title: Exposure to anti-malarial drugs and monitoring of adverse drug reactions using toll-free mobile phone calls in private retail sector in Sagamu, Nigeria: implications for pharmacovigilance.
abstract: BACKGROUND
  Adverse drug reactions (ADRs) contribute to ill-health or life-threatening outcomes of therapy during management of infectious diseases. The exposure to anti-malarial and use of mobile phone technology to report ADRs following drug exposures were investigated in Sagamu--a peri-urban community in Southwest Nigeria.
  
  
  METHODS
  Purchase of medicines was actively monitored for 28 days in three Community Pharmacies (CP) and four Patent and Proprietary Medicine Stores (PPMS) in the community. Information on experience of ADRs was obtained by telephone from 100 volunteers who purchased anti-malarials during the 28-day period.
  
  
  CONCLUSIONS
  A total of 12,093 purchases were recorded during the period. Antibiotics, analgesics, vitamins and anti-malarials were the most frequently purchased medicines. A total of 1,500 complete courses of anti-malarials were purchased (12.4% of total purchases); of this number, purchases of sulphadoxine-pyrimethamine (SP) and chloroquine (CQ) were highest (39.3 and 25.2% respectively). Other anti-malarials purchased were artesunate monotherapy (AS)--16.1%, artemether-lumefantrine (AL) 10.0%, amodiaquine (AQ)--6.6%, quinine (QNN)--1.9%, halofantrine (HF)--0.2% and proguanil (PR)--0.2%. CQ was the cheapest (USD 0.3) and halofantrine the most expensive (USD 7.7). AL was 15.6 times ($4.68) more expensive than CQ. The response to mobile phone monitoring of ADRs was 57% in the first 24 hours (day 1) after purchase and decreased to 33% by day 4. Participants in this monitoring exercise were mostly with low level of education (54%).
  
  
  CONCLUSIONS
  The findings from this study indicate that ineffective anti-malaria medicines including monotherapies remain widely available and are frequently purchased in the study area. Cost may be a factor in the continued use of ineffective monotherapies. Availability of a toll-free telephone line may facilitate pharmacovigilance and follow up of response to medicines in a resource-poor setting.
authors.affiliation: Communicable Disease Research Unit, Olabisi Onabanjo University Teaching Hospilal Sagamu, PMB 2002, Nigeria. ahmedade1@yahoo.co.uk
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Adedeji
authors.forename: Bilqees
authors.initials: B
authors.lastname: Sanusi
authors.forename: Azeez
authors.initials: A
authors.lastname: Tella
authors.forename: Motunrayo
authors.initials: M
authors.lastname: Akinsanya
authors.forename: Olubusola
authors.initials: O
authors.lastname: Ojo
authors.forename: Mufliat O
authors.initials: MO
authors.lastname: Akinwunmi
authors.forename: Olubukola A
authors.initials: OA
authors.lastname: Tikare
authors.forename: Isiaka A
authors.initials: IA
authors.lastname: Ogunwande
authors.forename: Omobola A
authors.initials: OA
authors.lastname: Ogundahunsi
authors.forename: Olajide O
authors.initials: OO
authors.lastname: Ayilara
authors.forename: Taofeeqah T
authors.initials: TT
authors.lastname: Ademola
authors.forename: Fatai A
authors.initials: FA
authors.lastname: Fehintola
authors.forename: Olumide A T
authors.initials: OA
authors.lastname: Ogundahunsi
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use*; D040421:Cell Phone; D004363:Drug Utilization / Q000706:statistics & numerical data; D006801:Humans; D009549:Nigeria
chemical_list: D000962:Antimalarials