A Household Survey of Source, Availability, and use of Antimalarials in a Rural Area of Tanzania

Abstract

The source, availability, and use of antimalarial drugs in a rural community in the Kibaha district of Tanzania were assessed. Using questionnaires, the heads of households and mothers/guardians of children under five years of age in 1000 randomly selected households were interviewed, and an inventory of antimalarials at all drug stores and shops in the area was carried out. The majority of the drugs stocked by both households and mothers/guardians were antimalarials, exclusively chloroquine. Only 20.1% of the mothers/guardians knew the correct pediatric dose regimen of the chloroquine syrup which they stocked the most. In contrast, 70.4% of the mothers/guardians stated the correct adult dose of chloroquine tablets. They had significantly (p < 0.025) higher mean ages than those who stated the dose incorrectly. Similarly, 78.6% of heads of households stated the correct adult dose of chloroquine tablets, and those with more education had better knowledge of dose regimens (p < 0.001). Drug stores were the main sources of malaria treatment for both the heads of households (72.2%) and the mothers/guardians (89.4%). Lack of drugs at public health facilities, as stated by more than 85.6% of the mothers /guardians, is a possible reason for this. Only four of the drug store sellers had professional training. Most malaria treatment in children occurs in the home and, thus, poor knowledge of pediatric chloroquine regimen by the mothers/guardians is of great concern. A simplified dose regimen, particularly the pediatric formulation for mothers/ guardians with limited education, should be developed. As these caregivers interact with the public and private health facilities, the quality of malaria management, including instructions given to them, needs to be assessed.