Abstract

BackgroundIn Nigeria, Artemisinin-based Combination Therapy (ACT) is the recommended first line antimalarial medicine for uncomplicated malaria. However, health care providers still continue the use of less efficacious medicines such as Sulphadoxine-pyrimethamine and chloroquine. We therefore determined preference for ACT (PFA) and factors associated with PFA among healthcare providers (HCP) in Lokoja, North-Central Nigeria as well as assessed healthcare providers’ knowledge of malaria case management.MethodsWe conducted a cross-sectional study among physicians, nurses, pharmacists, community health officers (CHOs), community health extension workers (CHEWs) and, patent and proprietary medicine vendors (PPMVs). Interviewer-administered questionnaires were administered to collect data on respondents’ characteristics, previously received malaria case management training and knowledge of malaria treatment. Knowledge scores ≥3 were categorised as good, maximum obtainable being 5.ResultsOf the 404 respondents, 214 (53.0%) were males. Overall, 219 (54.2%) respondents who received malaria case management training included PPMVs: 79 (65.8%), CHEWs: 25 (64.1%), CHOs: 5 (55.6%), nurses: 72 (48.7%), physicians: 35 (47.3%) and pharmacists: 3 (23.1%). Overall, 202 (50.0%) providers including physicians: 69 (93.2%), CHO: 8 (88.9%), CHEWs: 33 (84.6%), pharmacists: 8 (61.5%), nurses: 64 (43.2%) and PPMVs: 20 (16.5%), had good knowledge of malaria treatment guidelines. Overall, preference for ACT among healthcare providers was 39.6%. Physicians: 50 (67.6%), pharmacists: 7 (59.3%) CHOs: 5 (55.6%), CHEWS: 16 (41.0%), nurses: 56 (37.8%) and PPMV: 24 (19.8%) had PFA. Receiving malaria case management training (adjusted odds ratio [aOR]) = 2.3; CI = 1.4 – 3.7) and having good knowledge of malaria treatment (aOR = 4.0; CI = 2.4 – 6.7) were associated with PFA.ConclusionsOverall preference for ACT use was low among health care providers in this study. Preference for ACTs and proportion of health workers with good knowledge of malaria case management were even lower among PPMVs who had highest proportion of those who received malaria case management training. We recommend evaluation of current training quality, enhanced targeted training, follow-up supportive supervision of PPMVs and behavior change communication on ACT use.

Highlights

  • In Africa, Artemisinin-based combination therapy remains the medicine of first choice for malaria treatment in most endemic countries

  • The purpose of this study was to determine preference for Artemisinin-based Combination Therapy (ACT) (PFA) and factors associated with PFA among healthcare providers (HCP) in Lokoja, NorthCentral Nigeria, as well as assessed healthcare providers’ knowledge of malaria treatment guideline (MTG)

  • In primary healthcare centers (PHCs), malaria is treated by community health extension workers (CHEWs) and community health officers (CHOs), while physicians do same in secondary

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Summary

Introduction

We determined preference for ACT (PFA) and factors associated with PFA among healthcare providers (HCP) in Lokoja, North-Central Nigeria as well as assessed healthcare providers’ knowledge of malaria case management. In 2005, Nigeria adopted ACT for malaria treatment Despite this adoption ineffective medicines such as Sulphadoxine-pyrimethamine and chloroquine are still used to treat malaria. Preference for ACT among healthcare providers is influenced by price and availability of the medicine [6], health facility type [7] and knowledge of recommended antimalarial medicines [8]. The purpose of this study was to determine preference for ACT (PFA) and factors associated with PFA among healthcare providers (HCP) in Lokoja, NorthCentral Nigeria, as well as assessed healthcare providers’ knowledge of malaria treatment guideline (MTG)

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