Preference for Artemisinin–based combination therapy among healthcare providers, Lokoja, North-Central Nigeria

Welle, Sylvanus C.; Ajumobi, Olufemi; Dairo, Magbagbeola David; Balogun, Muhammad Shakir; Adewuyi, Peter; Adedokun, Babatunde; Nguku, Patrick; Gidado, Saheed; Ajayi, IkeOluwapo O.

doi:10.1186/s41256-018-0092-9

Cited by 19 publications

(11 citation statements)

References 21 publications

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“…Owing to diversity of causes of undernutrition, there is no silver bullet for stunting. To this end, a combination of such nutritional sensitive and specific interventions tailored to the local context can make impact [24, 25]. In the context of Tanzania, socio-demographic disadvantaged populations bear a significant brunt of stunting like other forms of undernutrition [4, 26, 27].…”

Section: Discussionmentioning

confidence: 99%

Trends in prevalence and determinants of stunting in Tanzania: an analysis of Tanzania demographic health surveys (1991–2016)

Sunguya

Zhu

Mpembeni

et al. 2019

Nutr J

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BackgroundTanzania has made a significant improvement in wasting and underweight indicators. However, stunting has remained persistently higher and varying between regions. We analyzed Tanzania Demographic and Health Survey (TDHS) datasets to examine (i) the trend of stunting over the period of 25 years in Tanzania and (ii) the remaining challenges and factors associated with stunting in the country.MethodsThis secondary data analysis included six TDHS datasets with data of 37,409 under-five children spreading in 1991–1992(n = 6587), 1996(n = 5437), 1999(n = 2556), 2004–05(n = 7231), 2009–10(n = 6597), and 2015–16(n = 9001) conducted in all regions of Tanzania. Variables specific to children and their caregivers were analyzed using SPSS version 22. The variables considered include child anthropometric variables, caregiver’s demographic characteristics and household’s socio-economic factors. We used frequencies and percentages to compare stunting prevalence across the six surveys and chi-square test and three-level hierarchical logistic regression to examine the factors associated with stunting also applying sample weighting as advised by TDHS.ResultsThe prevalence of stunting has declined by 30% over the period of 25 years in Tanzania. However, one in three children aged below five years remains stunted with overweight and obesity more than doubled (from 11 to 25%) in the same period among women of reproductive age. The factors associated with stunting included children living in female-headed households (AOR = 1.16, P = 0.014), aged 24–35 months (AOR = 1.75, P = 0.019), born with low birth weight (AOR = 2.14, P < 0.001) and with inconsistent or without breastfeeding (AOR = 3.46, P < 0.001 and AOR = 4.29, P = 0.001) respectively. The risk of stunting among children living in urban area (AOR = 0.56, P < 0.001), with higher caregiver’s education (AOR = 0.56, P = 0.018), obese mother (AOR = 0.63, P < 0.001), households with highest wealth index (AOR = 0.42, P < 0.001), and among girls (AOR = 0.77, P < 0.001).ConclusionsThe burden of stunting in Tanzania has declined by 30% in the past 25 years, but still affecting one in every three children. Efforts are needed to increase the pace of stunting decline especially among boys, children in rural areas, from poor, uneducated, and female-headed households, and through improving infant and young feeding practices. Effective and tailored nutrition-sensitive and specific interventions using multisectoral approaches should be considered to address these important determinants.

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Section: Discussionmentioning

confidence: 99%

Trends in prevalence and determinants of stunting in Tanzania: an analysis of Tanzania demographic health surveys (1991–2016)

Sunguya

Zhu

Mpembeni

et al. 2019

Nutr J

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“…Evidence has shown that the role of factors influencing performance of HWs vary with context and environment [24]. Furthermore, health workers’ perception of mRDT [11,17,23] as well as their antimalarial prescription practices also vary with settings [20,25,26].…”

Section: Introductionmentioning

confidence: 99%

Health workers’ perception of malaria rapid diagnostic test and factors influencing compliance with test results in Ebonyi state, Nigeria

