Treatment of uncomplicated malaria at public health facilities and medicine retailers in south-eastern Nigeria

Malaria Journal

Research

Virginia Wiseman¹  Lindsay J Mangham¹  Bonnie Cundill²  Ogochukwu Ezeoke³  Emmanuel Nwala³  Benjamin SC Uzochukwu⁴  Obinna Onwujekwe⁵ 

[1] Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria (Enugu Campus), Enugu, Nigeria;Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria (Enugu Campus), Enugu, Nigeria;Department of Community Medicine, College of Medicine, University of Nigeria (Enugu Campus), Enugu, Nigeria;Department of Health Administration and Management, College of Medicine, University of Nigeria (Enugu Campus), Enugu, Nigeria;Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria (Enugu Campus), Enugu, Nigeria;Department of Health Administration and Management, College of Medicine, University of Nigeria (Enugu Campus), Enugu, Nigeria;

关键词: Malaria;    Health Facility;    Health Worker;    Malaria Treatment;    Public Facility;   

DOI  :  10.1186/1475-2875-10-155

 received in 2011-02-21, accepted in 2011-06-08,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAt primary care facilities in Nigeria, national treatment guidelines state that malaria should be symptomatically diagnosed and treated with artemisinin-based combination therapy (ACT). Evidence from households and health care providers indicates that many patients do not receive the recommended treatment. This study sought to determine the extent of the problem by collecting data as patients and caregivers leave health facilities, and determine what influences the treatment received.MethodsA cross-sectional cluster survey of 2,039 respondents exiting public health centres, pharmacies and patent medicine dealers was undertaken in urban and rural settings in Enugu State, south-eastern Nigeria.ResultsAlthough 79% of febrile patients received an anti-malarial, only 23% received an ACT. Many patients (38%) received sulphadoxine-pyrimethamine (SP). A further 13% of patients received an artemisinin-derivative as a monotherapy. An estimated 66% of ACT dispensed was in the correct dose. The odds of a patient receiving an ACT was highly associated with consumer demand (OR: 55.5, p < 0.001).ConclusionFew febrile patients attending public health facilities, pharmacies and patent medicine dealers received an ACT, and the use of artemisinin-monotherapy and less effective anti-malarials is concerning. The results emphasize the importance of addressing both demand and supply-side influences on malaria treatment and the need for interventions that target consumer preferences as well as seek to improve health service provision.

【 授权许可】

CC BY   
© Mangham et al; licensee BioMed Central Ltd. 2011