Evaluation of Acute Diarrhea Treatment in Under-Five Children in Community Pharmacies in a State in Southeast Nigeria: A Simulated Client Approach

Abstract

Acute diarrhoea causes avoidable death in children worldwide. Community pharmacists are stakeholders in the treatment of self limiting conditions and are readily accessible for consultations to the patients in communities and neighbourhoods. This study was designed to evaluate the treatment of acute diarrhoea by community pharmacists through patient simulated approach. The study was carried out in three largest urban settlements, namely Awka, Onitsha and Nnewi in Anambra state, Nigeria using 84 registered community pharmacies. Six adequately trained data collectors who worked in pairs were dispatched to designated community pharmacies to collect the data. The data collectors mimicked clients with under five children showing signs and symptoms of acute diarrhoea and recorded their interactions without the knowledge of the pharmacists. The recorded interactions was transcribed and data was summarised with descriptive statistics and Chi-square. Majority of community Pharmacies’ practices in Anambra state 44(52.4%) was not compliant with the standard treatment guideline (STG). Out of the 45 community pharmacies in Onitsha, only 2(22.2%) was complaint with STG. Better compliance with STG was seen in Awka community Pharmacies 7(77.8%). No compliance was recorded in Nnewi. Chi-square test revealed a statistically significant association among the compliance of community Pharmacies in the three locations (? ²= 11.439; p = 0.022). Based on World Health Organization’s standard for treatment of acute diarrhea, the treatment of acute diarrhoea by the community pharmacists was inadequate. However, they were knowledgeable in some of the protocols.