Self-medication with chloroquine in a rural district of Tanzania: a therapeutic challenge for any future malaria treatment policy change in the country

Nsimba, Stephen E. D.; Rimoy, G.

doi:10.1111/j.1365-2710.2005.00645.x

Cited by 23 publications

(25 citation statements)

References 8 publications

(8 reference statements)

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“…Self-medication was equally practiced by men and women across all FGDs. Similar finding have been reported from other studies in Tanzania where the majority of participants self-medicated [4,35]. The use of non-prescribed drugs was common even in places where health professionals were easily accessible.…”

Section: Discussionsupporting

confidence: 89%

“…In the year 2000, malaria accounted for over 43% of outpatient attendance, 42% of all hospital admissions and 32% of hospital deaths in health facilities in Tanzania [14]. Self-medication with anti-malarial drugs has been widely practiced in different countries including Tanzania [4,15]. In recent years, there has been a reduction of malaria prevalence particularly in malaria endemic countries [16-19].…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, understanding the patterns of self-medication, especially with anti-malarials, during this period when most instances of fever are presumed to be due to non-malaria febrile illnesses is important. However, few studies on self-medication practice have been conducted in Tanzania [4,15]. In this study, self-medication practice among community members was assessed and information was gathered from health workers from primary health facilities and district hospital on the habit of self-medication among community members.…”

Section: Introductionmentioning

confidence: 99%

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Self-medication with anti-malarials is a common practice in rural communities of Kilosa district in Tanzania despite the reported decline of malaria

Chipwaza

Mugasa

Mayumana

et al. 2014

Malar J

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BackgroundSelf-medication has been widely practiced worldwide particularly in developing countries including Tanzania. In sub-Saharan Africa high incidences of malaria have contributed to self-medication with anti-malarial drugs. In recent years, there has been a gain in malaria control, which has led to decreased malaria transmission, morbidity and mortality. Therefore, understanding the patterns of self-medication during this period when most instances of fever are presumed to be due to non-malaria febrile illnesses is important. In this study, self-medication practice was assessed among community members and information on the habit of self-medication was gathered from health workers.MethodsTwelve focus group discussions (FGD) with members of communities and 14 in-depth interviews (IDI) with health workers were conducted in Kilosa district, Tanzania. The transcripts were coded into different categories by MaxQDA software and then analysed through thematic content analysis.ResultsThe study revealed that self-medication was a common practice among FGD participants. Anti-malarial drugs including sulphadoxine-pyrimethamine and quinine were frequently used by the participants for treatment of fever. Study participants reported that they visited health facilities following failure of self-medication or if there was no significant improvement after self-medication. The common reported reasons for self-medication were shortages of drugs at health facilities, long waiting time at health facilities, long distance to health facilities, inability to pay for health care charges and the freedom to choose the preferred drugs.ConclusionThis study demonstrated that self-medication practice is common among rural communities in the study area. The need for community awareness is emphasized for correct and comprehensive information about drawbacks associated with self-medication practices. Deliberate efforts by the government and other stakeholders to improve health care services, particularly at primary health care facilities will help to reduce self-medication practices.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Self-medication with anti-malarials is a common practice in rural communities of Kilosa district in Tanzania despite the reported decline of malaria

Chipwaza

Mugasa

Mayumana

et al. 2014

Malar J

View full text Add to dashboard Cite

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“…Self-medication with anti-malarial drugs has widely been practiced in several countries including Tanzania [22], [61]–[63]. Our findings have also shown this trend, where anti-malarial drugs were self-prescribed by majority of the participants.…”

Section: Discussionsupporting

confidence: 80%

Community Knowledge and Attitudes and Health Workers' Practices regarding Non-malaria Febrile Illnesses in Eastern Tanzania

