[01] Koto-Te-Nyiwa Ngbolua, Faculty of Medicine, University of Gbadolite, Gbadolite City, Democratic Republic of the Congo; Faculty of Science, University of Kinshasa, Kinshasa City, Democratic Republic of the Congo; Environment Management and Geography Department, Higher Pedagogical Institute of Abumombazi, Abumombazi, Democratic Republic of the Congo; Faculty of Science, University of Gbadolite, Gbadolite City, Democratic Republic of the Congo. [02] Guy Ngambika Kumbali, Faculty of Medicine, University of Gbadolite, Gbadolite City, Democratic Republic of the Congo. [03] Christian Amisi Motuta, Faculty of Medicine, University of Gbadolite, Gbadolite City, Democratic Republic of the Congo. [04] Colette Masengo Ashande, Faculty of Science, University of Gbadolite, Gbadolite City, Democratic Republic of the Congo. [05] Benjamin Zoawe Gbolo, Faculty of Science, University of Kinshasa, Kinshasa City, Democratic Republic of the Congo; Faculty of Science, University of Gbadolite, Gbadolite City, Democratic Republic of the Congo. [06] Gédéon Ngiala Bongo, Faculty of Science, University of Kinshasa, Kinshasa City, Democratic Republic of the Congo; Faculty of Science, University of Gbadolite, Gbadolite City, Democratic Republic of the Congo. [07] Ruphin D. Djolu, Faculty of Science, University of Gbadolite, Gbadolite City, Democratic Republic of the Congo. [08] Janvier Mukiza, Faculty of Medicine and Surgery, University of Gitwe, Nyanza, Rwanda. [09] Pius Tshimankinda Mpiana, Faculty of Science, University of Kinshasa, Kinshasa City, Democratic Republic of the Congo.

Gbadolite health area is located in the Ubangi eco-region where Malaria is hyper-endemic stable with a perennial transmission. The aim of this study was to evaluate the anti-malarial drugs use in this health area in Nord Ubangi Province, Democratic Republic of Congo. A retrospective cross-sectional study design was conducted using selected patient cards from January 2016 to December 2017. 400 patient records have been randomly selected and analyzed. Obtained results indicate that 69% of patients are between 6 and 71 years old, and 31% of cases are children under 5 years. 56% of patients are male compared to 44% of female. 63% of patients are literate while 37% are illiterate. The majority of anti-malarial drugs prescribers are physicians (54%) followed by nurses (46%). 54% of cases concern simple malaria, 37% of cases, severe malaria and 9% of cases concern other pathologies. However, the rapid diagnostic test for confirmation indicates that 46% of those surveyed have simple malaria, 37% have severe malaria, and 17% have other diseases (diabetes, ulcer, dermatitis and cardiovascular disease). Seven types of anti-malarials drugs (alone or combined: Cether-L^®, Artemether, Artesun^®, ACT, Quinine, Co-artem^® and ARH-L forte^®) are used in Gbadolite city. The tablet is the most commonly used pharmaceutical form (51%) followed by the injectable form (47%) and syrup (2%). These AMD are associated with antibiotics (35% of cases), vitamins (20%), anti-helminthics (19%) and anti-cough (4%). In 94% of cases, the dose of anti-malarials administered to patients is consistent. However, in 4% of cases, there is overdose while the sub-dose is estimated at 2% of cases. Based on current knowledge, this is a first report concerning cross-sectional study on the use of antimalarial-based drugs in Gbadolite health area and revealed that the use of anti-malarial drugs is not fully in agreement with the guideline despite good practice.

