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EFFECT OF ARTEMISININ-BASED TREATMENT POLICY ON CONSUMPTION PATTERN OF ANTIMALARIALS

The purpose of this study was to observe the effect of the 2004 national artemisinin-based malaria treatment policy on consumption pattern of antimalarials. The study was undertaken at the University of Ilorin Teaching Hospital (UITH), Nigeria. Prescription and sales data at our pharmacy outlets were gathered from January to December 2004 and compared with similar data for 2005 after policy introduction in January 2005. Total consumption of antimalarials in 2004 was 23,404 doses, made up of artemisinin-containing medications (ACMs; 18.5%); sulphadoxine-pyrimethamine (SP; 7.1%); chloroquine (CQ; 72.85%); and quinine (QUI; 1.6%), compared with 26,383 doses in 2005, made up of ACMs (50.00%); SP (22.7%); CQ (27.3%); and QUI (0%). Z-tests indicate that these differences in proportions were significant (P < 0.001) for ACMs and SP (increased) and decreased for CQ and QUI. The comparative retail price per dose of these medications was in the order: ACMs > QUI > SP > CQ. These data show increased use of antimalarials, with ACMs overtaking CQ as the dominant antimalarial class purchased from the pharmacies operated by the hospital in the first year of policy implementation. This suggests that cost alone may not be the overriding determinant of specific antimalarial consumption.

Received February 2, 2006. Accepted for publication August 15, 2006.

Acknowledgments: The authors thank our A. T. Orunmuyi, MBBS, for help in preparing the typescript. O.A.M. is a member of the training Sub Committee of the National Transition Committee on the 2004 artemisinin-based treatment policy of Nigeria since March 2005. A preliminary communication of part of our data was presented to Paediatrics Association of Nigeria in Jos, Nigeria in January 2006. This work is dedicated to the memory of Olukoye Ransome-Kuti, FWACP, and to Soludo Charles, PhD. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.

Disclaimer: No authors have any financial or other affiliations to any of the entities involved in the manufacturing or supply of antimalarial drugs.

^* Address correspondence to Emmanuel O. Okoro, Department of Medicine, University of Ilorin, PMB 1515 Ilorin, Kwara State, Nigeria. E-mail: eookoro2003{at}yahoo.co.uk

Authors’ addresses: Olugbenga A. Mokuolu, Directorate of Clinical Services and Training, University of Ilorin Teaching Hospital, PMB 1459, Ilorin, Kwara State, Nigeria. Emmanuel O. Okoro, Department of Medicine, University of Ilorin, PMB 1515 Ilorin, Kwara State, Nigeria, E-mail: eookoro2003{at}yahoo.co.uk. Susan O. Ayetoro, Committee for Safety and Efficacy of Medicines and Medical Devices, University of Ilorin Teaching Hospital, PMB 1459, Ilorin, Kwara State, Nigeria. Amos A. Adewara, Department of Statistics, University of Ilorin, PMB 1515, Ilorin, Kwara State, Nigeria.