHO prescribing indicators in a tertiary health facility in Maiduguri, North-eastern Nigeria. Port Harcourt Med J 2017; 11:67-7
Otokpa E, Ogunyemi AO, Ladi- Akinyemi TW, Onajole AT. Physicians compliance with malaria treatment guidelines of under five children in a secondary maternal and child care centre in Lagos State. J Com Med and Pri Health Care. 2019;31(1):40-47.
Chukwuocha UM, Brown A. Malaria treatment in children based on presumptive diagnosis: A make or mar? Pead Infectious Disease 2016; 1: 6. doi: 10.21767/2573-0282.100006
Oboli HO, Harrison-Church RJ. A new outline geography of West Africa. London: George G. Harrp and Co. Ltd. 1978;15:73-74.
UNFPA. Healthcare services in: UNFPA Assisted States of Nigeria, Sokoto state report. Abuja Nigeria: UNFPA Nigeria Country Office A; 2010.
National Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and Health Survey, Abuja, Nigeria and Rockville, Maryland, USA: NPC and ICF; 2018.2
Araoye M. Sample size determination in Research methodology with statistics for Health and Social Sciences. Ilorin: Nathadex publishers; 2004.
Igboeli U, Ukwe V, Ekwunife I. Increasing use of Artemisinin-based combination therapy for treatment o malaria infection in Nigerian hospitals. Pharmacy Practice. 2010; 8: 243-249.
Monday T, Ojo O, Emmanuel T, Idowu EO. Iyede OO, Taiwo SA, Antimalarial medicine preference and usage in rural and periurban communities in Lagos and Osun states in southwestern Nigeria. Malaria World Journal 2017;8(1).
Etuk E U, Egua M A, Muhammad AA. Prescription pattern of antimalarial drugs in children below 5 years in a tertiary health institution in Nigeria. Ann Afr Med 2015;7:24-28
Valentine OO, Adegoke AP, Gloria Nkpubre. Review of two-year prescription patterns of antimalarial drug regimen at NIPRD Health Center, Abuja. West Afr J Pharmacy 2014;25(1):86-9
Builders MI, Degge H, Peter JY, Ogbole E.Prescription pattern of antimalarial drugs in a teaching hospital in Nigeria. British Biomed Bulletin 2014;2(1):267-27
Nsengi YN, Christian B, Didier BN, Aline BE, Yves NL, Samuel MM, Clestin NN, Gauthier KM, Jean"‘Marie NK, Joris LL, Leon MK, Gaston LT. Drug use in the management of uncomplicated malaria in public health facilities in the Democratic Republic of the Congo. Malar J 2018; 17:189.
Goodman CA, Coleman PG, Mills A. Economic Analysis of Malaria Control in sub"‘Saharan Africa. Geneva: World Health Organization, Global Forum for Health Research, 2000.
Meremikwu M, Okomo U, Nwachukwu C, Oyo"‘Ita A, Eke"‘Njoku J, Okebe J, et al. Antimalarial drug prescribing practice in private and public health facilities in South-east Nigeria: a descriptive study. Malar J 2007; 6:55 https://doi.org/10.1186/1475-2875-6-55
Obiebi IP. Adherence to antimalarial drug policy among doctors in Delta State, Nigeria: implications for malaria control. Ghana Med J. 2019 Jun;53(2):109-116.
Koley M, Saha S, Arya S, Choubey G, Ghosh S, Purkait R et al. A study on drug utilization and prescription habits of physicians in a government homeopathic hospital in west Bengal. India Journal of Integrative Medicine. 2013; 11: 305-313.
Alyamani A, Hopf Y, Williams J. Prescription quality in an acute medical ward. Pharmaco-epidemiology Drug Safety 2009; 18: 1158-1165.
Fattouh R, Abu Hamad B. Impact of using essential drug list: Analysis of drug use indicators in Gaza Strip. East Mediterr Health J 2010; 16:886"‘92.
Bahrain Naseeb TA, Nasser MA. Drug prescribing indicators in primary health care centers in Bahrain. Saudi Med J 2005; 26:1436"‘8.
Afriyie DK, Amponsah SK, Antwi R, Nyoagbe SY, Bugyei KA. Prescribing trend of antimalarial drugs at the Ghana Police Hospital. J Infect Dev Countries 2015; 9:409"‘15.
El Mahalli AA. WHO/INRUD drug prescribing indicators at primary Health care centres in Eastern province, Saudi Arabia. East Mediterr Health J 2012; 18:1091"‘6.
Downloads
Published
How to Cite
Issue
Section
License
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