Malaria, Artemisinin-Based Combination Therapy, Survey, Pharmaco-Vigilance, Gbadolite

[01] M. Gentilini, B. Duflo, M. Danis, B. Lagardère, D. R. Lenoble, G. Brucker, J. Mouchet, M. Rosenheim. Médecine tropicale. Médecine-Sciences, Flammarion, 1986. [02] K. N. Ngbolua. Essai de Corrélation Stabilité thermodynamique-activité biologique des complexes de l’hémine avec les antipaludéens à noyau quinoléine, Mémoire de DEA, Université de Kinshasa, République Démocratique du Congo, 2005. [03] K. N. Ngbolua, H. Rafatro, H. Rakotoarimanana, S. U. Ratsimamanga, V. Mudogo, P. T. Mpiana, D. S. T. Tshibangu. Pharmacological screening of some traditionally-used antimalarial plants from the Democratic Republic of Congo compared to its ecological taxonomic equivalence in Madagascar. International Journal of Biological and Chemical Sciences, 5 (5): 1797-1804, 2011a. [04] K. N. Ngbolua, H. Rakotoarimanana, H. Rafatro, U. S. Ratsimamanga, V. Mudogo, P. T. Mpiana, D. S. T. Tshibangu. Comparative antimalarial and cytotoxic activities of two Vernonia species: V. amygdalina from the Democratic Republic of Congo and V. cinerea subsp vialis endemic to Madagascar. International Journal of Biological and Chemical Sciences, 5 (1): 345-353, 2011b. [05] K. N. Ngbolua. Evaluation de l’activité anti-drépanocytaire et antipaludique de quelques taxons végétaux de la République Démocratique du Congo et de Madagascar, Thèse de Doctorat: Université de Kinshasa, République Démocratique du Congo, 2012. [06] B. C. Kotanda, D. R. Djoza, J. Mukiza, B. Robijaona, K. N. Ngbolua. Influence of nursing socio-demographic factors on the accessibility to the artemisinin based-antimalarials in children under 5 years age at Gbado-Lite city (Nord-Ubangi, RD Congo). International Journal of Innovation and Scientific Research 38 (1): 148–155, 2018. [07] Programme d’Appui au Réseau des Aires Protégées (PARAP). Evaluation du massif forestier du Nord-Ubangi. Rapport final, République Démocratique du Congo, 2015. [08] D. M. Olson, E. Dinerstein. The Global 200: A representation approach to conserving the Earth’s most biologically valuable eco-regions. Conservation Biol. 12:502–515, 1998. [09] P. T. Mpiana. Contribution à l’étude thermodynamique et cinétique de la complexation de la protohemine et la deutérohémine avec les antipaludéens à noyau quinoléine. Thèse de doctorat, Université de Kinshasa, 2003. [10] D. D. Bibelayi, P. I. Kilunga, A. S. Lundemba, M. K. Bokolo, P. T. Mpiana, P. V. Tsalu, J. Pradon, C. C. Groom, C. W. Kadima, L. Van Meervelt, Z. G. Yav. Interaction of Iron (III)-5, 10, 15, 20-Tetrakis (4-Sulfonatophenyl) Porphyrin with Chloroquine, Quinine and Quinidine. Crystal Structure Theory and Applications 6: 25-38, 2017. [11] World Health Organization. How to investigate drug use in health facilities. Geneva: World Health Organization, 1993. http://apps.who.int/medic inedo cs/pdf/s2289 e/s2289 e.pdf. [12] L. Nyamangombe, K. N. Ngbolua, L. Nguma, N. Mumba, K. Takaisi, D. D. Bibelayi. Etude par immunofluorescence du taux d'anticorps antiplasmodium chez les populations vivant en zone d'endémie palustre, Annales Faculté des Sciences (Université de Kinshasa) 2:105-108, 2006. [13] R. Getachew, A. Wote, M. B. Eshetu. Evaluation of anti-malarial drugs’ use in Fitche Hospital, North Shoa, Oromia Region, Ethiopia. J Pharm Bioallied Sci. 8 (1): 39–42, 2016. [14] World Health Organization. Global report on anti-malarial drug efficacy and drug resistance: 2000-2010, Geneva, Switzerland, 2010. [15] M. A. Yousif, A. A. Adeel. Antimalarials prescribing patterns in Gezira state: Precepts and practices. East Mediterr Health J 6: 939-47, 2000. [16] K. N. Ngbolua, G. M. Ngemale, N. F. Konzi, C. A. Masengo, Z. B. Gbolo, B. M. Bangata, T. S. Yangba, N. Gbiangbada. Utilisation de produits forestiers non ligneux à Gbadolite (District du Nord-Ubangi, Province de l’Equateur, R. D. Congo): Cas de Cola