Effect of training on knowledge of antimalarial treatment policy and treatment practices of patent medicine vendors operating in rural areas of Lagos State Nigeria

Wednesday, 20 August 2014
Exhibit hall (Dena'ina Center)
Abisoye S Oyeyemi , College of Health Sciences, Niger Delta University, Bayelsa State, Nigeria
Babatunde E Ogunnowo , College of Medicine, University of Lagos, Lagos, Nigeria
Oluwakemi O Odukoya, MD , University of Lagos, Lagos, Nigeria
INTRODUCTION: Patent medicine vendors (PMVs) play an important role in community-based management of malaria in Nigeria. Nigeria adopted artemisinin-based combination therapy (ACT) for the treatment of uncomplicated malaria in 2004. This study aimed to determine the effect of training on the knowledge of the new antimalarial treatment policy and treatment practices of PMVs operating in rural local government areas (LGAs) of Lagos State Nigeria.

METHODS:  A group - randomized controlled trial was conducted. Two out of the four rural LGAs in the state were randomly selected into the intervention and control LGAs. Baseline data were collected using a questionnaire, observational checklist, and mystery client form. In each LGA, 90 PMVs were interviewed, their shops were observed, and mystery clients visited 20 of the shops. A training programme was conducted for the intervention LGA and post-intervention data were collected using the same instruments. The main outcome measures were “good” knowledge of the new policy, stock of recommended ACTs and sale of recommended ACTs.

RESULTS:  The training increased “good” knowledge of the policy by 35.5% (p<0.0001) in the intervention LGA compared to 6.6% in the control LGA (p=0.189). Shops having a stock of recommended ACTs increased by 25.6% (p<0.001) in the intervention LGA compared to 4.5% (p=0.597) in the control LGA. Post-intervention, 20% more PMVs (p=0.273) offered mystery clients ACTs as first antimalarial drug compared to 15% (p=0.501) in the control LGA.

CONCLUSIONS: Training of PMVs improved their knowledge of the current antimalarial treatment policy and their treatment practices but other determinants of malaria treatment in the rural areas need to be addressed. Nation-wide training of PMVs operating in the rural areas is recommended.