et al. 2019

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BackgroundThe standard practice in treating uncomplicated malaria is to prescribe artemisinin-based combination therapy (ACT) for only patients with positive test results. However, health workers (HWs) sometimes prescribe ACTs for patients with negative malaria rapid diagnostic test (mRDT) results. Available evidence on HWs perception of mRDT and their level of compliance with test results in Nigeria lacks adequate stratification by state and context. We assessed HWs perception of mRDT and factors influencing ACTs prescription to patients with negative mRDT results in Ebonyi state, Nigeria.MethodsA cross-sectional survey was conducted among 303 HWs who treat suspected malaria patients in 40 randomly selected public and private health facilities in Ebonyi state. Health workers’ perception of mRDT was assessed with 18 equally weighted five-point likert scale questions with maximum obtainable total score of 90. Scores ≥72 were graded as good and less, as poor perception. Data were analysed using descriptive statistics and logistic regression model at 5% significance level.ResultsMean age of respondents was 34.6±9.4 years, 229 (75.6%) were females, 180 (59.4%) community health workers and 67 (22.1%) medical doctors. Overall, 114 (37.6%) respondents across healthcare facility strata had poor perception of mRDT. Respondents who prescribed ACTs to patients with negative mRDT results within six months preceding the survey were 154 (50.8%) [PHCs: 50 (42.4%), General hospitals: 18 (47.4%), tertiary facility: 51 (79.7%) and missionary hospitals: 35 (42.2%)]. Poor HWs’ perception of mRDT promoted prescription of ACT to patients with negative mRDT results (AOR = 5.6, 95% C.I = 3.2–9.9). The likelihood of prescribing ACTs to patients with negative mRDT results was higher among HWs in public health facilities (AOR = 2.8, 95% C.I = 1.4–5.5) than those in the private.ConclusionsThe poor perception of mRDT and especially common prescribing of ACTs to patients with negative mRDT results among HWs in Ebonyi state calls for context specific interventions to improve their perception and compliance with mRDT test results.

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“…Factors that may have contributed to the slow adoption of the ACTs in the early years following the change in policy especially among public health care professionals included poor understanding of its concept, and cost, amongst others. Just recently, Welle et al (9) reported a low preference for the ACTs (39.6% ) among health care providers in Lokoja, North-Central Nigeria. A closer look at treatment guideline for management of uncomplicated malaria.…”

Section: Discussionmentioning

confidence: 99%

“…In Nigeria, all health care professionals irrespective of cadre or specialty are involved in the treatment of malaria (9). In addition, there is a significant self-management practice among HCPs which may be determined by both medicine factors such as the tolerability profile of the drug, the cost of the medicine as well as personal preference and preconceived ideas about a medicine.…”

Section: Mots-clésmentioning

confidence: 99%

Artemisinin-based antimalarial combination therapy amongst healthcare professionals in a tertiary facility in south-south Nigeria: preferences, tolerability, and cost considerations

Ayinbuomwan¹,

Opadeyi²,

Isah³

2022

REJHS

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Background: Nigeria adopted the Artemisinin-Based Combination Therapy (ACT) as the mainstay of treating uncomplicated malaria in February 2005. However, the individual preferences for the use of these medicines by health care professionals (HCP) as distinct from their observed prescribing practices is largely unknown. This study determined the preferences, tolerability and cost of the ACTs among HCPin Benin-City.Methods: This descriptive cross-sectional study was conducted in the University of Benin Teaching Hospital, Benin-City, Nigeria. Consenting HCPs were recruited consecutively for the study. Semistructured questionnaires were administered to doctors, nurses and pharmacists in the hospital. Information obtained included demographics, treatment of malaria in the previous year, antimalarial medication preferences and tolerability as well as cost of ACT.Results: A total of 556 HCPs, 295 doctors (54.1%), nurses 200 (36.0%), pharmacists 61(11.0%) completed the questionnaire. In the previous year, 224 (75.9%) doctors, 153 (79.1%) nurses, and 48 (70.5%) pharmacists had treatment for malaria and self-medication was highest among doctors (228, 77.3%). Artemether-Lumenfantrine was the most preferred antimalarial used, 294 (52.8%); however, 1.6% used chloroquine sulphate and ACTs were perceived to be ineffective by 25.4%. Adverse effects were experienced by 167 (29.1%) resulting in 50 (9.0%) discontinuing their medication. Between 500 and 1500 Naira (~US$1-4) was expended on ACT by 66.3% of the staff, while 21.4% were concerned about the high cost of medications.Conclusion: This study highlights the use and preferences, self-medication practices, perceived lack of effectiveness and high cost of ACTs from a HCP perspective. There is an urgent need to address these concerns in view of adverse consequences as well as the likely possibility of its the impact on prescribingpractices.

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Preference for Artemisinin–based combination therapy among healthcare providers, Lokoja, North-Central Nigeria

Cited by 19 publications

References 21 publications

Trends in prevalence and determinants of stunting in Tanzania: an analysis of Tanzania demographic health surveys (1991–2016)

Trends in prevalence and determinants of stunting in Tanzania: an analysis of Tanzania demographic health surveys (1991–2016)

Health workers’ perception of malaria rapid diagnostic test and factors influencing compliance with test results in Ebonyi state, Nigeria

Artemisinin-based antimalarial combination therapy amongst healthcare professionals in a tertiary facility in south-south Nigeria: preferences, tolerability, and cost considerations

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