Orapuh Journal | Journal of Oral & Public Health
Adherence to national malaria treatment guidelines: A retrospective study among healthcare workers in community pharmacies, Kinshasa, Democratic Republic of the Congo
PDF

Keywords

Adherence
treatment guideline
malaria management
PNLP
Urban Kinshasa

How to Cite

Mankulu Kakumba, J., Ive Kitenge, D., Mugisho Kasago, F., Kimbeni Malongo, T., Mbinze Kindenge, J., & Mana Kialengila, D. (2024). Adherence to national malaria treatment guidelines: A retrospective study among healthcare workers in community pharmacies, Kinshasa, Democratic Republic of the Congo. Orapuh Journal, 5(5), e1149. https://doi.org/10.4314/orapj.v5i5.49

Abstract

Introduction

Malaria is one of the leading causes of mortality in developing countries and remains a major public health problem globally.

Purpose

This retrospective cross-sectional study aimed to evaluate prescribers' adherence to the national malaria management policy in Kinshasa, DRC. Eight publicly accessible community pharmacies were randomly selected to collect malaria prescriptions in the Tshangu district.

Methods

The study surveyed authorized pharmacies and patients who agreed to participate through a simple, easy-to-understand questionnaire. A total of 1,088 prescriptions were collected. Of the 448 (41.2%) for treating severe malaria, 388 (86.6%) contained injectable Artesunate, 36 (8.04%) injectable Artemether, 24 (5.36%) injectable quinine, and 428 (95.5%) antibiotics. Of the 640 (58.8%) prescriptions for treating simple malaria, 488 (76.25%) contained Artemether-Lumefantrine tablets, 68 (10.625%) quinine tablets, 36 (5.625%) other antimalarials outside the recommended therapeutic combinations, and 552 (86.2%) antibiotics.

Results

The rate of adherence to the national malaria treatment policy was 18.75% for the treatment of severe malaria and 76.25% for the treatment of simple malaria.

Conclusion

Ongoing training for prescribers on national malaria management guidelines and increased public awareness of the activities of the National Malaria Control Program (PNLP) are necessary to improve adherence to the national malaria management policy. Additionally, we recommend that authorities ensure the guidelines are enforced by conducting periodic investigations in regional medical centers, with a focus on adherence to prescription rules.

https://doi.org/10.4314/orapj.v5i5.49
PDF

References

Akinde, O. S., & Taiwo, M. O. (2017). Emerging antibiotic resistance in Africa, threat to healthcare delivery. MOJ Biology and Medicine, 1, 114–115.

Ampadu, H. (2019). Prescribing patterns and compliance with World Health Organization recommendations for the management of severe malaria: A modified cohort event monitoring study in public health facilities in Ghana and Uganda. Malaria Journal, 18, 36.

Assefa, T., Abera, B., Bacha, T., & Beedemariam, G. (2018). Prescription completeness and drug use pattern in the university teaching hospital, Addis Ababa, Ethiopia. Journal of Basic and Clinical Pharmacy, 9, 90-95.

Batwala, V., Magnussen, P., Hansen, K. S., & Nuwaha, F. (2011). Cost-effectiveness of malaria microscopy and rapid diagnostic tests versus presumptive diagnosis: Implications for malaria control in Uganda. Malaria Journal, 10, 372.

CDC (Centre for Disease Control and Prevention). (2016). Impact of malaria.

Chinkhumba, J., Skarbinski, J., Chilima, B., Campbell, C., Ewing, V., San Joaquin, M., Sande, J., Ali, D., & Mathanga, D. (2010). Comparative field performance and adherence to test results of four malaria rapid diagnostic tests among febrile patients more than five years of age in Blantyre, Malawi. Malaria Journal, 9, 209.

Ciza, P. H., Sacre, P.-Y., Waffo, C., Coïc, L., Avohou, H., Mbinze, J. K., Ngono, R., Marini, R. D., Hubert, P., & Ziemons, E. (2019). Comparing the qualitative performances of handheld NIR and Raman spectrophotometers for the detection of falsified pharmaceutical products. Talanta, 1(202), 469–478.

Diggle, E., Asgary, R., Gore-Langton, G., Nahashon, E., Mungai, J., Harrison, R., Abagira, A., Eves, K., Grigoryan, Z., Soti, D., Juma, E., & Allan, R. (2014). Perceptions of malaria and acceptance of rapid diagnostic tests and related treatment practises among community members and health care providers in Greater Garissa, North Eastern Province, Kenya. Malaria Journal, 13, 502.

Dodoo, A. N. O., Fogg, C., Asiimwe, A., Nartey, E. T., Kodua, A., Tenkorang, O., & Ofori-Adjei, D. (2009). Pattern of drug utilization for treatment of uncomplicated malaria in urban Ghana following national treatment policy change to artemisinin-combination therapy. Malaria Journal, 8, 2.

D’Acremont, V., et al. (2011). Reduction of anti-malarial consumption after rapid diagnostic tests implementation in Dar es Salaam: A before-after and cluster randomized controlled study. Malaria Journal, 10, 107.

