सार
Introduction: This paper assesses Patent Medicine Vendors’ (PMVs) practices, awareness of new Nigerian Artemisinin Combination Therapy (ACT) policy, the anti-malarial drugs in stock and how the PMVs identify fake drugs.
Methodology: PMVs and medicine shops were selected through a multi-stage random sampling process, beginning with the purposive selection of three states that reflect major geographic and ethno-linguistic areas of Nigeria: Oyo (Southwest-Yoruba), Kaduna (Northcentral-Hausa), and Enugu (Southeast-Igbo). Local Government Areas (LGAs) in selected states were stratified into urban and rural strata, with two LGAs randomly sampled from each stratum in each state, and one ward (urban LGAs) or community (rural LGAs) randomly sampled from a list in each LGA. A complete listing of PMVs and drug shops was constructed at each site, yielding 111 PMVs and 106 medicine shops. Out of this number, a total of 110 PMVs consented to be interviewed. Results: Some PMVs (43.1%) were aware of the 2005 government policy that changed the recommended first-line treatment for malaria from chloroquine (CQ) to ACT, but significant differences were found between states (p<0.001). PMV shops stocked many brands of anti-malarial drugs (average 5.5 brands), with ACTs stocked in only 8.5% of the stores at a mean price of N504 ($4) per treatment, compared to
sulfadoxine-pyrimethamine (92% of shops, mean price of N90 ($0.7) and even monotherapy artesunates (32% of shops, mean price of N39 ($0.3). The PMVs identify a drug not bearing the National Agency for Food & Drug Administration and Control (NAFDAC) identification number as being fake or counterfeit.
Conclusion: PMVs need to be a part of the strategy to change treatment to ACTs if there are to be meaningful changes in the anti-malarial drugs that Nigerians receive.
Keywords: Patent medicine vendors, malaria, ACT, awareness, policy.
Résumé
Ce papier évaluait les pratiques de vendeurs ambulants des médicaments (PMVs), la sensibilisation a la nouvelle politique des CTAs aux Nigérians, Les médicaments antipaludéens en stock et comment les vendeurs ambulants identifient les faux médicaments. Les vendeurs ambulants et les boutiques de médicaments étaient sélectionnés au hasard par la technique de multi stage des PMVs et boutiques, commençant par une sélection orientée des états qui reflètent leur position majeure géographique et ethnolinguistique au Nigeria: Oyo (Sud d’Oeust-Yoruba), Kaduna (Nord Oeust- Hausa),et Enugu (Sud d’ Est-Igbo). Les districts (LGAs) sélectionnés dans les états étaient stratifiés en strates urbain et rural avec deux districts sélectionnés dans chaque état, et un quartier sélectionné (urbain)ou communauté(rurale). Une liste complète des PMVs et des boutiques de médicaments était construit à chaque coté, produisant 111 PMVs et 106 boutiques. 110 PMVs consentaient d’être interviewés. Quelques PMVs (43.1%) étaient éveillés dans la politique du gouvernement de 2005 qui à changer la première ligne de traitement recommandé du paludisme chloroquine (CQ) au CTA, mais des différences significatives étaient retrouvées entre les états (p<0.001). Les boutiques PMV stockaient plusieurs variétés des médicaments antipaludéens (moyenne 5.5 marques), avec CTAs stockés seulement dans 8.5% des boutiques au prix moyen de N504 ($4) par traitement, comparé à la sulfadoxine-pyrimethamine (92% des boutiques, prix moyen N90 ($0.7) et même artesunate monothérapie (32% des boutiques, prix moyen N39 ($0.3). Les PMVs identifient le médicament ne portant pas le numéro d’identification et d’enregistrement à l’agence de contrôle et d’administration des substances et médicaments au National (NAFDAC) comme étant des faux produits. PMVs doit faire partir des stratégies pour changer au CTAs si nous désirons les changements des médicaments antipaludéens reçu au Nigeria.
Correspondence: Prof. O. Oladepo, Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan. E-mail: oladepod@yahoo.com
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