Determinants of self-treatment with antimalarials in Ndola district, Zambia: a cross-sectional study

Antimalarial drug resistance has been an obstacle in the fight against malaria over the years. Antimalarial self-medication is one of the factors associated with antimalarial resistance, and is on the rise globally and has become quite common among developing populations. Self-medication is when individuals choose and use medications to treat symptoms they perceive or diagnose themselves, without the guidance of a healthcare professional. This study aimed at investigating prevalence and determinants of antimalarial drug self-medication among adults in Ndola district, Zambia. A cross-sectional study was conducted among adults in Ndola district, Zambia in June 2023. Using multistage cluster sampling, 446 participants were randomly selected and interviewed through a mobile-based structured questionnaire administered by the researchers using Kobo collect/kobo toolbox. The head of household was the primary participant. Data was then exported to Microsoft Excel, cleaned and coded, and thereafter exported to STATA version 16.1 for analysis. Chi-square tests and logistic regression analysis was used to test associations between categorical variables and to estimate the odds of antimalarial drug self-medication associated with the explanatory variables. The prevalence of antimalarial drug self-medication was 20% in this study population and the factors significantly associated were; moderate to mild illness, bad experience with hospital care, lack of knowledge about antimalarial drug resistance, and the perception that antimalarial drug self-medication was not risky. The finding that antimalarial self-medication was common in this study population is suggestive of a poor state of the health-care delivery system possibly due to inadequate manpower, stock out of drugs in health facilities, and lack of awareness about the risks of self-medication. This further suggests that there is great need for regulatory authorities to strengthen drug regulations and update the list of over-the-counter and essential medicines to ensure the safety of public health. In addition, authorities should repackage malaria sensitization messages to strongly highlight the risks of antimalarial drug self-medication.