ASSESSMENT OF RATIONAL USE OF ANTIRETROVIRAL DRUGS IN HEALTH INSTITUTIONS IN NIGERIA
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ABSTRACT
With the national prevalence of 5.0% in Nigeria, HIV infections have become one of the most dreadly medical challenges. Availability of highly active antiretroviral therapy (HAART) has given a new hope of living with somewhat terminal syndrome. The availability, affordability and effective usage of antiretrovirals in Kano (North West Nigeria) was studied to provide a data for compliance study with the National Standard Treatment Guideline (STG) and also for comparison with other International data. A total of 138 patients (pooled from three health institutions) were studied at random through a structured questionnaire and patient medication information record. The mean age of the patients was 35.6years with a standard deviation of 7.8 years. Antiretroviral drugs are readily available. However, affordability among the subjects studied was 97.5% and 47.5% at a subsidized federal government rate of one thousand naira per month and at a retail price of ten thousands naira per month respectively. Adherence to therapy was difficult with about 60% of the patients having missed at least a dose in their treatment schedule. In fact, 25% of them have missed at least a dose within a week preceding the study. Factors responsible for non-adherence (in decreasing order) were fasting, cumbersome (indefinite) treatment period, forgetfulness, side effects (mainly skin rash), fear of stigmatization (as patients can’t take medication in others presence), unavailability and travelling. The study also showed that 88.4% of the patients were on triple HAART with 11.6% on either dual or monotherapy. Antiretroviral drugs used in the management of HIV/AIDS were drawn from the lamivudine, Zidovudine, Stavudine, and Nevirapine group.
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