Geographic inequities in provision and utilization of malaria treatment services in southeast Nigeria: Diagnosis, providers and drugs

Onwujekwe, Obinna; Hanson, Kara; Uzochukwu, Benjamin; Ezeoke, Ogochukwu P; Eze, Soludo; Dike, Nkem

doi:10.1016/j.healthpol.2009.09.010

Cited by 24 publications

(28 citation statements)

References 15 publications

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“…There was higher proportion of self-diagnosis in rural than in urban areas for both adults and children. Rural self-diagnosis (Adult=89.7%; children=85.9%), Urban selfdiagnosis (Adult=83.3%; Children 79.2%) [16].…”

Section: Expected Outcome Unexpected Outcome Studiesmentioning

confidence: 99%

“…At the end of the assessment and appraisal exercise, seventeen (17) studies [14][15][16][17][18][19][20][21][23][24][25][26][27][28][29][30][31] that were of good quality based on the PCAqs assessment were included in this systematic review.…”

Section: Appraisalmentioning

confidence: 99%

“…Ability to read was associated with ACT adherence [20] [ 20,21] However, ability to read was statistically significant to number of antimalarial tablets left (p=0.049) [21] Adherence in urban and rural 96% of rural dwellers would not administer appropriate dosages [17] 65% of urbanites would use incomplete dose. Only 35% would administer correctly [17] [ 16,17,2 7] The consumption of ACTS was more in the urban areas for both adults (P value=0.001) and children (P value=0.005) [16].…”

Section: Expected Outcome Unexpected Outcome Studiesmentioning

confidence: 99%

“…Urbanites are more likely to have blood test malaria diagnosis than rural dwellers [16] Adherence and source of drugs P=0.005 those who source from pharmacy/chemists and government institutions were more likely to take correct dose than those from street vendors, private clinics, family/friends [16] [ 16] Citation 25% of poorest SES will use home treatment first [14] 14% of wealthiest SES will use home treatment first [14] 61.6% took antimalarial drugs without prescription [23] Self-diagnosis was slightly higher in rural adults and children (A=89.7%; 85.9%) than in urban adults and children (A=83.3%; C=79.2%) [26] Those in the poorer SES groups were however more likely to have previously sought treatment for their current illness prior to seeking treatment at the study facilities (p=0.002). Of these, 62.7% used the patent medicine dealers [30] Self-diagnosis was the most common diagnostic method in both rural and urban for adult and child diagnosis [16] Reasons for selfmedication 39.0% said less expensive than consultation; 10% said health institution was far away; 12.5% said neighbour/friend/relative previously took the same drug [23] [15,23] For those who had no prescription, the reasons given were as follows: 39.0% said procedure of acquisition (without prescription) was less costly; 23.0% took same drug for similar symptoms; 10% said health institution was far from their location; 12.5% said neighbour/friend/relative previously took the same drug [15].…”

Section: Expected Outcome Unexpected Outcome Studiesmentioning

confidence: 99%

“…Socioeconomic factors like income level can be key determining factor in treatment seeking and drug use behaviours of individuals and households. Relative to the level of poverty in malaria endemic countries, the high cost of antimalarial drugs -like the ACTs class of drugs -leads to drug use behaviours such as not using the recommended class of drugs [12], use of monotherapies, nonadherence to treatment regimen [13], presumptive and self-treatment [14][15][16] amongst others.…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Determinants of Antimalarial Drug Use Behaviours: A Systematic Review

Anyanwu¹,

Fulton²

2016

J Comm Pub Health Nursing

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Introduction: Malaria has been a major global health issue for centuries. Presently, the Artemisinin-based combination therapy (ACTs) is the most effective antimalarial drug and the recommended first line treatment by the WHO for uncomplicated malaria cases. Despite the current global reduction in malaria mortality and morbidity, the burden of malaria is still very significant, especially considering the economic, social, political and public health effects to endemic countries. A major threat to sustaining the reduction in malaria burden is the development and spread of resistance to antimalarial drugs by the Plasmodium parasites (mostly P. falciparum and P. vivax). Socioeconomic factors have been identified to affect antimalarial drug use behaviours. Nevertheless, the contributions of socioeconomic factors to antimalarial drug use behaviours have only been sparsely reported in studies; with most of the studies not primarily designed to identify or assess the association of these variables. In addition there is no existing systematic review of studies on the socioeconomic determinants of antimalarial drug use. Therefore, there is an important need for a systematic review to integrate the findings from the different primary studies so as to provide an insight into the interaction between these variables.

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Section: Expected Outcome Unexpected Outcome Studiesmentioning

confidence: 99%

Section: Appraisalmentioning

confidence: 99%

Section: Expected Outcome Unexpected Outcome Studiesmentioning

confidence: 99%

Section: Expected Outcome Unexpected Outcome Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Socioeconomic Determinants of Antimalarial Drug Use Behaviours: A Systematic Review

Anyanwu¹,

Fulton²

2016

J Comm Pub Health Nursing

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Moving towards universal coverage with malaria control interventions: achievements and challenges in rural Burkina Faso

Allegri

Louis

Tiendrebéogo

et al. 2012

Health Planning & Management

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This paper reports on a study, which assessed coverage with malaria control interventions in rural Burkina Faso, namely insecticide-treated mosquito nets (ITN) ownership, intermittent preventive treatment (IPTp) for pregnant women and artemisinin-based combination therapy (ACT) for under-five children. The study also addressed the distributional impact of such interventions, with specific reference to equity. The study used data from a representative household survey conducted on 1106 households in the Nouna Health District in 2010. Findings indicated that 59% of all households owned at least one ITN, 66% of all pregnant women received IPT at least once and 34% of under-five children reporting a malaria case were treated with ACT. Multivariate logistic regression revealed that higher socio-economic status, ownership of at least one radio and living in a village within a Health and Demographic Surveillance System were significantly positively associated with ITN, IPTp and ACT coverage. ITN coverage was higher among households in villages, which had previously hosted an ITN trial and/or the most favourable arm of a trial. Comparing current findings with previous estimates suggests that the country has made substantial progress towards scaling up malaria control interventions but that current coverage rates are still far from achieving the universal coverage targets set by the Roll Back Malaria Partnership. In addition, current coverage patterns reveal the existence of multiple inequities across groups, suggesting that current policies are inadequate to achieve equitable scaling up. Future planning of malaria control interventions ought to take into consideration current inadequacies and lead to programmes better designed to overcome them.

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Health-care availability, preference, and distance for women in urban Bo, Sierra Leone

Fleming

Ansumana

Bockarie

et al. 2016

Int J Public Health

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Geographic inequities in provision and utilization of malaria treatment services in southeast Nigeria: Diagnosis, providers and drugs

Cited by 24 publications

References 15 publications

Socioeconomic Determinants of Antimalarial Drug Use Behaviours: A Systematic Review

Socioeconomic Determinants of Antimalarial Drug Use Behaviours: A Systematic Review

Moving towards universal coverage with malaria control interventions: achievements and challenges in rural Burkina Faso

Health-care availability, preference, and distance for women in urban Bo, Sierra Leone

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