Prescription Pattern of Antimalarial Drugs in Two Secondary Health Facilities in Rivers State, Nigeria

Abstract

Background: Malaria is a major public health problem and is still accounting for increased morbidity and mortality till date when not properly treated. It is caused by species of the parasite, Plasmodium of which P.falciparum is mostly implicated. The disease burden is still very high in Nigeria where it accounts for more cases and deaths than any other country in the world. Prescription practices have been shown to influence the emergence of resistance to antimalarial drugs²

Objective: To assess the prescription pattern of antimalarials in adults at two secondary health facilities in Rivers State, Nigeria

Method: Prescription pattern of antimalarial drugs was carried out at General Hospitals Terabor and Ahoada with collection of data from medical records of 299 and 339 case notes respectively of malaria patients which were sorted out from the records for a period from January 2016 - September 2019. Essential data collected were age, type of anti-malarial prescribed, other drugs on prescription, total number of drugs per prescription and injectables prescribed. Descriptive statistics from Statistical Package for Social Sciences (SPSS version 22) was used for the analysis.

Results: The result showed that Artemisinin-based Combination Therapies (ACTs) was the most frequently prescribed antimalarial with Arthemeter/Lumefantrine having a prescription frequency of 181 (60.5%) and 248 (73.1%) respectively for Terabor and Ahoada General Hospitals followed by Dihydroartemisinin/Piperaquine 70(23.4%) and 58(17.1%) then Artesunate – Amodiaquine 17 (5.7%) and 12 (3.5%) respectively. The non-ACTs prescribed were Injection Artemether [ 8(2.7%) and 2(0.6%)]; Injection Arteether [7(2.30) and 15 (4.4%)]; Inject ion Artesunate [11(3.7%) and 3(0.9%)]; Quinine [3(1.0%) and 1(0.3%)] all for Terabor and Ahoada General Hospitals respectively.  Also, Sulphadoxine/Pyrimethamine 2 (0.7%) for Terabor and none for Ahoada.

Conclusion: Artemisinin-based combination therapies were most frequently prescribed as antimalarial drug in the two Health facilities. This indicates adherence to WHO 2015 Guideline on the prescription of anti-malarial medications for uncomplicated malaria. However, adherence to National Guidelines for the diagnosis and treatment of Malaria was not total. Percentage of drug prescribed using unbranded generic names was much lower as prescriptions were majorly either in innovator brand name or branded generic names.