Antimalarial Prescription Patterns and Adherence to the WHO 2024 Guidelines among Pregnant Women: A Retrospective Study from a Nigerian Tertiary Hospital

Background Adherence to the World Health Organization (WHO) treatment guidelines for malaria during pregnancy is crucial for improved maternal and perinatal health outcomes. This study aimed to assess antimalarial prescription patterns and adherence to the WHO 2024 guidelines during pregnancy using the Federal Medical Centre (FMC) Makurdi as a case study. Method A retrospective cross-sectional study was conducted using data extracted from the antenatal records of pregnant women who attended antenatal care (ANC) at FMC Makurdi between January and December 2024 and received antimalarial prescriptions. Descriptive statistics were used to summarize prescribing patterns and assess adherence to the WHO 2024 guidelines. Results A total of 1,062 eligible prescriptions were analysed. Most women were in their second or third trimesters (44.4% vs 55.0%) and had asymptomatic malaria (96.1%). The mean age was 28.0 ± 4.8 years, and the mean gestational age was 27.8 ± 5.8 weeks. Overall, sulfadoxine-pyrimethamine (SP) was the most commonly prescribed antimalarial medication (96.0%), whereas artemether-lumefantrine (AL) was mostly prescribed for uncomplicated malarial cases (92.5%). Furthermore, adherence to the WHO 2024 guidelines was high (99.4%), but trimester-specific deviations from the guidelines were noted. Conclusion FMC Makurdi highly adhered to the WHO 2024 guidelines for malaria treatment and prevention in pregnancy, but trimester-specific deviations, particularly in the first trimester, were identified. Continuous healthcare provider education and policy implementation are needed to ensure positive maternal and perinatal health outcomes, especially in malaria-endemic settings.