title: Self-reported use of anti-malarial drugs and health facility management of malaria in Ghana.
abstract: OBJECTIVE
  To assess the appropriateness of self-reported use of anti-malarial drugs prior to health facility attendance, and the management of malaria in two health facilities in Ghana.
  
  
  METHODS
  A structured questionnaire was used to collect data from 500 respondents who were diagnosed clinically and/or parasitologically for malaria at Agogo Presbyterian Hospital and Suntreso Polyclinic, both in the Ashanti Region of Ghana. Collected information included previous use of anti-malarial drugs prior to attending the health facilities, types of drugs used, how the drugs were used, and the sources of the drugs. In addition, the anti-malarial therapy given and outcomes at the two health facilities were assessed.
  
  
  RESULTS
  Of the 500 patients interviewed, 17% had severe malaria, 8% had moderate to severe malaria and 75% had uncomplicated malaria. Forty three percent of the respondents had taken anti-malarial drugs within two weeks prior to hospital attendance. The most commonly used anti-malarials were chloroquine (76%), sulphadoxine-pyrimethamine (9%), herbal preparations (9%) and amodiaquine (6%). The sources of these medicines were licensed chemical sellers (50%), pharmacies (21%), neighbouring clinics (9%) or "other" sources (20%) including left-over medicines at home. One hundred and sixty three (77%) of the 213 patients who had used anti-malarial drugs prior to attending the health facilities, used the drugs inappropriately. At the health facilities, the anti-malarials were prescribed and used according to the national standard treatment guidelines with good outcomes.
  
  
  CONCLUSIONS
  Prevalence of inappropriate use of anti-malarials in the community in Ghana is high. There is need for enhanced public health education on home-based management of malaria and training for workers in medicine supply outlets to ensure effective use of anti-malaria drugs in the country.
authors.affiliation: Department of Social Pharmacy, University of Kuopio, Finland. ohenebuabeng@msn.com
authors.forename: Kwame O
authors.initials: KO
authors.lastname: Buabeng
authors.forename: Mahama
authors.initials: M
authors.lastname: Duwiejua
authors.forename: Alex N O
authors.initials: AN
authors.lastname: Dodoo
authors.forename: Lloyd K
authors.initials: LK
authors.lastname: Matowe
authors.forename: Hannes
authors.initials: H
authors.lastname: Enlund
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005869:Ghana; D006268:Health Facilities; D006306:Health Surveys; D006801:Humans; D008288:Malaria / Q000188:drug therapy*; D010353:Patient Education as Topic; D011446:Prospective Studies; D012651:Self Medication; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials