Abstract
Patent medicine vendors (PMVs) are the most common source of antimalarial drugs and treatment for majority of Nigerians. The quality of their practice could have implications for malaria control. This study sought to explore the factors influencing the malaria treatment practices of PMVs for under-five children in Akwa Ibom State. A cross-sectional survey using an interviewer-administered questionnaire was conducted among 176 PMVs selected by simple random sampling from two local government areas (LGAs). In addition, four focus group discussions (FGD) were conducted to generate qualitative data. Quantitative data was analysed using SPSS version 20 while content analysis was done on the qualitative data. Artemisinin Combination Therapy (ACT) was the most frequently recommended antimalarial treatment by PMVs (75.6%) for children as against chloroquine (17%) and Sulphadoxine/Pyrimethamine (2.8%). However, only 39.2% of PMVs recommended the appropriate antimalarial treatment (ACTs at the right dose for age), while 71% recommended referral for severe malaria.Factors found to be associated with appropriate management of malaria from quantitative analysis included Educational qualification, attending malaria training and their knowledge of malaria. The FGDs showed that severity of child's illness, parents/caregivers drug request and perceived ability of the parents/caregiver to afford the drugs influenced PMVs malaria treatment practices. Knowledge of malaria, severity of child's illness and parents' drug request influenced the treatment practices of PMVs. Training PMVs on appropriate malaria management and community health education/sensitization to leverage on the influence of client-demand on ACT use is recommended to improve PMVs treatment practice. This study was conducted using mainly personal funds of the lead author with some support from the University of Uyo Teaching Hospital.
Highlights
Malaria remains a major public health problem worldwide, being responsible for an estimated 216 million cases of illness and 445,000 deaths in 2016, of which more than 80% were in the African region.[1]
This study explores the malaria treatment practices of Patent medicine vendors (PMVs) for under-five children based on the National policy on malaria diagnosis and treatment and identifies factors influencing these practices among PMVs in Akwa Ibom State
The antimalarial drug stocking pattern showed that Artemisinine-based Combination Therapy (ACT) was stocked by almost all the respondents. These findings generally suggest a positive uptake of the change in antimalarial treatment policy after almost a decade of change in policy from the use of Chloroquine to ACT by the Nigerian Government.[5]
Summary
Malaria remains a major public health problem worldwide, being responsible for an estimated 216 million cases of illness and 445,000 deaths in 2016, of which more than 80% were in the African region.[1] Majority of global malaria deaths occurred in children under five years of age.[1] In Nigeria, malaria accounts for 60% of outpatients visits and 30% of hospitalizations among under-five children. Malaria is one of the commonest causes of childhood mortality in the country and Nigeria along with 2 other countries (Congo DR and India) account for 40% of the global malaria deaths.[2] Prompt access to early diagnosis and effective antimalarial treatment have been identified as major strategies for reducing the morbidity and mortality attributable to malaria especially in children under-five years.[3]. Artemisinine-based Combination Therapy was adopted in 2005 in Nigeria as the recommended treatment for uncomplicated malaria in line with the position of WHO and following country-wide drug efficacy trials in 2002 and 2004 which showed chloroquine and sulphadoxine-pyrimethamine resistance by malaria parasites.[5] www.ghanamedj.org Volume 53 Number 3 September 2019
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