Prescription Pattern of Antimalarial Drugs in Children Below 5 years in a Tertiary Health Institution in Nigeria

Abstract

Background: This study examines the diagnosis of malaria and pattern of prescription of antimalarial drugs in the most vulnerable age group (the under 5 children) in the study environment in order to identify the possible shortcomings and suggest solutions so as to improve the treatment outcome in future. Methods: The hospital records of 430 children with malaria infection admitted for treatment in a chosen tertiary health facility between January to December 2005 were selected for study. Forty-eight case records were excluded due to incomplete information. Data on demographic, clinical features of disease, diagnostic procedures, drug administration and the treatment out come were collected from the patients\u2019 records. Results: Analysis of the data revealed that more male (213) than female (169) children were admitted for malaria treatment: Fever with convulsion (55.8%) was the commonest presenting symptoms, and anemia was the most frequent complications of malaria recorded. Chloroquine was found to be the most prescribed antimalarial agent and overall antemisinin-based drug was prescribed either as a first or second line treatment in only 18.2% of the cases. The death rate recorded was 16%. Conclusion: The pattern of antimalarial drugs prescription in the study center in most cases did not meet the recommended guidelines. The prescriptions were predominantly chloroquine, instead of artemisinin based. The death rate was comparatively high. Measures to raise the level of awareness among the practitioners on the current National policy on malaria treatment through seminars and workshops were suggested.Introduction: Cette \ue9tude examine le diagnostic du paludisme et le mod\ue8le de l\u2019ordonnance des m\ue9dicaments antipalud\ue9ens pour le groupe d\u2019\ue2ge le plus vuln\ue9rable (les enfants de moins de cinq ans), dans le but d\u2019 identifier les d\ue9faillances possibles et alors sugg\ue9rer des solutions pour ainsi am\ue9liorer les soins dans l\u2019avenir. M\ue9thodes: L\u2019\ue9tude a \ue9t\ue9 bas\ue9e sur les donn\ue9es de l\u2019h\uf4pital portant sur 430 enfants atteints du paludisme et hospitalis\ue9s dans des centres m\ue9dicaux s\ue9lectionn\ue9s de troisi\ue8me cat\ue9gorie, entre Janvier et D\ue9cembre, 2005. Quarante huit cas ont \ue9t\ue9 exclus pour l\u2019insuffisance d\u2019information. Les donn\ue9es d\ue9mographiques, les sympt\uf4mes des maladies, les proc\ue9dures du diagnostic, l\u2019administration de m\ue9dicaments et le r\ue9sultat des traitements ont \ue9t\ue9 collect\ue9s du registre des malades. R\ue9sultats: L\u2019analyse des donn\ue9es a r\ue9v\ue9l\ue9 que plus des gar\ue7ons (213) que des filles (169) ont \ue9t\ue9 hospitalis\ue9s pour les traitements du paludisme. La fi\ue8vre avec convulsions (55,8 pour cent) \ue9tait plus fr\ue9quente tandis que l\u2019an\ue9mie \ue9tait la complication palud\ue9enne la plus not\ue9e. Il a \ue9t\ue9 aussi not\ue9 que la chloroquine a \ue9t\ue9 le m\ue9dicament antipalud\ue9en le plus prescrit et que les m\ue9dicaments sp\ue9cialis\ue9s \ue0 base de l\u2019Art\ue9misinine ont \ue9t\ue9, en tout et pour tout, prescrits en premi\ue8re et en deuxi\ue8me positions de traitement couvrant ainsi 18,2 pour cent seulement des cas. Le taux de mortalit\ue9 \ue9tait \ue0 16 pour cent. Conclusion: Le mod\ue8le de la prescription des m\ue9dicaments antipalud\ue9ens, dans le centre de cette \ue9tude, n\u2019a pas atteint le niveau des recommandations dans beaucoup de cas. Les prescriptions \ue9taient en majorit\ue9 la chloroquine au lieu des m\ue9dicaments sp\ue9cialis\ue9s a base Art\ue9misinine. Le taux de mortalit\ue9 est relativement \ue9lev\ue9. Des mesures d\u2019intensifier la sensibilisation pour les praticiens a travers s\ue9minaire et ateliers sur la Nouvelle Politique Nationale sur le traitement du paludisme ont \ue9t\ue9 sugg\ue9r\ue9es