Abstract:
Background: Despite recent strides made towards reducing the emergence of artemisinin resistance, inappropriate
dispensing practices for anti-malarials in both private and public sectors affect treatment outcomes negatively. In
Ghana, private retail pharmacies are the most accessible health facilities for managing diseases of common occurrence.
However, there is growing concern about the number of patients harmed by dispensing errors in the management
of malaria in retail pharmacies. Although considerable work has been done in this area, several questions
regarding dispensing practices remain unanswered. This study, therefore, sought to investigate the predictors of
appropriate dispensing practices for anti-malarials in community pharmacies in the La Nkwantanang-Madina municipality
of Greater Accra, Ghana.
Methods: A cross-sectional analytic study was conducted in sixty-one randomly selected community pharmacies
in the La Nkwantanang-Madina. Data from 230 clients and 106 dispensers were analysed. It was checked for internal
consistency and completeness then entered and analysed using STATA I/C version 14.0. Frequencies, Chi square tests,
and logistic regression analyses were conducted, accounting for clustering.
Results and discussion: Of the 106 dispensers interviewed, 71.4% were medicine counter assistants. The mean age
of dispensers was 30.4 years (SD 8.8). Over 88.0% of clients were advised to complete the full course of their antimalarials.
However, the 8-h loading dose principle for artemether-lumefantrine was not explained to 88.3% of the
clients. More than half of the clients (52.2%) were given appropriate dispensing information on anti-malarial use. Most
clients (66.1%), were dispensed anti-malarials without malaria tests. Dispensers with more than a 10-years experience
were less likely to dispense artemisinin-based combinations appropriately relative to dispensers with less than 2 years
experience (AOR = 0.04, 95% CI 0.002–0.802 p-value = 0.036) while pharmacy interns were about 19 times more likely
(AOR = 18.5, 95% CI 1.40–245.6 p-value = 0.03) to dispense artemisinin-based combinations appropriately compared
to pharmacists.
Conclusion: Dispensing practices for anti-malarials is unsatisfactory. There is a need to enforce existing legislation
with educational programmes directed towards dispensers especially those with more than 10 years experience.
Specific adherence to the World Health Organization Test, Treat and Track initiative should be encouraged to ensure
effective use of anti-malarials.
