Medication utilization and illness management study in Nigeria

Little is known about rates of illness, illness management, or drug utilization in developing countries.

To determine patterns of illness and drug utilization in urban and rural households in Nigeria.

A survey was developed and validated for data collection. A random sample from some communities in Owan East Local Government Area (LGA) of Edo State, Nigeria, was selected, based on a national population survey, using both the supervisory and enumeration areas of the LGA. We determined the sample size using methods described by Cochran, including 5% precision, 5% α, and allowing for 5% data error. Respondents were queried in face-to-face interviews about illnesses in their households during the previous 2 weeks; demographic information; how they were treated; and where they sought treatment, advice, and medicines. As well, we determined how they kept families well. Descriptive statistics were used to summarize data.

Out of 549 persons, 497 completed the questionnaires, giving a response rate of 90.5%. Of these respondents, 395 (79.5%) reported 517 illnesses during the previous 2 weeks. The average age of the ill person was 30.6 ± 24.3 years (range 3 months to 95 years). Percentages by age were: infants younger than 1 year 1.0%, children aged 1-17 years 36.0%, and adults aged ≥18 years 63.0%. Average monthly income per household was low (13,247 naira/88.31 US$). Malaria and its symptoms (fever, chills, joint pain, headache, gastrointestinal problems) and upper respiratory symptoms were most common. A majority (44.8%) of the ill persons self-treated, with 93.6% using antibiotic and antimalarial drugs. Among the households surveyed, 42.1% had drugs on hand (average 2.3 ± 1.3, range 1-7, median 2) for disease prevention, and the most used drugs were analgesics (46.2%) and antimalarial drugs (37.3%).

Illness is frequent in Nigeria and is usually self-treated with antibiotic and antimalarial drugs. Medications were reported to be the most frequently used measure to prevent household illness. The implications of these findings are discussed.