Problems of chloroquine-resistant P. falciparum in Nigeria: one antimalaria drugs' utilisation in metropolitan Calabar.

We studied the antimalarial drugs utilisation pattern in urban Calabar, with a view to determining what drugs people take when they have malaria attack and who diagnoses and prescribes the drugs. We used a standard questionnaire data sheet to record the results of the interview carried out by the authors. Malaria symptoms and the drugs consumed were diagnosed and prescribed respectively by self (54pc), qualified medical doctor (32pc) and others including paramedical staff (2pc). The rest (12pc) took traditional remedies. The antimalarial drugs (chloroquine, fansidar, camouqin) were chosen because of their efficacy/popularity (21pc), cheapness (43pc) and availability (34pc). Among those interviewed, only 21.2pc took the adequate curative dose of 25 mg/kg chloroquine for 3 days according to WHO recommendations. Majority of the consumers took their drugs orally, but some (17pc) had chloroquine injections, administered, in some cases, by ill-qualified patient medicine dealer. The results show that there is an association between the level of education and the pattern of remedy sought by the respondents (p less than 0.05). Self-medication was practised significantly more by those with formal education than by those without (p less than 0.05). The trend of consulting patent medicine dealers for prescription decreased with acquisition of more formal education. Conversely, significantly more of the respondents with higher education consulted qualified medical doctors or paramedical staff (P less than 0.05). Two aspects of drug abuse observed here, i.e. the utilisation of sub-curative doses of chloroquine and monotherapy are believed to be two of the factors that lead to the several chloroquine treatment failures which have been recently reported in Calabar, and other areas of Nigeria.