Incidence, pattern and determinants of self-medication for fevers in children: A survey of caregivers in an emergency unit in Benin City, Nigeria

Submitted: 4 June 2022
Accepted: 28 July 2022
Published: 16 September 2022
Abstract Views: 442
PDF: 200
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Self-medication is common in medically underserved areas, with disastrous consequences. It is necessary to determine the frequency and risk factors in our area. The purpose of this study was to find out the frequency, pattern, and risk factors for self-medication for febrile childhood illnesses among caregivers seen in the emergency paediatric unit. A descriptive, cross-sectional design was used for this study. Participants included caregivers for children seen in the unit. A semi-structured questionnaire was used to collect data, which included sections on demography, determinants, pattern, and reasons for self-medication, as well as actual reports of self-medication in the previous three weeks. In order to identify risk factors for self-medication, inferential analyses were performed. P-values less than 0.05 were considered significant. The study included 153 caregivers, with an average (SD) age of 45.6 (13.8) years. Self-medication for fevers in children was 25.5%, with 20 (51.3%) of the children treated being under the age of five. Antipyretics (20.3%) and antimalarials (13.7%), particularly artemisinin-based combination therapy (ACT), were the most commonly used drugs. Place of residence (p= 0.011), living arrangement (p= 0.030), and awareness of an adverse drug event (p= 0.045) are factors that influence self-medication in the previous three weeks. Having health insurance, NHIS (OR = 2.734, 95% CI: 1.120-6.678; p=0.027), and using an insecticide-treated net (OR = 0.272, 95% CI: 0.117-0.634; p=0.003) are also independent predictors of self-medication. With multifactorial determinants in the setting, self-medication is common. There is a need for increased access to subsidized healthcare for children, as well as caregiver education on the potential harms of self-medication.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

