Abstract
The ravaging consequences of Malaria in Sub-Saharan Africa (SSA) have been a subject of serious concern to every stakeholder. Literature and anecdotal evidence shows that around 60% of Nigerians seek fever treatment from Patent Medicine Vendors (PMVs) despite the limited formal dispensing knowledge most possess. This study attempts to establish a base line of knowledge, attitude and practices of Malaria control among PMVs in Gombe Metropolis, North Eastern Nigeria. The study was a descriptive cross sectional survey based on structured questionnaires used to collect relevant information from 109 PMVs selected by purposive sampling technique. The result show that 85.3% of the participants in this study correctly identified fever or high body temperature as the common sign of uncomplicated (UC) Malaria, while 70.6% recognized convulsion as one of the main symptoms of severe Malaria. Furthermore, 86.2% of the PMVs also knew that sleeping inside treated nets constitute one of the best ways to prevent Malaria. In the same vein, awareness of change in Malaria treatment policy from monotherapy to Artemisinin based combination therapy (ACT) was high (73.3%) among them. However, those PMVs that had ever undergone some degree of drug dispensing training exhibited a significantly higher level of awareness of change in malaria treatment policy (X2 =17.903, P = 0.000). Although 85.3% of PMVs frequently recommend Arthemeter Lumefantrine (AL) as treatment of uncomplicated Malaria, only 39.4% of the participants would refer severe malaria cases. Even though most Malaria control awareness and practice variables were found to be fairly good among the participants, it is clear from the study that there is the need for enhanced training, monitoring and supervision by the relevant authorities so as to fully harness the vast potential in PMVs.
Highlights
According to the WHO world Malaria report, an estimated 212 million cases of malaria occur worldwide and 90% malaria cases were in the WHO African Region, with 29% being contributed by Nigeria alone [1]
The data analyzed show that the participants mean age was 30.41±9.26 years and 88% of the participants age lie between 17 and 40 depicting an active population engaged in the vending trade within the study area
What is still considered worrisome is 29.40% of the Patent Medicine Vendors (PMVs) who took part in this study affirmed dispensing monotherapies as malaria treatment which leaves gap that still needs to be filled by continuous targeted behavior change communication (BCC) activities. This re-echoes the call for improvement in performance of PMVs through training especially in Sub-saharan Africa and other LMICs countries [3,30,32,33,34] and our findings show that only 39.40% of the PMVs in the study area indicated their willingness to always refer clients with symptoms of severe malaria to health facilities for further prognosis cum treatment
Summary
According to the WHO world Malaria report, an estimated 212 million cases of malaria occur worldwide and 90% malaria cases were in the WHO African Region, with 29% being contributed by Nigeria alone [1]. The apprehension on the use of this medium is around the lack of existing veritable machinery for effective monitoring and quality assurance, and lack of capacity for service delivery considering the fact that the licensing requirement for PMVs has no minimum academic benchmark [15] This is against the back drop of preponderant cases of fake drugs dispensation by Patent Medicine Shops, lack of adherence to the Pharmaceutical Council of Nigeria stipulated rules of practice for PMVs, rampant cases of inappropriate dispensing and irrational use or dosing of drugs sold by PMVs [2, 16, 17, 18]. The National Agency for Food and Drugs Administration and Control (NAFDAC) is charged with testing, approval, registration as well as inspection of drug manufacturing premises and regulations of advertisement of pharmaceutical in country [2, 17,20]
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