Knowledge and attitude of primary healthcare workers towards rational prescription of artemisinin-based combination therapy in the treatment of uncomplicated malaria in Ondo State, Southwestern Nigeria

Introduction and objective. For an effective and desired outcome of therapy to be achieved, the technical capacity of the healthcare worker is a key factor. The aim of the study is to assess knowledge and attitudes of primary healthcare (PHC) workers towards rational artemisinin-based combination therapy (ACT) prescribed in the treatment of uncomplicated malaria. Materials and method. This is a descriptive cross-sectional survey in which a self-administered structured questionnaire was used. A combination of stratified and multistage sampling techniques where utilized in the selection of the healthcare workers (HCWs). Results. Of the 422 respondents, 100 (23.7%) were males and 322 (76.3%) were females. Respondents with less than five years in practice accounted for 36%, while 64% had six years and above of practice. Community health extension workers (CHEW) accounted for 54%, while 46% were either community health officers (CHO), nurses, midwives, Bachelors of Science (BSc) in community health, or with other qualifications. A total of 390 (92.4%) were aware of the availability of ACTs and used the malaria treatment protocols, whereas 28 (6.6%) still used monotherapy for simple malaria treatment, and 2.7% did not use any form of test before initiating treatment. Co-administration of non-ACTs with ACTs accounted for 12%, with 88% prescribing paracetamol with ACTs. 67% of the respondents required capacity building in rational ACT use. Conclusion. The majority of the respondents had the requisite knowledge and skills coupled with positive attitudes in prescribing ACTs. Some respondents could not distinguish between an ACTs and a monotherapy. This may affect the exact application of the malaria treatment protocols, especially at the PHC level.