Antimalarial drug prescribing practice in private and public health facilities in South-east Nigeria: a descriptive study

Abstract

Background: Nigeria's national standard has recently moved to artemisinin combination treatments for malaria. As clinicians in the private sector are responsible for attending a large proportion of the population ill with malaria, this study compared prescribing in the private and public sector in one State in Nigeria prior to promoting ACTs.w:\fmbatch_out

Prescribing practices for pediatric out-patients: A case study of two teaching hospitals in Nigeria

“…The high use of antimalarial agents found in the study is most likely due to the fact that children living in malaria endemic areas like Nigeria are vulnerable to frequent bouts of malaria attacks. WHO recommends that in promoting rational use of drugs, prescription of drugs should be in their international nonproprietary names [25]. The use of generic names results in low treatment cost and prevents errors and confusion in writing and dispensing prescriptions [26].…”

pfmdr1 Amplification Associated with Clinical Resistance to Mefloquine in West Africa: Implications for Efficacy of Artemisinin Combination Therapies

“…Furthermore, lumefantrine, widely prescribed in Africa with artemether, is well known to also select the pfmdr1 genotype leading to a lesser susceptibility to aryl amino alcohols (7,22). Added to this, the prevalence of pfmdr1 amplification may be increased by some combined formulations, such as MQ plus artesunate and MQ plus sulfadoxinepyrimethamine, used in several African countries although not supported by official health policies (14,20). The global switch from CQ to aryl amino alcohol-based ACTs would be a critical conjunction for the emergence of clones with drug resistance related to the pfmdr1 genotype.…”

Plasmodium falciparum Isolates with Increased pfmdr1 Copy Number Circulate in West Africa

“…Moreover, in addition to fake formulations, many drugs are used without the authorization of the Ministries of Public Health. In Africa, against WHO recommendations, artesunate and MQ are used in monotherapy and MQ-SP are already being used (9). A misuse of these antimalarial drugs could lead to a rapid increase in the prevalence of strains with amplified pfmdr1, since the transmission level of malaria in Africa is the highest of all areas where malaria is endemic.…”