How do Metronidazole Drawbacks Impact Patient Compliance and Therapeutic Outcomes in Treating Amoebiasis in Rwanda

Abstract

Amoebiasis is a parasitic disease with significant public health concerns in the Tropics. Metronidazole which is the first line most common prescribed medicine has shown a number of side effects difficult to tolerate by some patients, and many cases of true or erroneous treatment failure or frequent relapses have been observed among students of the University of Rwanda. This study aimed to evaluate how metronidazole side effects impact patients’ compliance, misuse practice, and therapeutic outcomes. A cross-sectional survey was conducted using a self-administered questionnaire to 115 students who had used before or were on metronidazole treatment for amoebiasis at the time of study.  The data showed almost all respondents experienced at least one of the known metronidazole side effects including nausea, vomiting, headache, dry mouth or metallic taste, stomach upset, loss of appetite, dizziness, fatigue, somnolence, constipation, diarrhoea, rash, dysuria, itching and fever. About 36.8% of respondents were judged noncompliant, stopping taking medicine. There was a significant association between the number of side effects experienced per respondent and the status of patient compliance; and also between compliance status and clinical improvement (p<0.001). Notwithstanding patient’s noncompliance and a possible actual metronidazole resistance, some of relapses could be due to incomplete prescribing regimen which does not associate lumen (anti cysts) molecules and metronidazole. Prescribers are invited to seriously address this issue for a better achievement of amoeba eradication.