Assessment of Antimalarial Drug Adherence among Children Under Five in Rural Communities of Benue State, North Central Nigeria

Background: Adherence to prescribed antimalarial regimens is essential for treatment success and the prevention of recrudescence and drug resistance. In rural North Central Nigeria, adherence among caregivers administering antimalarials to young children remains poorly characterised. This study assessed antimalarial drug adherence among caregivers of children under five in rural communities of Benue State. Methods: A cross-sectional survey was carried out in six rural communities across two local government areas. Caregivers of 260 children who had received artemisinin-based combination therapy in the preceding four weeks were interviewed using a structured questionnaire. Adherence was assessed by caregiver self-report and pill count where applicable. Barriers to adherence were explored using Likert-scale items. Results: Complete adherence was reported in 52 percent of cases. Major barriers included side effects experienced by the child (38%), forgetting doses (32%), and improvement of symptoms before completing the course (28%). Mothers with secondary education demonstrated significantly higher adherence rates than those with no formal schooling (p less than 0.01). Conclusion: Antimalarial adherence among caregivers in rural Benue is suboptimal and is influenced by educational status and perceived side effects. Health worker counselling and reminder interventions at dispensing points should be strengthened. Keywords: antimalarial adherence, children under five, Benue, caregivers, artemisinin-based combination therapy