Prescribing practices for malaria in a rural Ugandan hospital: evaluation of a new malaria treatment policy

Nj Kalyango,Ps Ucakacon,P Kutyabam,Ar Odoi,J Achan

doi:10.4314/ahs.v11i3.70071

Abstract

Increasing resistance to first line antimalarial drugs led to a change in the antimalarial policy of Uganda in 2005. Successful implementation of this policy depends on changing prescribing patterns of health workers. To describe prescribing patterns for malaria and associated factors in a rural Ugandan hospital following a change in antimalarial treatment policy from chloroquine plus sulphadoxine-pyrimethamine to artemisinin-based combination therapies. From the outpatients register, 715 prescriptions for malaria were reviewed. Data was collected on patient demographics, prescriber factors and prescription patterns. Prescriptions were considered to conform to the new antimalarial policy if artemether-lumefantrine was prescribed for uncomplicated malaria or quinine for treatment failure or complicated malaria. The most frequently prescribed antimalarials for uncomplicated and complicated malaria were artemetherlumefantrine (n=564, 88.5%) and quinine (n=66, 84.6%) respectively. The proportion of prescriptions conforming to the new antimalarial treatment policy was 88.1% (n=630). Predictors of conformity were: duration in service of less than 6 years (OR=3.40. CI=1.24-9.33), prescriber's profession (OR=97.51, CI=27.29-348.34) and diagnosis of uncomplicated malaria (OR=10.13, CI=3.37-30.42). Adequate training and provision of information relevant to the needs of different cadres of health workers is needed to promote effective uptake of new treatment policies.

Highlights

Malaria remains an important public health concern, especially in tropical countries where almost all the infections occur
The results show that most prescribers were conforming to the new antimalarial treatment policy, a considerable number has not adapted to the change (11.9%)
The findings from this study indicate that the majority of health workers conformed to the antimalarial treatment policy, a few of the prescriptions were contrary to the new treatment guidelines

Summary

Introduction

Malaria remains an important public health concern, especially in tropical countries where almost all the infections occur It is an important cause of death and illness in children and adults in tropical countries[1]. Increasing resistance to first line antimalarial drugs led to a change in the antimalarial policy of Uganda in 2005. Successful implementation of this policy depends on changing prescribing patterns of health workers. Prescriptions were considered to conform to the new antimalarial policy if artemether-lumefantrine was prescribed for uncomplicated malaria or quinine for treatment failure or complicated malaria. The proportion of prescriptions conforming to the new antimalarial treatment policy was 88.1% (n=630).

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Methods

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Discussion

Conclusion