title: Differences in malaria care seeking and dispensing outcomes for adults and children attending drug vendors in Nasarawa, Nigeria.
abstract: OBJECTIVE
  To characterise the differences in care seeking behaviour and dispensing outcomes between adults and children purchasing drugs for malaria at retail shops in Nigeria.
  
  
  METHODS
  In Nasarawa State, retail drug shops were enumerated and a subset of those stocking antimalarials were selected as study sites and surveyed. Customers exiting shops after purchasing antimalarial drugs were surveyed and tested with a malaria rapid diagnostic test. Sick adults and caregivers accompanying sick children were eligible, but individuals purchasing drugs for a sick person that was not present were excluded. Multivariate regression analysis was used to identify the correlates of care seeking and the quality of interaction at the shop.
  
  
  RESULTS
  Of 737 participants, 80% were adults and 20% were children (under age 18). Caregivers of sick children were more likely to obtain a prescription prior to attending a drug retailer than adults seeking care for themselves and waited a shorter time before seeking care. Caregivers of sick children were also more likely than sick adults to have been asked about symptoms by the retailer, to have been given an examination, and to have purchased an ACT. Fewer than half of respondents had purchased an ACT. Only 14% of adults, but 27% of children were RDT-positive; RDT-positive children were more likely to have had an ACT purchased for them than RDT-positive adults.
  
  
  CONCLUSIONS
  Children with suspected malaria tend to receive better care at drug retailers than adults. The degree of overtreatment and prevalence of dispensing non-recommended antimalarials emphasise the need for routine diagnosis before treatment to properly treat both malaria and non-malaria illnesses.
authors: Global Health Group, Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.
authors: Jenny
authors: J
authors: Liu
authors: Society for Family Health, Garki, Abuja, FCT, Nigeria.
authors: Chinwoke
authors: C
authors: Isiguzo
authors: Global Health Group, Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.
authors: Maia
authors: M
authors: Sieverding
mesh_terms: D000328:Adult; D000367:Age Factors; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003132:Commerce; D003625:Data Collection; D003955:Diagnostic Tests, Routine; D004359:Drug Therapy, Combination; D005260:Female; D015438:Health Behavior; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D010593:Pharmaceutical Services; D010594:Pharmacies; D015995:Prevalence; D055815:Young Adult
chemical_list: D000962:Antimalarials; D037621:Artemisinins
keywords: Nigeria; boutiques de médicaments; búsqueda de cuidados para malaria; care seeking; drug shops; farmacias; malaria; paludisme; recherche de soins