Co-administration of traditional remedies and orthodox antimalarials in southwestern Nigeria: prevalence, demographic correlates, and implications for treatment policy
6 affiliations
- 1Department of Medical Microbiology and Parasitology, Federal University of Health Science Ila-Orangun, Ila-Orangun, Nigeria
- 2Parasitology and Vector Biology Unit, Department of Animal and Environmental Biology, Osun State University, Osogbo, Nigeria
- 3Department of Medical Laboratory Science, Federal University of Health Science Ila-Orangun, Ila-Orangun, Nigeria
- 4Medical Research Council Unit, London School of Hygiene & Tropical Medicine, Fajara, Gambia
- 5Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
- 6Department of Plant Biology, Osun State University, Osogbo, Nigeria
Abstract
Background: The efficacy of first-line artemisinin-based combination therapies (ACTs) in Nigeria is threatened by non-adherence to clinical guidelines. This includes the widespread use of traditional and herbal medicines (THMs) and discontinued monotherapies. This study aimed to quantify the prevalence of these practices, identify the populations most at-risk, and elucidate the treatment pathways involved to inform targeted public health interventions.
Methods: A community-based cross-sectional survey was administered to 1500 adults in Osun State, Nigeria, using multi-stage sampling. Data on socio-demographics, treatment-seeking behaviour, and antimalarial/THM use were collected. Logistic regression analyses identified factors independently associated with THM use and high-risk practices.
Results: 40.7% of respondents reported using THMs for malaria. Their use was independently associated with age ≥ 30 years (aOR: 3.21, 95% CI 2.45–4.21), female gender (aOR: 1.68, 95% CI 1.30–2.17), education at secondary level or below (aOR: 7.45, 95% CI 5.89–9.42), and rural residence (aOR: 13.10, 95% CI 10.15–16.91). THM users were significantly more likely to initiate treatment through informal sources (54.9 vs. 3.4%, p < 0.001) and to report using chloroquine (57.4%) and injectable artemisinin monotherapies. Overall awareness of drug resistance (34.2%) and ACT completion importance (25.3%) was low. Critically, all antimalarial therapy must be preceded by parasitological confirmation, as treating undifferentiated febrile illnesses in high-transmission settings can exert sub-therapeutic selective pressure on concurrent asymptomatic parasitemia.
Conclusions: The co-administration of THMs and non-recommended antimalarials is common and follows distinct demographic and behavioural patterns. These practices, facilitated by informal treatment channels and low therapeutic literacy, represent a clear deviation from national policy and threaten ACT effectiveness. The findings provide an evidence base for the Nigerian Malaria Elimination Programme to design community-specific interventions, including vendor regulation and education campaigns targeting high-risk groups.
Related
- Molecular evidence of SARS-CoV-2 detection on cockroaches in Shiraz, southwestern Iran and potential implications for mechanical carriage
- Disaster Risk Governance and Microbial Infection Transmission in Nigeria: Public Administration Implications
- Traditional Chinese medicine core medication patterns for type 2 diabetes mellitus and their implications for dietary nursing
- Multi-target network modulation of Traditional Chinese Medicine in radiation enteropathy: mechanistic insights and therapeutic implications.
- Emergence and spread of Plasmodium falciparum PX1 polymorphisms associated with decreased susceptibility to antimalarials in Uganda
BibTeX
@article{odediji2026coadministration,
title = {{Co-administration of traditional remedies and orthodox antimalarials in southwestern Nigeria: prevalence, demographic correlates, and implications for treatment policy}},
author = {S. A. Odediji and L. O. Busari and A. O. Olawuyi and K. O. Amoo and B. O. Amoo-Adeboye and Y. O. Yusuff and M. Odediji and O. A. Surakat and M. A. Adeleke},
journal = {Malaria Journal},
year = {2026},
month = aug,
doi = {10.1186/s12936-026-06088-4},
url = {https://doi.org/10.1186/s12936-026-06088-4},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Co-administration of traditional remedies and orthodox antimalarials in southwestern Nigeria: prevalence, demographic correlates, and implications for treatment policy
AU - S. A. Odediji
AU - L. O. Busari
AU - A. O. Olawuyi
AU - K. O. Amoo
AU - B. O. Amoo-Adeboye
AU - Y. O. Yusuff
AU - M. Odediji
AU - O. A. Surakat
AU - M. A. Adeleke
PY - 2026
DA - 2026/08/06
JO - Malaria Journal
DO - 10.1186/s12936-026-06088-4
UR - https://doi.org/10.1186/s12936-026-06088-4
AB - Background: The efficacy of first-line artemisinin-based combination therapies (ACTs) in Nigeria is threatened by non-adherence to clinical guidelines. This includes the widespread use of traditional and herbal medicines (THMs) and discontinued monotherapies. This study aimed to quantify the prevalence of these practices, identify the populations most at-risk, and elucidate the treatment pathways involved to inform targeted public health interventions. Methods: A community-based cross-sectional survey was administered to 1500 adults in Osun State, Nigeria, using multi-stage sampling. Data on socio-demographics, treatment-seeking behaviour, and antimalarial/THM use were collected. Logistic regression analyses identified factors independently associated with THM use and high-risk practices. Results: 40.7% of respondents reported using THMs for malaria. Their use was independently associated with age ≥ 30 years (aOR: 3.21, 95% CI 2.45–4.21), female gender (aOR: 1.68, 95% CI 1.30–2.17), education at secondary level or below (aOR: 7.45, 95% CI 5.89–9.42), and rural residence (aOR: 13.10, 95% CI 10.15–16.91). THM users were significantly more likely to initiate treatment through informal sources (54.9 vs. 3.4%, p < 0.001) and to report using chloroquine (57.4%) and injectable artemisinin monotherapies. Overall awareness of drug resistance (34.2%) and ACT completion importance (25.3%) was low. Critically, all antimalarial therapy must be preceded by parasitological confirmation, as treating undifferentiated febrile illnesses in high-transmission settings can exert sub-therapeutic selective pressure on concurrent asymptomatic parasitemia. Conclusions: The co-administration of THMs and non-recommended antimalarials is common and follows distinct demographic and behavioural patterns. These practices, facilitated by informal treatment channels and low therapeutic literacy, represent a clear deviation from national policy and threaten ACT effectiveness. The findings provide an evidence base for the Nigerian Malaria Elimination Programme to design community-specific interventions, including vendor regulation and education campaigns targeting high-risk groups.
SN - 1475-2875
ER -