The Pattern of Act Prescription in the Ledzokuku-Krowor Municipal Assembly

Abstract

Introduction: The concerns of possible resistance development by P. falciparum to most artemisinin-based combination therapies (ACT’s) is imminent and to an extent due to the non-uniform use of the ACT’s and drug pressure. This has necessitated the need to routinely monitor the drug efficacy every couple of years in all countries where malaria is endemic and studies on patterns of ACT prescription is also needed as an essential component to complement efficacy studies. Objective: To describe the patterns of ACT prescription in the Ledzokuku-Krowor Municipal Assembly. Method: A descriptive cross-sectional survey was carried out for the study. Five (5) health care facilities were randomly selected within the Ledzokuku-Krowor Municipal Assembly. All prescribers within the selected health care facilities were administered with structured questionnaires. Also, fifty (50) patient folders were randomly selected from a pool of 2017 confirmed malaria cases at the Out-Patient Department (OPD) in each of the five selected health care facilities. Data on the ACT types prescribed for patients who were diagnosed with malaria was abstracted. Results: The most frequently prescribed ACT for uncomplicated and complicated malaria were artemether-lumefantrine 62.4% (156/250) and artesunate injection + artemether-lumefantrine 22.4% (56/250) respectively. The proportion of uncomplicated malaria cases correctly treated was 73.6% (184/250) and that for complicated malaria cases correctly treated was 85% (56/66). The most prevailing reasons given by all the prescribers that governed their choice of ACT prescribed included ready availability of the drugs 32.3% (20/62), its effectiveness 22.6% (14/62), side effect 19.4% (12/62) and cost 16.1% (10/62). Prescribers age (P<0.05), occupation (whether specialist or general practitioner) (P<0.001) and work experience (P<0.001) were found to be significantly associated with the ACT type they prescribed Conclusion: This study indicates that there is implementation of artemisinin combination therapy (ACT) prescription for malaria cases in health facilities within the Ledzokuku-Krowor Municipal Assembly however there is the need for the National Malaria Control Program (NMCP) to roll out campaign programs on the various ACTs available in Ghana and the need to vary their prescription in order to prevent pressure on one type in order to delay possible resistance that could develop.