Knowledge, Attitudes, Practices, and Implementation of Nigeria’s Chloroquine Withdrawal Policy in a Federal University Community
DOI:
https://doi.org/10.59493/advpbl/2026.1.6Keywords:
Artemisinin-based combination therapies, chloroquine , drug resistance, malaria, Nigeria, policy complianceAbstract
Chloroquine was withdrawn from first-line malaria treatment in Nigeria because of widespread Plasmodium falciparum resistance and was replaced by artemisinin-based combination therapies (ACTs). Nevertheless, continued access to and use of chloroquine may weaken implementation of the withdrawal policy. This study assessed implementation of the policy by examining knowledge, attitudes, practices, barriers, and predictors of compliant malaria treatment. A convergent mixed-methods cross-sectional survey was conducted among 456 students and staff of David Umahi Federal University of Health Sciences, Ebonyi State, Nigeria. Quantitative data were analysed in Stata version 17 using descriptive statistics, Pearson’s chi-square test, and multivariable logistic regression, with statistical significance set at p < 0.05. Open-ended responses were analysed thematically. Policy implementation was incomplete: 44.1% of respondents had low compliance, 47.1% moderate compliance, and 8.8% high compliance. Occupation was associated with knowledge (p < 0.001), while attitude was associated with treatment practice (p < 0.001). Higher knowledge predicted positive attitudes (AOR = 1.74, 95% CI: 1.56–1.94) and compliant practices (AOR = 1.18, 95% CI: 1.08–1.29). Major barriers were inadequate public awareness, continued chloroquine availability, weak enforcement, and limited affordability of ACTs. Nigeria’s chloroquine withdrawal policy remains only partially implemented in the study setting. Coordinated public education, regulatory enforcement, affordable access to ACTs, and training of healthcare providers and medicine vendors are required to improve compliance.
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