Prescribing Patterns of Antimalarial Drugs in Urban Health Facilities in Dar-es-Salaam, Tanzania with Special Emphasis on Sulfa-based Drugs

S E D Nsimba; A Y Massele; M Y Warsame; G Tomson

S E D Nsimba Muhimbili College of Health Sciences, P.O. Box 65010, Dar-es-Salaam, Tanzania
A Y Massele Muhimbili College of Health Sciences, P.O. Box 65010, Dar-es-Salaam, Tanzania
M Y Warsame Division of International Health Care Research (IHCAR), Department of Public Health Sciences, Karolinska Institutet, S-17176, Stockholm, Sweden
G Tomson Muhimbili College of Health Sciences, P.O. Box 65010, Dar-es-Salaam, Tanzania

Keywords: Antimalarial drugs, sulfa-based drugs, rational prescribing, Health care providers, Prescribers.

Abstract

Proper diagnosis of malaria, rational prescribing and use of antimalarial drugs are fundamental to malaria case management, prevention of drug resistance and reduction of side effects. We assessed the prescribing pattern of antimalarial drugs in 2 health centres and 3 district hospitals in the Dar-es-salaam region. A total of 2500 prescriptions issued to outpatients from these facilities were investigated. Furthermore, a questionnaire was administered to those outpatients whose prescriptions contained antimalarial drugs. The majority of the outpatients (78%) reported to have used chloroquine before, while 66% admitted using sulfa-based antimalarial drugs once or more times before. Of the prescriptions issued 60% contained sulfa-based drugs while 40% had chloroquine. Most patients (85%) did not know the difference between the sulfa-based drugs, while 33% did not know how to use them. Private pharmacies were the main sources of these sulfa-based drugs since they were not available at the health facilities.
This study shows that most patients are not aware of the type of drugs being prescribed to them or how to use them properly. The high prescription rate of sulfa-based drugs without proper diagnosis of resistant malaria seems irrational. Thus, there is a need for educational programmes targeting prescribers in these facilities. It is also important to assess the dispensing behaviours of drug sellers and the prescribing practices of health care providers in private facilities in Dar-es-salaam and in the country.