Exposure to anti-malarial drugs and monitoring of adverse drug reactions using toll-free mobile phone calls in private retail sector in Sagamu, Nigeria: implications for pharmacovigilance

<p>Abstract</p> <p>Background</p> <p>Adverse drug reactions (ADRs) contribute to ill-health or life-threatening outcomes of therapy during management of infectious diseases. The exposure to anti-malarial and use of mobile phone technology to report ADRs following drug exposures were investigated in Sagamu - a peri-urban community in Southwest Nigeria.</p> <p>Methods</p> <p>Purchase of medicines was actively monitored for 28 days in three Community Pharmacies (CP) and four Patent and Proprietary Medicine Stores (PPMS) in the community. Information on experience of ADRs was obtained by telephone from 100 volunteers who purchased anti-malarials during the 28-day period.</p> <p>Results and Discussion</p> <p>A total of 12,093 purchases were recorded during the period. Antibiotics, analgesics, vitamins and anti-malarials were the most frequently purchased medicines. A total of 1,500 complete courses of anti-malarials were purchased (12.4% of total purchases); of this number, purchases of sulphadoxine-pyrimethamine (SP) and chloroquine (CQ) were highest (39.3 and 25.2% respectiuvely). Other anti-malarials purchased were artesunate monotherapy (AS) - 16.1%, artemether-lumefantrine (AL) 10.0%, amodiaquine (AQ) - 6.6%, quinine (QNN) - 1.9%, halofantrine (HF) - 0.2% and proguanil (PR) - 0.2%. CQ was the cheapest (USD 0.3) and halofantrine the most expensive (USD 7.7). AL was 15.6 times ($4.68) more expensive than CQ. The response to mobile phone monitoring of ADRs was 57% in the first 24 hours (day 1) after purchase and decreased to 33% by day 4. Participants in this monitoring exercise were mostly with low level of education (54%).</p> <p>Conclusion</p> <p>The findings from this study indicate that ineffective anti-malaria medicines including monotherapies remain widely available and are frequently purchased in the study area. Cost may be a factor in the continued use of ineffective monotherapies. Availability of a toll-free telephone line may facilitate pharmacovigilance and follow up of response to medicines in a resource-poor setting.</p

Comparative effectiveness of two stabilization exercise positions on pain and functional disability of patients with low back pain

The study investigated the effects of two stabilization exercise positions (prone and supine) on pain intensity (PI) and functional disability (FD) of patients with nonspecific chronic low back pain (NSCLBP). The 56 sub-jects that completed the study were randomly assigned into stabiliza-tion in prone (SIP) (n=19), stabilization in supine (SIS) (n=20), and prone and supine (SIPS) position (n=17) groups. Subjects in all the groups re-ceived infrared radiation for 15 min and kneading massage at the low back region. Subjects in SIP, SIS, and SIPS groups received stabilization exercise in prone lying, supine lying and combination of both positions respectively. Treatment was applied twice weekly for eight weeks. PI and FD level of each subject were measured at baseline, 4th and 8th week of the treatment sessions. Data were analyzed using descriptive and inferential statistics. The alpha level was set at P 0.05) of the treat-ment sessions across the three groups when compared. It can be con-cluded that stabilization exercises carried out in prone, supine and combination of the two positions were equally effective in managing pain and disability of patients with NSCLBP. However, no position was superior to the other