MOTHER'S KNOWLEDGE, PERCEPTIONS AND USE OF ARTEMISININ BASED COMBINATION THERAPY FOR TREATING MALARIA AMONG UNDER-FIVES, IN IBARAPA CENTRAL LOCAL GOVERNMENT AREA, NIGERIA.

Abstract

The promotion of Artemisinin based Combination Therapy (ACT) in Nigeria involving use of Artemisinin - based drugs such as Coartem is due to the increasing prevalence of Chloroquine resistant malaria. However, the knowledge, perceptions and use of the therapy among mothers of under-fives have not been well explored. This study therefore assessed the knowledge, perceptions and pattern of use of ACT among mothers of under-fives in lbarapa Central Government Area, Oyo state, Nigeria. The study was a cross-sectional survey of mothers of under under-fives who consented to be involved in the study. Igboora and Idere, the two main communities in the LGA were purposively selected. A four- stage random sampling technique was used to select 720 participants from 360 households in the two communities. A validated questionnaire, which included a 36-point malaria and ACT knowledge scale was used for data collection. The data were analysed using descriptive statistics. The mean age was 29± 5.3 years and slightly more than half (50.7%) had primary education. Thirty percents had ever heard about ACT and the most common source of information was healthcare facilities (69.0%). The overall mean knowledge score on malaria and artemisinin-based combination drugs was 6.9 ± 4.8 while the mean knowledge scores by level of education were: non-formal education (5.8±3.6), primary (6.8±4.6); secondary (7.9±5.5) and tertiary education (11.3±6.4). Only 27.0% had ever used Coartem, the first-line artemisinin- based combination drug in Nigeria. Chloroquine was the first-line drug for treating children with malaria among 59.0% of current ACT users. The reasons adduced for the preference for Chloroquine included ready availability (30.2%), frequent prescription by health workers (27.8%) and low cost (12.4%). The level of formal education of current Coartem users were: none (17.1%). primary (47.7%). Secondary (22.5%) and tertiary education (10.7%). Respondents' pattern of treating children using ACT included doctors' prescription (17.6%)., mild fever (4.6%); and onset of malaria symptoms (3.3%). Most current users or Coartem (90.6%) obtained it from public health facilities. A majority (78.0%) of current ACT users correctly stated how it should be used while 80.0% were of the view that it was more effective compared with Chloroquine .Only 27.0% of participants perceived ACT to be more effective than Chloroquine and 90.6% considered it affordable. Many (59.0%) of the current users perceived artemisinin based combination drugs to be readily available. Seventy-eight percent of the current ACT users reported more tolerable side effects of the drug compared with Chloroquine. The level of knowledge of Artemisinin based Combination Therapy (ACT) w as low and use of Coartem as first-line drug for treating malaria in under-fives is not yet a common practice among nursing mothers in the study area. Advocacy, public enlightenment and social marketing strategies are necessary to address the situation.