Malaria case management in an area with civil unrest in Cameroon: A retrospective study from 2006–2021

Abstract Background Malaria remains a serious health challenge; thus, the need for continual improvements in treatment regimens and the adoption of new treatment guidelines to enhance case management is vital. We report trends in malaria case management over a 16-year period at the Jakiri Health Centre in Cameroon, an area that has been plagued with civil unrest since 2016. Methods Data were collected retrospectively from consultation, laboratory, and prescription registers and double entered into Excel. Analysis was conducted using SPSS statistics and Microsoft Excel. Results A total of 3,800 febrile patients visited the outpatient department (OPD), and 8,324 prescriptions were received by patients. Of these prescriptions, 11.6% (964) were anti-malarials, 3.5% (291) were ferrous sulfate (FS), 40.8% (3,396) were antibiotics (AB), and 44.1% (3,673) were analgesics. The antimalarials prescribed were artemisinin-based combination therapies (ACTs) 83.2% (802) and quinine (Q) 16.8% (162). No ACTs were prescribed between 2006 and 2011. The 5 to < 15 years age group received the highest proportion of ACTs (42.3%), followed by the 1 to < 5 years age group (31.8%). Males were more likely to be prescribed ACTs than females were (OR = 1.336, 95% CI 1.141–1.564; p < 0.0001). Between 2006 and 2013, the number of quinine prescriptions increased from 17.2% (21) in 2006 to a peak of 26.1% (30) in 2009 and progressively decreased to 0% between 2014 and 2019. Antibiotic prescription rates were high across all age groups. Analgesics were prescribed to all patients across age groups for malaria-positive patients. The prescription of antimalarials to malaria-negative patients was relatively low over time. Conclusion This study demonstrated that recommended malaria treatment guidelines have been adopted by the Jakiri Health Centre, which has transitioned from quinine as a first-line treatment to ACTs. ACTs were not used in the facility until 2012. The prevalence of malaria is still very high, and most anti-malaria treatments are appropriate. However, antibiotics and analgesics were found to be highly prescribed.