Gindola, Y., Getahun, D., Sugerman, D., Tongren, E., Tokarz, R., Wossen, M., Demissie, K., Zemelak, E., Okugn, A., Wendimu, J., Hailu, G., Tegistu, M., & Begna, D. (2022). Adherence to national malaria clinical management and testing guidelines in selected private clinics of Gambela Town, Gambela Region, Ethiopia: A mixed method study. Malaria Journal, 21(164), 2.

Irikefe, P. O. (2019). Adherence to antimalarial drug policy among doctors in Delta State, Nigeria: Implications for malaria control. Ghana Medical Journal, 53(2), 109-116.

Kaur, H., Allan, E. L., Mamadu, I., Hall, Z., Ibe, O., El Sherbiny, M., van Wyk, A., Yeung, S., Swamidoss, I., Green, M. D., Dwivedi, P., Culzoni, M. J., Clarke, S., Schellenberg, D., & Fernandez, F. M. (2015). Quality of artemisinin-based combination formulations for malaria treatment: Prevalence and risk factors for poor quality medicines in public facilities and private sector drug outlets in Enugu, Nigeria. PLOS One, 10(5).

Kakumba, J. M., Kindenge, J. M., Kapepula, P. M., Iyamba, J. M. L., Mashi, M. L., Mulwahali, J. W., & Kialengila, D. M. (2023). Evaluation of antibiotic prescribing pattern using WHO Access, Watch, and Reserve classification in Kinshasa, Democratic Republic of Congo. Antibiotics, 12, 1239.

Makenga, G., Menon, S., Baraka, V., Minja, T. T., Nakato, S., Delgado-Ratto, C., Francis, F., Lusingu, J. P. A., & Van Geertruyden, J. P. (2020). Prevalence of malaria parasitaemia in school-aged children and pregnant women in endemic settings of sub-Saharan Africa: A systematic review and meta-analysis. Parasite Epidemiology and Control, 11, 00188.

Mana, D. K., Kapepula, P. M., & Ngombe, N. K. (2021). Completeness assessment of handwritten medical prescriptions in Southeast Kinshasa community pharmacies. International Journal of Pharmaceutical Sciences and Research, 12(9), 5117-5124.

Manyando, C., Njunju, E. M., Chileshe, J., Siziya, S., & Shiff, C. (2014). Rapid diagnostic tests for malaria and health workers’ adherence to test results at health facilities in Zambia. Malaria Journal, 13, 166.

PNLP (Programme National de Lutte contre le Paludisme). (2017). Equipe de l’évaluation d’impact de la RDC. Evaluation de l’impact des interventions de lutte contre le paludisme sur la mortalité toutes causes confondues chez les enfants de moins de cinq ans en République Démocratique du Congo de 2005 à 2015: Synthèse des résultats préliminaires.

PNLP. (2020). Plan Stratégique National de Lutte contre le Paludisme 2020-2023, 22.

PNLP. (2023). Plan Stratégique National de Lutte contre le Paludisme RDC, Kinshasa 2020-2023, 15.

Salomão, C. A., Sacarlal, J., Chilundo, B., & Gudo, A. S. (2015). Prescription practices for malaria in Mozambique: Poor adherence to the national protocols for malaria treatment in 22 public health facilities. Malaria Journal, 14, 483.

Sigauque, B., Bardají, A., Sanz, S., Maixenchs, M., Ordi, J., Aponte, J. J., Mabunda, S., Alonso, P. L., & Menéndez, C. (2011). Impact of malaria at the end of pregnancy on infant mortality and morbidity. Journal of Infectious Diseases, 203, 691–699.

Tiono, A. B., Ouedraogo, A., Bougouma, E. C., Diarra, A., Konaté, A. T., Nébié, I., & Sirima, S. B. (2009). Placental malaria and low birth weight in pregnant women living in a rural area of Burkina Faso following the use of three preventive treatment regimens. Malaria Journal, 8, 1-8.

WHO (World Health Organization). (2002). Promoting rational use of medicines: Core components – WHO policy perspectives on medicines.

WHO. (2012). World malaria report, 27–58.

WHO. (2020). World malaria report.

WHO. (2021). Access, Watch, Reserve (AWaRe) classification of antibiotics for evaluation and monitoring of use.

WHO. (2021). World malaria report.

WHO. (2021). WHO malaria treatment guidelines (2nd ed.).

WHO. (2022). Guidelines for the treatment of malaria (3rd ed.). World Health Organization, Regional Office for Africa.

WHO. (2024). World malaria day: Accelerating the fight against malaria for a more equitable world.

Yilma, Z., Mekonnen, T., Siraj, E. A., Agmassie, Z., Yehualaw, A., Debasu, Z., Tafere, C., & Ararsie, M. (2020). Assessment of prescription completeness and drug use pattern in Tibebe-Ghion Comprehensive Specialized Hospital, Bahir Dar, Ethiopia. Biomedical Research International, 2(6), 111-115.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.