Determination of Adherence to Artemisinin-Based Combination Therapy (Act) As the First Line Treatment of Uncomplicated Malaria in the Mampong Municipality, Ashanti

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INTRODUCTION Following the failure of chloroquine as first line for the treatment of uncomplicated malaria, many countries including Ghana have changed their anti-malarial treatment policy to artemisinin-based combination therapy (ACT). However, adherence remains the key to the realisation of the goals of the new policy. OBJECTIVES The main objective was to determine the adherence of prescribers and clients to ACT as the first line treatment of uncomplicated malaria in Mampong Municipality. METHODOLOGY A descriptive cross-sectional survey using methods recommended in the WHO guidelines on “How to investigate drug use in health facilities” by the “International Network for the Rational Use of Drugs (INRUD)” was employed. A total of 2,776 OPD records of cases of uncomplicated malaria between 1st January, 2006 to 31st December, 2008 were systematically sampled and reviewed. Fifteen prescribers, eleven pharmacist/dispensing technicians and 250 clients were interviewed. All the six accredited NHIS Pharmacies (2) and chemical shops (4) and ten randomly selected chemical shops were also surveyed for the availability of ACT. FINDINGS Prescribers and clients adherence to ACT was found to be moderate (75.4 percent and 74.4 percent for prescribers and clients respectively) although prescribers had been trained and were prescribing ACT as first line treatment for uncomplicated. Some prescribers still prescribe mono-therapies such as suspension amodiaquine since they claimed there is no better formulation of ACT (Artesunate-Amodiaquine) for children. xiii ACT was available in all public health facilities in the municipality. ACT prescribing increased from 2006 to 2008 as chloroquine and sulfadoxine pyrimethamine prescribing reduced to zero in 2008. Major side effect of ACT was bodily weakness. CONCLUSION Adherence to the new anti-malaria treatment policy was found to be 75.4 percent and 74.4 percent for prescribers and clients respectively at the time of the survey.
A Thesis Submitted to the Department of Clinical and Social Pharmacy In Partial Fulfilment of the Requirement for the Award of MASTER of CLINICAL PHARMACY,