Evaluation of availability and use of chroloqiune plus sulfadoxine pyrimethamine in Lira District

Abstract

Background Half of the world’s population is at the risk of malaria and an estimated 243million cases led to nearly 830,000 deaths in 2008, with most of the cases and death found in Africa. The morbidity and mortality caused by malaria in Africa is very high, especially in children under five years. Uganda is one of the African counties with very high malaria prevalence and Malaria is the leading cause of mortality even after the change of malaria treatment policy in 2006. Objectives: The determined the extent of availability and use of CQ and SP in Lira District and also to establish factors influencing their use in the community. Methods: A cross sectional survey was carried out in 20 health Facilities and 24 drug outlets in Lira district. From the drug outlets, data were collected on the availability of the different anti-malarial drugs, their cost, expiry dates, and different brands of ACTS. From the patients’ record forms in the health facilities, 318 prescriptions for malaria were reviewed. Data were collected on prescription pattern and accessibility of the drug by the patients from the facility. In the community, 81 household heads were interviewed. Here data was collected on the availability of drugs at home, sources of drugs, sources of medical advice and reasons for the preference of a particular drug and on demographics. Results: CQ (n=3, 13%) and SP (n=21, 88%) are still available in the drug outlets in Lira district. However, the availability of CQ in drug out lets is low compare to other anti-malarial medicines like Artemether Lumefantrine (n=22, 92%), Quinine (n=18, 75%). The extent of community use of CQ has declined since the introduction of ACTs. Only 10% of the 81 respondents were using CQ. Artemether+Lumefantrine (n=121, 38%) and Quinine (n=121, 38%) were the most prescribed antimalarial drugs by the health workers of Lira district. Conclusion: The availability and use of CQ has decreased in Lira district while the availability and use of SP has not changed. SP was mainly being used in IPTp and when ACTs were out of stock.