Antimalarial Use in the Management of Malaria in Pregnancy in a Tertiary Care Setting in Sokoto, North Western Nigeria

Abstract

Background: Malaria in pregnancy still remains a public health concern that needs to be addressed; it ranks among the commonest causes of complications in pregnancy, leading to maternal morbidity and mortality. Objectives: This study is aimed at reviewing the pattern of antimalarial use in the management of malaria in pregnancy so as to determine the compliance of prescribers to recommended guidelines and policies of drug use in pregnancy, and review the core prescribing indicators. Methodology: This was a retrospective study conducted between 1st January 2012 to 31st December 2012 at the Department of Obstetrics and Gynecology Usmanu Danfodiyo University teaching hospital (UDUTH), Sokoto – Nigeria. Case notes of pregnant women seen and managed as a case of Malaria in pregnancy within the study period were retrieved. Data analysis was done using the statistical package for social sciences (SPSS) 17.0. Results: Four hundred and eighty two case folders were retrieved within the study period. The mean age was 26.8 ± 5.01 years. Artemisinin combination therapy (ACTs) were the most commonly prescribed drugs; Artemether-lumefantrine 68% (328), artemether 42 (8.7%), artesunate and artesunate-SP each 20 (4.1%) of the patients respectively. The diagnostic approach was clinical symptomatology (62.2%) and Laboratory confirmed in only (37.8%). Generic prescribing accounted for 48.9%, injectables and antibiotics accounted for 21.2% and 43.2% respectively. Conclusions and Recommendations: Optimum adherence to recommended treatment guidelines is advocated. ACTs were the most prescribed antimalarial irrespective of the trimester. There was lack of compliance with prompt parasitological confirmation by microscopy or Rapid Diagnostic Tests (RDTs) in many of the patients suspected of malaria. Core prescribing indicators were not in consonance with standard reference values in this study. An urgent need for continuing medical education and professiona