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

A review of the Tandanicolinae (=Monodhelminthinae) (Digenea, Fellodistomidae), with a description of Prosogonarium angelae N-Sp

The Tandanicolinae is reviewed, redefined and considered a subfamily of the Fellodistomidae. The Monodhelminthinae Dollfus, 1937, Mehratrematinae Srivastava, 1939, Prosogonariinae Mehra, 1963 and Buckleytrematinae Yamaguti, 1971 are synonyms of the Tandanicolinae. Genera included in the Tandanicolinae are Tandanicola, Monodhelmis, Buckleytrema and Prosogonarium. Burnellus and Mehratrema are made new synonyms of Monodhelmis. The composition of each genus is reviewed. Monodhelmis arii Yamaguti, 1952, Mehratrema arii Gu & Shen, 1979, Mehratrema dollfusi Srivastava, 1939, Monodhelmis philippinensis Velasquez, 1961, Mehratrema polynemusinis Chauhan, 1943 and Mehratrema skrjabini Karyakarte, 1969 are considered synonyms of Monodhelmis torpedinis. Monodhelmis elongatus Bilqees, 1970 is considered a species inquirenda. Prosogonarium angelae n. sp. is described from Euristhmus lepturus from Moreton Bay, Queensland. It is distinguished by the number and distribution of the vitelline follicles and the extent of the caeca. New records are given for Monodhelmis torpedinis from Arius graeffei and E. lepturus, M. trichofurcata from Tandanus tandanus, and Buckleytrema indica from A. graeffei, all from southern Queensland. Buckleytrema indica is redescribed and B. postacetabulorchis is synonymised with that species. Relationships within the Tandanicolinae were considered by cladistic analysis