Pattern of Prescription of Anti-malarial Drugs in the Primary Health Care Facilities in Sokoto State Nigeria

Introduction: Prescription practices for malaria have been shown to influence the emergence of resistance to antimalarial drugs. Appropriate antimalarial drug use contributes to reductions in morbidity and mortality due to malaria with a consequent socioeconomic benefit, thus the success of a new malaria treatment policy would depend on the adherence of health care providers and patients to treatment recommendations. This study aimed to determine the prescribing pattern of anti-malaria in primary health care facilities in Sokoto State.

Methods: A cross sectional study was carried-out in the Primary Health Care facilities in Sokoto State. Screening of prescription forms from the patients who presented at the outpatient clinic during the period of the study in the selected health facilities was done at the point of exit, and only those with antimalarial prescription were consecutively selected. An interviewer administered questionnaire was used to obtained brief history of the illness among 276 respondents who were enrolled in to the study. Record of Rapid Diagnostic Test (mRDT) for the diagnosis of the malaria was obtained from the patients and or their caregivers. Data were analyzed using IBM® SPSS version 20 statistical packages.

Results: Majority 85 (30.8%) of the respondents were aged ≤ 1-10 years followed by 21-30 years 81 (29.3) Of the 276 antimalarial prescription forms obtained from the respondents, artemisinin- based combination therapy (ACT) was 166 (60.1%) and monotherapy was 110 (39.9%). The commonest artemisinin-based combination therapy prescribed for the respondents was Artemether-Lumefantrine 141 (84.9%) followed by Artesunate- Amodiaquine 16 (9.6%). The commonest oral mono-therapy prescribed was Sulphadoxine-pyrimethamine 28 (75.7%) while the most prescribed injectable monotherapy was artemether 59 (80.8%). Rapid Diagnostic Test for malaria (mRDT) was done for 274 (99.3%) respondents; those with mRDT positive were 238 (86.9%). The commonest presenting symptoms was fever 274 (99.3%) flowed by headache 225 (80.7%) and loss of appetite 215 (77.9%).

Conclusion: The pattern of antimalarial prescription observed in this study was mainly artemisinin-based combination therapy. However, antimalarial monotherapy is still being prescribed. There is need for regular training of the health care workers on the appropriate treatment of malaria using the national guideline for treatment of malaria. Regular supply and availability of ACTs in all health facilities across the state will ensure full compliance with national guideline for malaria treatment using ACTs.