ASSESSMENT OF KNOWLEDGE ON USE OF ARTEMETHER LUMEFANTRINE IN MANAGEMENT OF UNCOMPLICATED MALARIA AMONG OUTPATIENTS AT KIUTH

Table of Contents

APPROVAL ................................................................................................................................... ii

ACKNOWLEDGEMENTS ........................................................................................................... iii

LIST OF ABBREVIATIONS: ...................................................................................................... iv

LIST OF TABLES ......................................................................................................................... ix

LIST OF FIGURES ......................................................................................................................... x

ABSTRACT ................................................................................................................................. xii

CHAPTER ONE .............................................................................................................................. 1

INTRODUCTION ........................................................................................................................... 1

BACKGROUND ............................................................................................................................. !

STATEMENT OF PROBLEM ....................................................................................................... .3

MAIN OBJECTIVE ........................................................................................................................ 3

SPECIFIC OBJECTIVES ................................................................................................................ 3

RESEARCH QUESTIONS ............................................................................................................. 3

RESEARCH HYPOTHESIS .......................................................................................................... .4

1.8 JUSTIFICATION OF THE STUDY ........................................................................................ .4

CHAPTER TWO: LITERATURE REVIEW .................................................................................. 5

2.1 PATIENTS' KNOWLEDGE ON THEIR MEDICATION ....................................................... 5

2.3 STUDIES ON ARTEMETHER-LUMEFANTRINE ANTIMALARIAL THERAPY ............. 6

CHAPTER THREE: METI-IODOLOGY ........................................................................................ 9

3.0 STUDY AREA AND STUDY POPULATION ........................................................................ 9

3.1 STUDY DESIGN ...................................................................................................................... 9

The study was a ............................................................................................................................... 9

3.2 SAMPLE SIZE DETERMINATION AND SAMPLING METHOD ....................................... 9

3.4 DATA COLLECTION, METHODS AND TOOLS ............................................................... 10

3.4.1 QUESTIONNAIRE .............................................................................................................. 10

3.4.2 ETHICAL CONSIDERATION ............................................................................................ 10

3.4.3 DATA QUALITY ASSURANCE ........................................................................................ 10

3.5 DATA PROCESSING AND ANALYSIS .............................................................................. 10

CHAPTER FOUR: RESULTS AND DISCUSSION .................................................................... 11

4.1 Descriptive analysis of demographic characteristics of the respondents ................................. 11

4.1.1 Sex of respondents ................................................................................................................ 11

4.1.2 Age of respondents ............................................................................................................... 11

4.1.3 Education level of patients .................................................................................................... 12

4.1.4 Marital status of the respondents .......................................................................................... 12

4.2 Identifying the medicines received .......................................................................................... 13

4.3. Analysis of the frequency of use of medicine by the patients ................................................ 14

4.4 Frequency of obtaining the drug as over-the-counter previously by the patients .................... l6

4.5 The number of tablets patients that will be taken as per their response .................................. 16

4.6 Way of taking medicine ........................................................................................................... l7

4. 7 Predicted adherence to dose timing ......................................................................................... 17

4.8 Reasons why patients do not complete the whole dose of AL ................................................ 19

4.9 Common side effects associated with the use of the drug experienced by the patients .......... 20

4.10 What is done when patients experience side effects .............................................................. 21

4.11 Action taken when they vomit within 2 hours after taking AL ............................................. 22

4.12 Foods and drinks used while taking AL reported by the patients .......................................... 22

4.13 Other medicines patients were/had used ................................................................................ 23

4.14 Awareness of use of AL in pregnancy ................................................................................... 23

4.14 Way of keeping the drug at home .......................................................................................... 24

4.15 DISCUSSION ........................................................................................................................ 25

4.15.1 Patient demographic data .................................................................................................... 25

4.15.1.1 Sex ofrespondents ........................................................................................................... 25

4.15.1.2 Age of respondents .......................................................................................................... 25

4.15.1.3 Level ofEducation ........................................................................................................... 25