acuminata (P. Beauv.) Schott & Endl. (Malvaceae) et de Piper guineense Schumach. & Thonn. (Piperaceae). Congo Sciences 2 (2): 61-66, 2014. [17] K. N. Ngbolua, K. H. Yabuda, M. Abia, N. G. Bongo, K. Mabe, G. A. Nzamonga, A. C. Masengo, D. R. Djolu, B. J. Likolo, G. N. Ngemale, M. M. Molongo, M. Mangbukudua, K. M. Kamienge, K. A. Gbatea, Z. Bosanza, M. Mongeke, L. M. Muanza. Preliminary ecological study of plant species of Lokame Natural Forest (Nord Ubangi Province, Democratic Republic of the Congo): A special emphasis on Non-timber Forest Products. J. of Advanced Botany and Zoology 5 (2): 1-6, 2017a. [18] K. N. Ngbolua, B. S. Ambayi, N. G. Bongo, A. C. Masengo, D. R. Djolu, B. J. Likolo, Z. B. Gbolo, S. Ngunde-te-Ngunde, B. J. Iteku, P. T. Mpiana. Ethno-botanical survey and floristic study of medicinal plant taxa used by Traditional Healers in Gbadolite city (Province of Nord-Ubangi, Congo-Kinshasa). Journal of Modern Drug Discovery and Drug Delivery Research 5 (2): 1-7, 2017b. doi: 10.5281/zenodo/1116857. [19] K. N. Ngbolua, B. S. Ambayi, N. G. Bongo, D. R. Djolu, G. A. Nzamonga, A. C. Masengo, J. L. Koyagialo, K. A. Gbatea, M. M. Ndaba, K. R. Kowozogono. Preliminary survey on the bushmeat sector in Nord-Ubangi Province (DR Congo): Case of Gbado-Lite city and its surroundings. J. Advanced Botany and Zoology 5 (3): 1-7, 2017c. doi: 10.5281/zenedo.1024570. [20] World Health Organization. Universal access to malaria diagnostic testing: an operational manual. Geneva, Switerzeland: 2011. [21] World Health Organization. T3: Test. Treat. Track. Scaling up Diagnostic Testing, Treatment and Surveillance for Malaria. Geneva, Switerzeland: 2012. [22] K. R. Kabongo, A. M. Ntetani. High school student’s area target group for fight against self-medication with antimalarial drugs: A pilot study in university of Kinshasa, Democratic Republic of Congo: Journal of Tropical Medicine, Article ID 6438639, 3 pages, 2016. http://dx.doi.org/10.1155/2016/6438639. [23] C. Mulenga, B. Kawimbe. Self-treatment of uncomplicated malaria at community level in Masala Township, Ndola District, Zambia: Prevalence, Knowledge and Factors influencing self-treatment. Malaria Control & Elimination 4:133, 2015. doi:10.4172/2470-6965.1000133. [24] M. N. K. Babayara, B. Addo. Presumptive treatment of malaria in Ghana: Was it ever useful? Evidence from the Kassena-Nankana district of Northern Ghana. Malaria Research and Treatment. Article ID 3408089, 6 pages, 2018. https://doi.org/10.1155/2018/3408089. [25] P. N. Mandokoa, V. Sinou, D. M. Mbongi, N. D. Mumba, K. G. Mesia, L. J. Likwela, K. Shamamba, M. L. Tshilolo, T. Muyembe, D. Parzy. Access to artemisinin-based combination therapies and other anti-malarial drugs in Kinshasa. Médecine et maladies infectieuses 48: 269–277, 2018. https://doi.org/10.1016/j.medmal.2018.02.003. [26] P. G. Bray, S. A. Ward, P. M. O’Neill. Quinolines and Artemisinin: Chemistry, Biology and History. CTM 295: 3-38, 2005. [27] M. D. Tringle, H. Jewell, J. L. Maggs, P. M. O’Neill, B K. Park. The bioactivation of amodiaquine by human polymorphonuclear leukocytes in vitro: Chemical mechanisms and the effect of fluorine substitution. Biochem. Pharmaco. 50: 1113-1119, 1995. [28] H. Jewell, A. C. Harrison, P. M. O’Neill, J. E. Ruscoe, B. K. Park. Role of hepatic metabolism in the bioactivation and detoxication of amodiaquine. Xenobiotica 25: 199-217, 1995. [29] D. J. Naisbit, D. P. Williams, P. M. O’Neill, J. L. Maggs, D. J. Willock, M. Pirmohamed et al. Metabolism-dependent neutrophil cytotoxicity of amodiaquine: A comparaison with pyronaridine and related antimalarial drugs. Chem. Res. Toxicol. 11: 1586-1595, 1998. [30] R. N. Okoro, M. O. Jamiu. The Cross-Sectional Evaluation of the Use of Artemisinin-Based Combination Therapy for Treatment of Malaria Infection at a Tertiary Hospital in Nigeria. Journal of Tropical Medicine, Article ID 2025858, 2018.