Perception of the efficacy of artemisinin-based combination therapy (ACT) and chloroquine prescription pattern and among nurses in South-West Nigeria

Abstract

Background-Malaria remains a threat to millions of children despite the recent advances recorded in the fight against the disease which remain the 3 rd largest killer of children below the age of 5 years in endemic regions. Drug resistant plasmodium species continues to limit the fight against malaria, while the spread of fake and substandard antimalarial drugs has been recognized as a major problem across Africa because of its association with drug resistant parasite. We aim to find out the prescription pattern of chloroquine among nurses in South-West Nigeria and perception of artemisinin-based combination therapy (ACT). Design and methods-About 180 pre-tested questionnaires were administered to randomly selected nurses out of which 155 were sufficiently completed and suitable for analysis. Results-Majority (56.1%) still have confidence in the efficacy of CQ which was still being prescribed by 45.2% of the respondents. CQ was mostly prescribed by those who had previous ACT treatment failure experience (54.3%) with their patients, P=0.03; as well as those who believe that ACT resistance malaria is now in circulation (44.3%). Fifty (32.3%) of our respondents claimed that they had come across fake and substandard ACT, from which 40.0% now prescribe CQ. Discussion-The high rate of CQ prescription in this study showed that many of the health workers were still resistant to the change in antimalarial treatment policy, which is related to unsatisfactory experience with ACT. Additional measures are urgently required to verify this experience so as to win the confidence of healthcare workers away from chloroquine. Keywords: Artemisinin-based combination therapy (ACT), chloroquine, substandard antimalarial