4.15.1.4 Marital status ................................................................................................................... 25

4.15.1.5 Occupation of the patients ............................................................................................... 25

4.15.2 Knowledge about the drug .................................................................................................. 26

4.15.2.1 Identify the brand, strength and dosage form of the drug ................................................ 26

4.15.2.2 Frequency of use of AL by the patients this year ............................................................ 26

4.15.2.3 The number of tablets taken and way of taking the drug ................................................ 27

4.15.2.4 Adherence to dosing time ................................................................................................ 27

4.15.2.5 Relationship between level of Education of patients and the time taken to complete the dose .................................. 28

4.15.2.6 Relationship between level of Education of patients and what is done when they experience side effects ..................... 30

4.15.2.7 Reasons for not completing the dose ............................................................................... 30

4.15.2.8 Relationship/effect of marital status on the time taken to complete dose of AL ............. 3l

4.15.2.9 Relationship between patients' occupation and time taken to complete the dose ........... 32

4.15.2.10 Action taken when they vomit within 2 hours after taking AL ..................................... 33

4.15.2.11 Knowledge on food recommendations of AL ............................................................... 33

4.15.2.14 Knowledge of use during pregnancy ............................................................................. 35

4.15.2.15 Knowledge on keeping the drug at home ...................................................................... 36

CHAPTER FIVE: CONCLUSION AND RECOMMENDATIONS ........................................... 37

5.1 CONCLUSION ....................................................................................................................... .37

5.2 RECOMMENDATIONS ........................................................................................................ .37

5.3 SUGGESTIONS FOR FURTHER RESEARCH .................................................................... 38

REFERENCES .............................................................................................................................. 39

APPENDIX 1: QUESTIONNAIRE TO THE RESPONDENTS ................................................. .41 

ABSTRACT 

This study sought to assess the knowledge on the use of Artemether/ therapy in the management of uncomplicated malaria among out patients treated at KIU-TI-L A cross sectional study design was employed in this study. Data was collected from August to October 2018 using a questionnaire by simple Random sampling and was entered and analyzed using Microsoft Excel spread sheet and Statistical Package of Social Sciences (SPSS) version 20 respectively. The results were presented in form of tables, charts, graphs and Pearson Chi Square test were generated. The minimum and maximum age of the respondents was 0.5 and 55 respectively given that Skewness was greater than I. (1.043). The findings of the study have demonstrated that the patients' knowledge on use of Artemether Lumefantrine for management of uncomplicated malaria is inadequate following key parameters of dosing time, duration of treatment, dietary recommendations and response to side effects. Ce1tain aspects which could affect proper use of the drug like knowledge on the possible side effects and what to do when they experience them, the AL dietary requirements and why they should not stop taking their drug even when they feel better before the treatment is over, what to do if they vomited any dose were not clearly understood by the patients. It was found out that patients' level of Education had no significant effect on their knowledge on use of AL. Other patient factors like Marital status, Patient occupation and the frequency of obtaining AL as OTC were not significantly associated with the knowledge expressed by the patients on AL. The major challenges to poor use in this setting were related to difficulties in following expected dosing schedule and most especially the time for the second close, time for completion of the dose, dietary recommendations and what is done when the drug is vomited which could be sorted out through improved counseling and patient Education on taking the medication by the dispenser or pharmacist. CONCLUSION: Patients did not have adequate knowledge on the dispensed drug and particularly on the dosing schedule and dietary recommendations associated with the use of AL. The patients' level of Education did not have a significant effect on the knowledge on use of AL expressed by the patients. This could imply that the quality of patient- service provider interaction and particularly counseling and emphasis on all issues pertaining the use of the dispensed drugs is weak. RECOMMENDATIONS: Re-train health workers particularly dispensers/pharmacists on the purpose of effective counseling on disease and treatment issues of the patients. Ensure that all first doses of AL be administered before the patient leaves the health facility. Set a follow up strategy of the patient to assess response to therapy at least after two days and solve any problems that may have resulted from treatment.