Abstract:

Nigeria changed its malaria treatment drug (AMD) policy in 2005 from use of chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) to more effective Artemisinin-based combination therapy (ACT). SP is exclusively reserved for malaria in pregnancy prevention. Sixty percent of Nigerians patronize Patent Medicine Vendors (PMVs). This study assessed AMDs stocking and dispensing practices of urban and rural based PMVs. This is a cross-sectional survey of 120 PMVs in ten LGAs of Akwa Ibom State, Nigeria. The LGAs were divided into five urban and five rural.12 PMVs were selected from each LGA. A one page questionnaire was used to elicit information on brand-names of AMDs, drug-active-ingredients, cost, and popularity amongst clients. Data was analyzed and results presented in simple frequencies, mean, and confidence intervals (CI). 1,150 AMDs were found under 86 brand-names. Mean in urban shops was 22.6 [SD±20.5] compared to rural 20.1 [SD±16.9]. ACT was more common in urban (71.1% at 95% CI: 0.579-0.822); SP (36.4% at 95% 0.109-0.692); CQ (33.3% at 95% CI: 0.075-0.701); and rural ACT (28.8 % at 95% CI: 0.178-0.421); SP (63.6% at 95% CI: 0.308-0.891); CQ (66.7%. at 95% CI: 0.299-0.925). Drug popularity in both areas, clients preferred ACT (74.0%, CI: 0.639-0.832); CQ (12.7%, CI: 0.066-0.217), SP (8.6%, CI: 0.033-0.161); and MADs (4.8%, 0.013-0.115).The cost of drugs ranged < N100 per dose for SP and CQ to ACTs > N301. Twelve years after the change, non-recommended drugs are still prescribed. Promoting training, cost reduction and availability of appropriate and efficacious AMDs may boost current malaria control efforts.

Keywords: Antimalarial drugs, patent medicine vendors, urban and rural, stocking and dispensing.

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