Adverse drug reactions are an important causes of death and account for 5–35% of hospital admissions. Operation Save the World from Adverse Drug Reactions is a drug safety surveillance programme ...developed in 2005 by the Institute of Human Virology Nigeria (IHVN) to address the under-reporting of adverse drug reaction in Nigeria, where millions of people use antiretroviral, anti-tuberculosis, and anti-malaria drugs. The drug safety surveillance programme runs in major public hospitals but is managed by the National Pharmacovigilance Center in collaboration with IHVN. The goal is to ensure public and global health, while the primary outcome is the reporting of adverse drug reactions to the Uppsala Monitoring Centre, through the Nigerian National Agency for Food and Drug Administration and Control (NAFDAC). Pharmacovigilance training and the publishing of papers are secondary outcomes.
The drug safety surveillance programme in Nigeria combines six key activities: collaboration between government and the private sector; the training of medical doctors, pharmacists, and nurses; establishment of pharmacovigilance centres in public hospitals; development of platforms for submitting individual case safety reports; the publishing of peer-review articles; and submission of individual case safety reports. To ensure sustainability, we collaborated with the Nigerian Government and research institutions, and trained only government health-care workers, who were randomly selected from a pool of applicants that applied to advertisements in three national newspapers.
Between 2004 and 2016, Nigeria's National Pharmacovigilance Center received 16 500 individual case safety reports out of 80 000 adverse drug reaction reporting forms. The number of health-care workers who were trained in the reporting of adverse drug reactions was fewer than 300 and there was no training model during this time. However, between 2014 and 2018 when Operation Save the World from Adverse Drug Reactions was introduced and implemented, more than 5000 individual case safety reports, with more than 40 000 reactions were submitted. Furthermore, more than 3000 health-care workers have been trained in the reporting of adverse drug reactions, and a Structured Pharmacovigilance and Training Initiative (SPHARTI) model has been developed, with two peer-reviewed articles published. Serious adverse drug reactions, such as bilateral gynaecomastia, violent psychiatric disorders, and Stevens-Johnson syndrome have also been reported.
The drug safety surveillance programme Operation Save the World from Adverse Drug Reactions has increased the reporting of adverse drug reactions in Nigeria and increased the critical mass of qualified health-care workers trained in the reporting of adverse drug reactions. The strength of the programme is in the combination of the six key activities. Challenges remain in establishing causality of the reported reactions and operating the programme at primary health centres.
US PEPFAR.
Master of Public Health - MPH
The World Health Organisation estimates that more than 50% of medicines are inappropriately used globally. The situation is worst in developing countries such as ...Nigeria, where irrational prescribing practices account for wastage of resources, catastrophic medicines costs and poor access to health services. In 2005, the Social Health Insurance Programme was launched as a financially sustainable model to achieve cost effective and affordable health care services including medicines. This study investigated prescribing practices and availability of medicines in the Social Health Insurance Programme in accredited public sector secondary hospitals in the Federal Capital Territory, Nigeria.Methodology:The study is a descriptive, cross-sectional and retrospective survey of prescriptions of insured outpatients in the Federal Capital Territory, Nigeria. Four hospitals were selected by stratification of thirteen (13) public secondary hospitals in the territory into urban/peri-urban areas, followed by random selection of two hospitals from each stratum.A total of seven hundred and twenty (720) retrospective prescription encounters of insured outpatients were systematically selected from encounters between July 2009 and June 2010 at the selected facilities. Data on prescribing practices and the extent to which prescribed medicines were provided were assessed with the use of modified WHO/INRUD indicators. Descriptive statistics were generated with Epi-info (version 3.4.3) and SPSS (version 17.0)Results: ;
Out of the seven hundred and twenty (720) prescriptions that were assessed analgesics/NSAID, antibiotics, antimalarials and haematinics/vitamins collectively accounted for 67.4% of the medicines prescribed.A comparison of the results with WHO/Derived reference values showed that average number of medicines prescribed per prescription (3.5 ±1, p<0.001) and the rate of antibiotic prescribing (53.7%, p=0.009) were higher than the WHO recommended ranges of (1.6-1.8) and (20.0- 25.4%) respectively.The use of generic names in prescribing (50.9%, p<0.0009) and medicines prescribed from the Essential Medicine List (74.2%, p=0.05) were considerably lower than the standard (100%) However, the rate of injection prescribing (12.49%, p=0.4) was within the recommended range (10.1–17.0%).The study also found that 85.1%, (p=0.001) of prescribed medicines were dispensed, while 93.4% (p=0.256) of essential medicines were dispensed which was lower than the recommended standard (100%). Overall, only 58%,(p<0.0001) of patients had all prescribed medicines completely dispensed and this was significantly lower than the desired standard (100%.) in social health insurance programmes.Conclusions:The findings of this study show trends toward irrational prescribing practices as characterized by poly-pharmacy, overuse of antibiotics, sub-optimal generic prescribing, as well as poor adherence to the use of NHIS-Essential Medicine List. There was sub-optimal provision of prescribed medicines. These are potential threats to the scheme‟s goal of universal access to;
health care in the year 2015. Pragmatic multi-component interventions are recommended to promote rational prescribing and improve equity in access to essential medicines.
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