Antimalarial drug prescribing practice in private and public health facilities in South-east Nigeria: a descriptive study
Meremikwu, M.; Okomo, U.; Nwachukwu, C.; Oyo-Ita, A.; Eke-Njoku, J.; Okebe, J.; Oyo-Ita, E.; Garner, P.
Malaria Journal 6: 55
2007
ISSN/ISBN: 1475-2875 PMID: 17480216 DOI: 10.1186/1475-2875-6-55Document Number: 553937
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. Objective: To assess prescribing for uncomplicated malaria in government and private health facilities in Cross River State. Method: Audit of 665 patient records at six private and seven government health facilities in 2003. Results: Clinicians in the private sector were less likely to record history or physical examination than those in public facilities, but otherwise practice and prescribing were similar. Overall, 45% of patients had a diagnostic blood slides; 77% were prescribed monotherapy, either chloroquine (30.2%), sulphadoxine-pyrimethamine (22.7%) or artemisinin derivatives alone (15.8%). Some 20.8% were prescribed combination therapy; the commonest was chloroquine with sulphadoxine-pyrimethamine. A few patients (3.5%) were prescribed sulphadoxine-pyrimethamine-mefloquine in the private sector, and only 3.0% patients were prescribed artemisinin combination treatments. Conclusion: Malaria treatments were varied, but there were not large differences between the public and private sector. Very few are following current WHO guidelines. Monotherapy with artemisinin derivatives is relatively common.