Antimalarial treatment patterns among pregnant women attending antenatal care clinics in south east Nigeria and the future implications

Ezenduka, Charles; Nworgu, Chizoba; Godman, Brian; Massele, Amos; Esimone, Charles Okechukwu

doi:10.1111/ijcp.12913

Cited by 4 publications

(15 citation statements)

References 24 publications

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“…Malaria occurs most often in pregnant women and young children . The greatest burden is in tropical regions, and in Africa, malaria remains one of the most common diagnoses .…”

Section: Introductionmentioning

confidence: 99%

“…Malaria occurs most often in pregnant women and young children . The greatest burden is in tropical regions, and in Africa, malaria remains one of the most common diagnoses . For many years, malaria has been a leading cause of death in sub‐Saharan Africa especially among children, although the number of deaths is decreasing, helped by the availability of rapid diagnostic tests, prevention programmes and antimalarial medicines .…”

Section: Introductionmentioning

confidence: 99%

“…The impact of malaria can be far‐reaching. In pregnancy, malaria can lead to birth complications, an increased risk of communicable and noncommunicable diseases, and a high risk of both maternal and perinatal morbidity and mortality . Malaria in pregnancy contributes to an estimated 100 000 neonatal deaths and 10 000 maternal deaths annually .…”

Section: Introductionmentioning

confidence: 99%

“…Malaria in pregnancy contributes to an estimated 100 000 neonatal deaths and 10 000 maternal deaths annually . In Nigeria, up to 11% of maternal deaths and 30% of childhood deaths are due to malaria . Malaria also results in considerable economic burden for households, including high co‐payments for medicines in countries including Tanzania [ as well as reduced economic growth .…”

Section: Introductionmentioning

confidence: 99%

“…In 2005, the Ministry of Health and Social Welfare, United Republic of Tanzania, changed the recommended treatment for uncomplicated malaria from sulphadoxine–pyrimethamine (SP) to artemisinin‐based combination therapy (ACT) – specifically artemether–lumefantrine (ALU) . However, SP remains the medicine of choice for intermittent preventive treatment in pregnancy (IPTp) in Tanzania and across Africa . ACT is also the recommended first‐line treatment in the second and third trimesters of pregnancy for uncomplicated malaria, with quinine still recommended for severe malaria across all trimesters as dihydroartemisinin/piperaquine (DPQ) as well as for second‐line treatment .…”

Section: Introductionmentioning

confidence: 99%

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Medicines dispensers' knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

Mwita

Jande

Marwa

et al. 2017

J Pharm Health Serv Res

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Objectives In 2005, Tanzania changed its policy for uncomplicated malaria treatment from sulphadoxine–pyrimethamine (SP) to artemisinin‐based combination therapy (ACT), specifically artemether–lumefantrine (ALU). SP remains the medicine of choice for intermittent preventive treatment in pregnancy (IPTp). There is a need to assess dispensers' knowledge regarding the treatment of uncomplicated malaria and IPTp in Tanzania given appreciable self‐purchasing to improve future care. Methods Descriptive cross‐sectional design with structured questionnaires to capture quantitative data, with qualitative data captured using focus groups. The study was performed at 32 private pharmacies and 33 Accredited Drug Dispensing Outlets in the Nyamagana and Sengerema Districts in Tanzania, with 20 dispensers included in the qualitative discussions. Key findings The knowledge level of dispensers in the private medicine outlets was variable. Most dispensers knew ALU was first‐line treatment in uncomplicated malaria, however variable knowledge about taking ALU with fatty meals. Generally, dispensers had poor knowledge about dosing intervals for SP in IPTp and variable knowledge regarding treatments in the first trimester. Overall, 49% had good knowledge and 48% had moderate knowledge of ACT in uncomplicated malaria. There was a significant relationship between dispenser type and knowledge of ACT but no statistical relationship between the level of knowledge on IPTp and the dispenser. Conclusions The majority of dispensers in private medicines outlets have good knowledge on ACT policy in the treatment of uncomplicated malaria; however, few dispensers had good knowledge on IPTp, which may contribute to irrational dispensing of SP. This needs addressing given the extent of self‐purchasing in Tanzania.

