Self-reported use of anti-malarial drugs and health facility management of malaria in Ghana

Abstract

Objective: To assess the appropriateness of self-reported use of anti-malarial drugs prior to health facility attendance, and the management of malaria in two health facilities in Ghana.Method: A structured questionnaire was used to collect data from 500 respondents who were diagnosed clinically and/or parasitologically for malaria at Agogo Presbyterian Hospital and Suntreso Polyclinic, both in the Ashanti Region of Ghana. Collected information included previous use of anti-malarial drugs prior to attending the health facilities, types of drugs used, how the drugs were used, and the sources of the drugs. In addition, the anti-malarial therapy given and outcomes at the two health facilities were assessed. Results:Of the 500 patients interviewed, 17% had severe malaria, 8% had moderate to severe malaria and 75% had uncomplicated malaria. Forty three percent of the respondents had taken antimalarial drugs within two weeks prior to hospital attendance. The most commonly used antimalarials were chloroquine (76%), sulphadoxine-pyrimethamine (9%), herbal preparations (9%) and amodiaquine (6%). The sources of these medicines were licensed chemical sellers (50%), pharmacies (21%), neighbouring clinics (9%) or "other" sources (20%) including left-over medicines at home. One hundred and sixty three (77%) of the 213 patients who had used anti-malarial drugs prior to attending the health facilities, used the drugs inappropriately. At the health facilities, the anti-malarials were prescribed and used according to the national standard treatment guidelines with good outcomes. Conclusion:Prevalence of inappropriate use of anti-malarials in the community in Ghana is high. There is need for enhanced public health education on home-based management of malaria and training for workers in medicine supply outlets to ensure effective use of anti-malaria drugs in the country.

Antibiotic Use and Misuse Among Adults in Magwagwa Ward, Nyamira County in Kenya

“…Other sources of unprescribed drugs were what remained from previous illness, from friends/relatives and the shops. These findings are similar to those reported locally in Kenya (Deressa, et al 2003;Buabeng, et al 2007;Aborah, et al 2013). Sourcing medications from what remained in previous illness, friends/relatives and local shops is alarming because these sources indicate possible overdose, under dose, poor adherence to recommended prescription.…”

“…It has a population of 23 The study targeted the residents of Magwagwa ward in Nyamira County. This population involved adults aged 18-75 years old both male and female.…”

Evaluation of Antimalarial Drug use in Tertiary Care Teaching Hospital

“…Each year, between 300 and 500 million new cases are reported worldwide. 4 The global tally of malaria in 2015 was 212 million cases and 4, 29,000 deaths. According to the report fewer than half of the 91 malaria affected countries and territories are on track to achieve the 2020 milestone of a 40% reduction in case incidence and mortility.…”

Knowledge and perceptions of prescribers regarding adherence to standard treatment guidelines for malaria: a comparative cross-sectional study from Pakistan

“…Responses were assigned as 1 = yes/correct and 2 = no/incorrect. Subscale 1 included 2 questions regarding standard treatment regimens for P. vivax (score 2-4) while subscale 2 included 4 questions regarding standard treatment regimens for P. falciparum (score [4][5][6][7][8]. The composite score range was 6-12 and a lower score indicated better knowledge.…”

“…In the case of malaria several studies have reported inappropriate prescribing practices in both public and private health-care facilities due to lack of adherence of prescribers with the STGs [3][4][5][6]. Other studies have reported improved case management after implementation of STGs, but have shown little impact on prescribing habits due to lack of follow up on the implementation of these guidelines [7][8][9]. Rational prescribing requires that prescribers follow a standard process of prescribing in accordance with STGs, which enables a consistent, therapeutically effective and economically efficient use of drugs.…”