Assessment of compliance to WHO's Test, Treat and Track (T3) Initiative of Artemisinin-Combination-Therapy (ACT) among Pharmacists and Patent Proprietary Medicine Vendors in Urban and Rural Lagos, Southwest Nigeria

• Published in: Diversity and equality in health and care 2020-01, Vol.17 (6)
• Main Authors: Olukosi, Adeola, Bamgboye M Afolabi, Sola, Ajibaye, Ayorinde, James, Sabdat kama, Aina, O O, Agomo, C O, Musa, A Z, Salako, Babatunde
• Format: Article
• Language: English
• Subjects: Case management; Combination therapy; Community pharmacists; Compliance; Drug stores; Higher education; Malaria; Pharmacies; Pharmacists; Pharmacy; Rural areas; Rural communities; Secondary education; Semistructured questionnaires; Technicians; Vendors
• ISSN: 2049-5471; 2049-548X

Background: Community pharmacies and Patent Proprietary Medicine Vendors (PPMVs) play key roles in case management of malaria at the community level. However, their compliance with the WHO Test, Treat and Track (T3) Initiative for effective management of malaria cases are poorly documented. This study assessed the degree to which community pharmacies and PPMVs comply with the T3 initiative in Mushin, an urban area and in rural area of Ikorodu in Lagos State, Nigeria. Methods: This was a cross-sectional exploratory study that collected data with a semi-structured questionnaire from pharmacies and PPMV outlets. Results: A total of 136 drug outlets (75 in urban, 61 in rural settings), manned by 44 Pharmacists, 8 Pharmacy technicians, 15 Pharmacy assistants and 69 PPMVs participated in this survey. Most staff (73, 53.7%) was aged 21-30 years with more males (87, 64.0%) than females (49, 36.0%). In all, 51 (37.5%) had post-secondary education with only 3 (2.2%) having no formal education. Pharmacists were approximately five times more likely to have been trained on RDT/ACT use than PPMVs (χ²=18.57, P-value=0.00002, OR=4.91, 95% CI: 2.34, 10.31), more in rural (χ²=8.44, P-value=0.004, OR=5.60, 95% CI: 1.68, 18.70) than in urban (χ²=5.23, P-value=0.02, OR=3.27, 95% CI: 1.17, 9.15) setting. Sale of ACT based on RDT test was slightly more likely among PPMVs than Pharmacists (χ²=0.37, P-value=0.54, OR=1.44, 95% CI: 0.45, 4.62) in urban setting but more likely among Pharmacists than among PPMVs in rural setting (χ²=0.71, P-value=0.40, OR=1.69, 95% CI: 0.50, 5.71). Overall, 102 (75.0%) respondents (52 from Pharmacies and 50 from PPMVs) reviewed their clients and 63.1% referred them to the hospital if they did not get better. Conclusion: This study demonstrated that overall, the “Test, Treat and Track” initiative of the WHO was moderately implemented in both the urban and rural study sites. Pharmacists and allied professions in rural setting were trained on the use of RDT to diagnose malaria, but very few PPMVs in urban setting received such training. PPMV’s should be further empowered in the urban settings to promote the T3 initiative.