Assessment of Plasmodium falciparum Antimalarial Drug Use and Treatment Outcomes at Primary Healthcare Level in Borno State

Rational use of artemisinin-based combination therapy at primary healthcare level is essential for malaria control in conflict-affected northeastern states, where healthcare systems face structural fragility. This study assessed antimalarial drug prescribing practices and treatment outcomes among malaria-confirmed patients at primary healthcare centres in non-conflict zones of Borno State, Northeast Nigeria. Retrospective review of treatment registers from 15 primary healthcare centres over a 12-month period was complemented by exit interviews with 200 malaria patients or their caregivers. National malaria treatment guideline adherence rates, treatment completion rates, and 14-day clinical outcome data were evaluated. Artemisinin-based combination therapy was prescribed in 79.2 percent of confirmed cases, with the remaining cases receiving artemisinin monotherapy or non-artemisinin drugs. Treatment completion rate was 71.8 percent, with affordability and side effects cited as reasons for early discontinuation. Fourteen-day treatment failure was documented in 8.4 percent of cases where follow-up was achieved. Facilities with trained malaria focal persons had significantly higher guideline compliance. The study recommends enhanced malaria treatment training for primary healthcare workers and financial barriers reduction strategies in Borno State. Keywords: antimalarial drugs, treatment outcomes, primary healthcare, artemisinin, Borno State.