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“…Malaria occurs most often in pregnant women and young children . The greatest burden is in tropical regions, and in Africa, malaria remains one of the most common diagnoses .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Medicines dispensers' knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

Mwita

Jande

Marwa

et al. 2017

J Pharm Health Serv Res

Self Cite

View full text Add to dashboard Cite

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Evaluating the Treatment Costs for Uncomplicated Malaria at a Public Healthcare Facility in Nigeria and the Implications

Ezenduka

Falleiros

Godman

2017

PharmacoEconomics Open

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BackgroundAccurate information on the facility costs of treatment is essential to enhance decision making and funding for malaria control.ObjectiveThe objective of this study was to estimate the costs of providing treatment for uncomplicated malaria through a public health facility in Nigeria.MethodsHospital costs were estimated from a provider perspective, applying a standard costing procedure. Capital and recurrent expenditures were estimated using an ingredient approach combined with step-down methodology. Costs attributable to malaria treatment were calculated based on the proportion of malaria cases to total outpatient visits. The costs were calculated in local currency [Naira (N)] and converted to US dollars at the 2013 exchange rate.ResultsTotal annual costs of N28.723 million (US$182,953.65) were spent by the facility on the treatment of uncomplicated malaria, at a rate of US$31.49 per case, representing approximately 25% of the hospital’s total expenditure in the study year. Personnel accounted for over 82.5% of total expenditure, followed by antimalarial medicines at 6.6%. More than 45% of outpatients visits were for uncomplicated malaria. Changes in personnel costs, drug prices and malaria prevalence significantly impacted on the study results, indicating the need for improved efficiency in the use of hospital resources.ConclusionMalaria treatment currently consumes a considerable amount of resources in the facility, driven mainly by personnel cost and a high proportion of malaria cases. There is scope for enhanced efficiency to prevent waste and reduce costs to the provider and ultimately the consumer.

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Compliance with South Africa’s Antimicrobial Resistance National Strategy Framework: are we there yet?

Engler

Meyer

Schellack

et al. 2020

Journal of Chemotherapy

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Antimicrobial resistance (AMR) is a growing problem worldwide. South Africa has recently released its Antimicrobial Resistance National Strategy Framework (referred to as the Framework) to instigate antimicrobial stewardship programmes (ASPs). Consequently, there is a need to assess compliance with the Framework. Methods: Descriptive study design, collecting quantitative data, among pre-selected public healthcare facilities. One healthcare professional from each participating facility, involved in ASPs, invited to participate.Results: Overall 26 facilities from 8 provinces participated. Average compliance to the Framework was 59.5% for the 26 facilities, with 38.0% for community health centres, 66.8% for referral hospitals and 73.5% for national central hospitals. For 7 facilities compliance was <50% while 5 facilities were >80% compliant. Conclusion: Although some facilities complied well with the Framework, overall compliance was sub-optimal. With the introduction of universal healthcare in South Africa, coupled with growing AMR rates, ongoing initiatives to reduce should be targeted at non-compliant facilities.

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Antimalarial treatment patterns among pregnant women attending antenatal care clinics in south east Nigeria and the future implications

Abstract: Current practice indicates greater conformity with guidelines particularly in the second and three trimesters vs previous studies. However, there are still concerns with prescribing practices in the first trimester, especially in private health facilities. This needs addressing.

Cited by 4 publications

References 24 publications

Medicines dispensers' knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

Medicines dispensers' knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

Evaluating the Treatment Costs for Uncomplicated Malaria at a Public Healthcare Facility in Nigeria and the Implications

Compliance with South Africa’s Antimicrobial Resistance National Strategy Framework: are we there yet?

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