World Health Organization. 2000‎. Guidelines for the regulatory assessment of medicinal products for use in self-medication. World Health Organization. Available from: https://apps.who.int/iris/handle/10665/66154
Tesfamariam S, Anand IS, Kaleab G, et al. Self-medication with over the counter drugs, prevalence of risky practice and its associated factors in pharmacy outlets of Asmara, Eritrea. BMC Public Health 2019;19:159. DOI: https://doi.org/10.1186/s12889-019-6470-5
Moritz K, Seiberth JM, Schiek S, Bertsche T. The impact of evidence from clinical trials on counselling for over-the-counter drugs: A national survey of pharmaceutical staff in German pharmacies. J Clin Pharm Ther 2019;44:895-903. DOI: https://doi.org/10.1111/jcpt.13013
Kawuma R, Chimukuche RS, Francis SC, et al. Knowledge, use (misuse) and perceptions of over-the-counter analgesics in sub-Saharan Africa: a scoping review. Glob Health Action 2021;14:1955476. DOI: https://doi.org/10.1080/16549716.2021.1955476
Babalola OJ, Ajumobi O, Ajayi IO. Rural-urban disparities and factors associated with delayed care-seeking and testing for malaria before medication use by mothers of under-five children, Igabi LGA, Kaduna Nigeria. Malar J 2020;19:294. DOI: https://doi.org/10.1186/s12936-020-03371-w
Omale UI, Oka OU, Okeke IM, et al. Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey. BMC Health Serv Res 2021;21:857. DOI: https://doi.org/10.1186/s12913-021-06865-8
Ruiz ME. Risks of self-medication practices. Curr Drug Saf 2010;5:315-23. DOI: https://doi.org/10.2174/157488610792245966
Romandini A, Pani A, Schenardi PA, et al. Antibiotic resistance in pediatric infections: Global emerging threats, predicting the near future. Antibiotics (Basel) 2021;10:393. DOI: https://doi.org/10.3390/antibiotics10040393
Xu J, Wang X, Sun KS, et al. Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China. Antimicrob Resist Infect Control 2020;9:150. DOI: https://doi.org/10.1186/s13756-020-00811-9
Mahony M, McMullan B, Brown J, Kennedy SE. Multidrug-resistant organisms in urinary tract infections in children. Pediatr Nephrol 2020;35:1563-73. DOI: https://doi.org/10.1007/s00467-019-04316-5
Craig BM, Hartman JD, Owens MA, Brown DS. Prevalence and losses in quality-adjusted life years of child health conditions: a burden of disease analysis. Matern Child Health J 2016;20:862-9. DOI: https://doi.org/10.1007/s10995-015-1874-z
McNeil JC, Vallejo JG, Kok EY, et al. Clinical and microbiologic variables predictive of orthopedic complications following staphylococcus aureus acute hematogenous osteoarticular infections in children. Clin Infect Dis 2019;69:1955-61. DOI: https://doi.org/10.1093/cid/ciz109
Wegbom AI, Edet CK, Raimi O, et al. Self-medication practices and associated factors in the prevention and/or treatment of COVID-19 virus: a population-based survey in Nigeria. Front Public Health 2021;9:606801. DOI: https://doi.org/10.3389/fpubh.2021.606801
Quincho-Lopez A, Benites-Ibarra CA, Hilario-Gomez MM, et al. Self-medication practices to prevent or manage COVID-19: A systematic review. PLoS One 2021;16:e0259317. DOI: https://doi.org/10.1371/journal.pone.0259317
Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med 2013;35:121-6. DOI: https://doi.org/10.4103/0253-7176.116232
Ibadin, MO, Akpede, GO. A revised scoring scheme for the classification of socio-economic status in Nigeria. Niger J Paediatr 2021;48:26–33. DOI: https://doi.org/10.4314/njp.v48i1.5
Iribhogbe OI, Odoya EM. Self-medication practice with antimalarials & the determinants of malaria treatment-seeking behavior among postpartum mothers in a rural community in Nigeria. Pharmacoepidemiol Drug Saf 2021;30:435-44. DOI: https://doi.org/10.1002/pds.5178
Mensah BN, Agyemang IB, Afriyie DK, Amponsah SK. Self-medication practice in Akuse, a rural setting in Ghana. Niger Postgrad Med J 2019;26:189-94 DOI: https://doi.org/10.4103/npmj.npmj_87_19
Bogale AA, Amhare AF, Chang J, et al. Knowledge, attitude, and practice of self-medication with antibiotics among community residents in Addis Ababa, Ethiopia. Expert Rev Anti Infect Ther 2019;17:459-66. DOI: https://doi.org/10.1080/14787210.2019.1620105
Gesesew H, Berhane K, Siraj ES, et al. The impact of war on the health system of the Tigray region in Ethiopia: an assessment. BMJ Glob Health 2021;6:e007328. DOI: https://doi.org/10.1136/bmjgh-2021-007328
Effa E, Arikpo D, Oringanje C, et al. Human resources for health governance and leadership strategies for improving health outcomes in low- and middle-income countries: a narrative review. J Public Health (Oxf) 2021;43:i67-i85. DOI: https://doi.org/10.1093/pubmed/fdaa264
Apetoh E, Tilly M, Baxerres C, Le Hesran JY. Home treatment and use of informal market of pharmaceutical drugs for the management of paediatric malaria in Cotonou, Benin. Malar J 2018;17:354. DOI: https://doi.org/10.1186/s12936-018-2504-1
Derbie A, Mekonnen D, Adugna M, et al. therapeutic efficacy of artemether-lumefantrine (Coartem®) for the treatment of uncomplicated falciparum malaria in Africa: A systematic review. J Parasitol Res 2020;2020:7371681. DOI: https://doi.org/10.1155/2020/7371681
Marwa K, Kapesa A, Baraka V, et al. Therapeutic efficacy of artemether-lumefantrine, artesunate-amodiaquine and dihydroartemisinin-piperaquine in the treatment of uncomplicated Plasmodium falciparum malaria in Sub-Saharan Africa: A systematic review and meta-analysis. PLoS One 2022;17:e0264339. DOI: https://doi.org/10.1371/journal.pone.0264339
WorldWide Antimalarial Resistance Network Falciparum Haematology Study Group. Haematological consequences of acute uncomplicated falciparum malaria: a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data. BMC Med 2022;20:85.
Arya A, Kojom Foko LP, Chaudhry S, et al. Artemisinin-based combination therapy (ACT) and drug resistance molecular markers: A systematic review of clinical studies from two malaria endemic regions - India and sub-Saharan Africa. Int J Parasitol Drugs Drug Resist 2021;15:43-56. DOI: https://doi.org/10.1016/j.ijpddr.2020.11.006
Muoneke VU, Una AF, Mbachu C, et al. Caregivers’ Perception and Practice of Self-medication for Fevers in Under-five Children: A Cross-sectional Study in a Rural Community, South-East Nigeria. JAMMR 14;27:1-2. DOI: https://doi.org/10.9734/JAMMR/2018/44904
Samir N, Hassan MZ, Biswas MAAJ, et al. Antibiotic use for febrile illness among under-5 children in Bangladesh: A nationally representative sample survey. Antibiotics (Basel) 2021;10:1153. DOI: https://doi.org/10.3390/antibiotics10101153
Abiodun MT, Ilori OR. Caregivers’ perception and determinants of delayed presentation of children with severe malaria in an emergency room in Benin City, Nigeria. Niger Postgrad Med J 2022; 10.4103/npmj.npmj_80_22 DOI: https://doi.org/10.4103/npmj.npmj_80_22
Oluwafemi R O, Abiodun MT. Morbidity and mortality pattern at the Emergency Paediatric Unit of Mother and Child Hospital Akure, Nigeria. Ann Biomed Sci 2016;15:151-9.
Abiodun MT, Sadoh WE. Socio-demographic characteristics and pre-hospital care of children with circulatory failure in a children’s emergency room in southern Nigeria. Pan Afr Med J 2021;40:65. DOI: https://doi.org/10.11604/pamj.2021.40.65.30003
Aregbeshola BS, Khan SM. Primary Health Care in Nigeria: 24 Years after Olikoye Ransome-Kuti’s Leadership. Front Public Health 2017;5:48. DOI: https://doi.org/10.3389/fpubh.2017.00048
Omonijo AO, Omonijo A, Okoh HI, Ibrahim AO. Relationship between the Usage of Long-Lasting Insecticide-Treated Bed Nets (LLITNs) and Malaria Prevalence among School-Age Children in Southwestern Nigeria. J Environ Public Health 2021;2021:8821397. DOI: https://doi.org/10.1155/2021/8821397
Pryce J, Richardson M, Lengeler C. Insecticide-treated nets for preventing malaria. Cochrane Database Syst Rev 2018;11:CD000363. DOI: https://doi.org/10.1002/14651858.CD000363.pub3
Alawode GO, Adewole DA. Assessment of the design and implementation challenges of the National Health Insurance Scheme in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public Health 2021;21:124. DOI: https://doi.org/10.1186/s12889-020-10133-5

How to Cite

Abiodun, M. T., & Ayinboumwan, S. A. (2022). Incidence, pattern and determinants of self-medication for fevers in children: A survey of caregivers in an emergency unit in Benin City, Nigeria. Annals of Clinical and Biomedical Research, 3(2). https://doi.org/10.4081/acbr.2022.215