Self-medication with anti-malarials is a common practice in rural communities of Kilosa district in Tanzania despite the reported decline of malaria

Abstract

BackgroundSelf-medication has been widely practiced worldwide particularly in developing countries including Tanzania. In sub-Saharan Africa high incidences of malaria have contributed to self-medication with anti-malarial drugs. In recent years, there has been a gain in malaria control, which has led to decreased malaria transmission, morbidity and mortality. Therefore, understanding the patterns of self-medication during this period when most instances of fever are presumed to be due to non-malaria febrile illnesses is important. In this study, self-medication practice was assessed among community members and information on the habit of self-medication was gathered from health workers.MethodsTwelve focus group discussions (FGD) with members of communities and 14 in-depth interviews (IDI) with health workers were conducted in Kilosa district, Tanzania. The transcripts were coded into different categories by MaxQDA software and then analysed through thematic content analysis.ResultsThe study revealed that self-medication was a common practice among FGD participants. Anti-malarial drugs including sulphadoxine-pyrimethamine and quinine were frequently used by the participants for treatment of fever. Study participants reported that they visited health facilities following failure of self-medication or if there was no significant improvement after self-medication. The common reported reasons for self-medication were shortages of drugs at health facilities, long waiting time at health facilities, long distance to health facilities, inability to pay for health care charges and the freedom to choose the preferred drugs.ConclusionThis study demonstrated that self-medication practice is common among rural communities in the study area. The need for community awareness is emphasized for correct and comprehensive information about drawbacks associated with self-medication practices. Deliberate efforts by the government and other stakeholders to improve health care services, particularly at primary health care facilities will help to reduce self-medication practices.

Level and Correlates of Self-medication among Adults in a Rural Setting of Mainland Tanzania

“…Despite the limited data on self-and OTC medications in Tanzania, the current available data on SM and OTC in Tanzania have focused mainly on malaria and fever-related illnesses [5][6][7] . In all these cases, SM and OTC medications were found to be very common practices among interviewed participants.…”

“…Previous studies from subSaharan Africa with different study population and with specific types of morbidities found higher prevalence (over 70%) of SM [14][15][16] . Furthermore, in one rural area of Tanzania, a recent qualitative study suggested SM practices to be common [5] . Therefore, the prevalence of SM in this study is within the expected limits.…”

Medicines dispensers' knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

“…The greatest burden is in tropical regions, and in Africa, malaria remains one of the most common diagnoses . For many years, malaria has been a leading cause of death in sub‐Saharan Africa especially among children, although the number of deaths is decreasing, helped by the availability of rapid diagnostic tests, prevention programmes and antimalarial medicines . Malaria also has a significant impact on morbidity .…”

“…As a result, malaria is one of the leading public health concerns in infected countries, causing up to 660 000 deaths per year or higher . Malaria is also a public health concern in Tanzania where in 2000, malaria accounted for over 43% of outpatient attendance, 42% of all hospital admissions and 32% of hospital deaths, with a similar situation in Uganda . The prevalence of confirmed malaria in children under five in Tanzania using a rapid diagnostic test (mRDT) in 2011–2012 was 9% .…”

Challenges of malaria diagnosis in clinical settings and disease surveillance under reduced malaria burden in Tanzania

“…Most community members in malaria endemic countries, including Tanzania lack the correct knowledge about the causes of febrile illnesses and most have the notion that fever and malaria are synonymous and quite often used interchangeably [30,54]; therefore even at a time that malaria has remarkably declined, malaria is still perceived to be a much more common cause of fever [12,13,61,62]. Due to lack of knowledge, most clients expect a positive malaria test and when given negative results, sometimes they may not accept them and would put pressure on the prescriber to consider a diagnosis of malaria [63], and if the prescriber do not concur they may resort to self-medication with antimalarial drugs [64,65].…”