Adherence to antimalarial drug policy among doctors in Delta State, Nigeria: implications for malaria control

Abstract

Background: Malaria is a public health problem compounded with a widespread emergence of drug-resistant Plasmodium falciparum which necessitated the formulation of a new antimalarial drug policy (AMP).

Objective: This study was designed to assess adherence to the policy among physicians in health facilities in Delta state, Nigeria.

Design: Cross-sectional, analytic study. Data were collected with a semi-structured questionnaire.

Setting: Two secondary and one tertiary health facilities in Delta State, Nigeria

Participants: Physicians selected with a simple random technique from the facilities
Main outcome measures: Prescribing pattern of antimalarial drugs and adherence to WHO treatment guideline among doctors.

Results: Majority (90.8%) of respondents believed the antimalarial policy (AMP) should be strictly adhered to, although three-fifth (61.0%) of them rated its performance as poor. The level of adherence to the national antimalarial drug policy was high (78.5%) as most doctors prescribed Arthemeter-Lumefantrine, AL for uncomplicated malaria however barely two-fifth (35.4%) adhered to prescribing injectable Artesunate for complicated malaria. AL, (71.9%)
was the most prescribed antimalarial drug for uncomplicated malaria The most prescribed antimalarial drugs for complicated malaria was artesunate (40.0%) followed by quinine (27.6%) and artemether (26.7%); although, chloroquine was also prescribed.

Conclusion: The level of adherence to AMP among doctors was sub-optimal. Continuous education of doctors on the new AMP is needed to achieve malarial control.

Keywords: Adherence, antimalarial, drug policy, resistance, guidelines

Funding: No funding was received for this study