Acceptance of ACTs by patients in private healthcare facilities in Surulere, Lagos state

Abstract

Chloroquine has remained the first line in the management of malaria for over five decades. The avalanche of published research works and books on Chloroquine attests to its success and usefulness. Although, Chloroquine and Sulfadoxine / Pyrimethamine are readily available and inexpensive, P. falciparum parasites are resistant to these therapies in most parts of the tropics necessitating a switch in the antimalaria policy to Artemisinin-based combination therapies (ACTs). However, studies hitherto conducted revealed that the ACTs were not yet accepted by patients suffering from malaria and justified the position of the researchers to determine if the situation had changed. 15 health facilities including private clinics and community pharmacies were used as target locations. Pretested questionnaires were administered on 30 randomly selected patients (2 per facility). A recovery rate of 100% was recorded. Most of the respondents were female. Majority of them were aged between 20-24 years. Most of the respondents could accurately interpret ACTs and many of them knew the ACT drugs in addition to other antimalaria drugs such as chloroquine and sulphadoxine plus pyrimethamine. Many of the respondents have used ACTs before. Though a definite preference for sulphadoxine plus pyrimethamine is still observed, majority of the respondents chose ACTs as their second line. Very few of the respondents indicated using chloroquine for their last malaria episode. From the results, the level of acceptance of ACTs and other Artemisinin products is high (50%) probably because more information is available on ACTs to both healthcare personnel and patients through mass media like television, radio, newspapers. It can be concluded that there is better acceptance of Artemisinin products (26.67% for ACTs, 23.33% for Artemisinin monotherapy) by patients though results still show a relative preference for sulphadoxine plus pyrimethamine (40%) probably because of the ease of the use (single dose administration) and cost. Information on adherence to therapy with ACTs must be sustained to prevent rapid emergence of resistance species to ACTs.