Compliance With Guidelines on Seasonal Malaria Chemoprevention in Kwara State, Northcentral Nigeria

C. O. Agomo, E. Shekarau, N. C. Ogbulafor, N. Abdullahi, B Oyetunji, C Okoronkwo, P. Uhomoibhi, O. A. Mokuolu

Abstract

BACKGROUND: Seasonal malaria chemoprevention (SMC) is an
effective strategy for reducing malaria morbidity and mortality in
children aged 3-59 months in areas with seasonal malaria transmission.
Sulphadoxine-pyrimethamine plus amodiaquine is given to an eligible
child at monthly interval during the peak malaria transmission season.
The aim of this study was to determine the level of compliance with SMC
guidelines by community drug distributors during SMC implementation
in Kwara State.

METHOD: Caregivers of eligible children from six Local Government
Areas were interviewed using structured questionnaire on KoboCollect
app downloaded on hand-held android devices. The questionnaire was
composed of questions on caregiver's demographics, SMC drug
administration, and adherence to SMC protocol.

RESULTS: A total of 1,314 caregivers were interviewed, most of them
were female 1076 (81.9%), married 1200 (91.3%) and literate 795
(60.5%). The mean SMC coverage for the 4 cycles was 1183(88.5%).
SMC information was received by 1166 (88.7%) of caregivers. Most of
the caregivers 1166 (88.7%) heard about SMC. Overall, SPAQ
administration was directly observed in most cases 1169 (91.5%), second
dose was given 1226 (96.0%) and drugs were fully ingested 1140(89.3%).
Poor compliance was observed in home visits by lead mothers 988
(77.4%). The report of adverse drug reactions was low 132 (10.3% [95%
CI: 8.8-12.3%]), the commonest being severe vomiting 50 (37.9%). There
were significant (P<0.05) variations in SMC implementation across the 6
LGAs in virtually all the performance indicators. SPAQ administration
to over-age children was low 128 (10.0%),

CONCLUSION: Overall, the compliance with SMC implementation
guidelines in Kwara state was good though significant differences in
performance were observed across the six LGAs. Home visits by lead
mothers were generally poor. The self-reported coverage of SMC by
caregivers was commendable. WAJM 2024; 41 (1): 55 - 64.

KEYWORDS: Seasonal Malaria Chemoprevention, SPAQ,
Compliance, Children, Northcentral Nigeria, Rainy season