ADHERENCE TO CURRENT GUIDELINES ON PRESCRIPTION OF ANTIMALARIALS AND ASSOCIATED FACTORS AMONG HEALTHCARE PROVIDERS IN LOKOJA LOCAL GOVERNMENT AREA, KOGI STATE, NIGERIA

Abstract

Adherence to current treatment guidelines of prescription of antimalarials by healthcare providers can promote better malarial treatment outcomes. However, adherence level and factors influencing adherence to treatment guidelines have not been well explore. This study was carried out to assess the level of adherence to current guidelines on prescription of antimalarials and associated factors among healthcare providers in Lokoja Local Government Area, Kogi State, Nigeria. The study was cross-sectional in design. A total of 404 healthcare providers aged 18-65years were selected through stratified random sampling from public health facilities and patent medicine stores. A semi-structured interviewer-administered questionnaire was used to collect data on socio-demographic characteristics of respondents, knowledge and training on current guidelines and prescription practice. Adherence was defined as correct prescription of artemisinin-based combination therapy for uncomplicated malaria in a child and adult. Knowledge of current guidelines was assessed on a 5-point scale in which scores ≥3 were categorised as good knowledge while scores <3 were categorised as poor. Data were analyzed using descriptive statistics, Chi-square test and logistic regression with significance level set at 0.05. Age of respondents was 36.9±9.2years. The respondents were nurses (36.6%), patent medicine vendors (30.0%), doctors (18.3%), community health extension workers (9.7%), pharmacists (3.2%) and community health officers (2.2%). Over half (53.0%) were males and about three-quarters (74.4%) were married. Half (50.0%) had good knowledge of the guidelines of which 34.2% were doctors and 4.0% each were community health officers and pharmacists. About 67.0% requested for a confirmatory test before treatment. In all, 54.2% had been trained on guidelines of which 36.1 % were patent medicine vendors while only 1.4% were pharmacists. Overall adherence to guidelines on anti-malaria prescription was 39.0%. The adherence level among doctors was 67.6%, community health officers (55.6%), pharmacists (19.8%). Respondents who were trained on the guidelines were twice more likely to adhere with guidelines (AOR=2.28; CI=1.41-3.69) while respondents with good knowledge were four times more likely to adhere to guidelines compared to those with poor knowledge (AOR=3.99; Cl=2.39-6.69). Knowledge of and adherence to current guidelines on antimalarials prescription was generally low in Lokoja among community health officers, nurses, pharmacists and patent medicine vendors in the study. Government should train these categories of health care providers to improve their knowledge and adherence to the guidelines.