et al. 2014

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IntroductionAlthough malaria has been the leading cause of fever for many years, with improved control regimes malaria transmission, morbidity and mortality have decreased. Recent studies have increasingly demonstrated the importance of non-malaria fevers, which have significantly improved our understanding of etiologies of febrile illnesses. A number of non-malaria febrile illnesses including Rift Valley Fever, dengue fever, Chikungunya virus infection, leptospirosis, tick-borne relapsing fever and Q-fever have been reported in Tanzania. This study aimed at assessing the awareness of communities and practices of health workers on non-malaria febrile illnesses.MethodsTwelve focus group discussions with members of communities and 14 in-depth interviews with health workers were conducted in Kilosa district, Tanzania. Transcripts were coded into different groups using MaxQDA software and analyzed through thematic content analysis.ResultsThe study revealed that the awareness of the study participants on non-malaria febrile illnesses was low and many community members believed that most instances of fever are due to malaria. In addition, the majority had inappropriate beliefs about the possible causes of fever. In most cases, non-malaria febrile illnesses were considered following a negative Malaria Rapid Diagnostic Test (mRDT) result or persistent fevers after completion of anti-malaria dosage. Therefore, in the absence of mRDTs, there is over diagnosis of malaria and under diagnosis of non-malaria illnesses. Shortages of diagnostic facilities for febrile illnesses including mRDTs were repeatedly reported as a major barrier to proper diagnosis and treatment of febrile patients.ConclusionOur results emphasize the need for creating community awareness on other causes of fever apart from malaria. Based on our study, appropriate treatment of febrile patients will require inputs geared towards strengthening of diagnostic facilities, drugs availability and optimal staffing of health facilities.

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“…This may result in overuse of antimalarial drugs (Mwanziva et al, 2008) and increases the chance of developing drug resistance (Maude et al, 2009;White, 2010). Furthermore, self-treatment (Nsimba & Rimoy, 2005;Hodel et al, 2009) and mistreatment of febrile illnesses in health facilities results into increasing hospitalization and deaths due to diseases other than malaria. The objective of this study was to estimate the malaria burden based on serological data and prevalence of malaria, and compare it with existing self-treatment practices in the community and in medical practice in Magugu, a malaria endemic area of northern Tanzania.…”

Section: Introductionmentioning

confidence: 99%

Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania

Mwanziva

Manjurano

Mbugi

et al. 2011

Tanzania J Hlth Res

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Malaria morbidity and mortality data from clinical records provide essential information towards defining disease burden in the area and for planning control strategies, but should be augmented with data on transmission intensity and serological data as measures for exposure to malaria. The objective of this study was to estimate the malaria burden based on serological data and prevalence of malaria, and compare it with existing self-treatment practices in Magugu in Babati District of northern Tanzania. Prospectively, 470 individuals were selected for the study. Both microscopy and Rapid Diagnostic Test (RDT) were used for malaria diagnosis. Seroprevalence of antibodies to merozoite surface proteins (MSP-119) and apical membrane antigen (AMA-1) was performed and the entomological inoculation rate (EIR) was estimated. To complement this information, retrospective data on treatment history, prescriptions by physicians and use of bed nets were collected. Malaria prevalence in the area was 6.8% (32/470). Of 130 individuals treated with artemisinin combination therapy (ACT), 22.3 % (29/130) were slide confirmed while 75.3% (98/130) of them were blood smear negative. Three of the slides confirmed individuals were not treated with ACT. Fever was reported in 38.2% of individuals, of whom 48.8 % (88/180) were given ACT. Forty-two (32.3%) of those who received ACT had no history of fever. About half (51.1%) of those treated with ACT were children <10 years old. Immunoglobulin against MSP-119 was positive in 16.9% (74/437) while against AMA-1 was positive in 29.8 % (130/436). Transmission intensity was estimated at <0.2 infectious bites per person per year. The RDT was highly specific (96.3%) but with low sensitivity (15.6%). In conclusion, Magugu is a low endemic area. There is substantial over diagnosis, over treatment and self treatment in the community. The burden of malaria based on medical records is over estimated as was mostly presumptive. The low sensitivity of RDT reflects the low number of immune individuals as well as the low parasite density. ________________________________________________________________________________

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Self-medication with chloroquine in a rural district of Tanzania: a therapeutic challenge for any future malaria treatment policy change in the country

Abstract: There is a need to educate both rural communities, and health care providers about rational prescribing, dispensing and use of antimalarials.

Cited by 23 publications

References 8 publications

Self-medication with anti-malarials is a common practice in rural communities of Kilosa district in Tanzania despite the reported decline of malaria

Self-medication with anti-malarials is a common practice in rural communities of Kilosa district in Tanzania despite the reported decline of malaria

Community Knowledge and Attitudes and Health Workers' Practices regarding Non-malaria Febrile Illnesses in Eastern Tanzania

Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania

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