Published in PLOS One on 2026-04-20, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Edidiong Orok, Oluwaseun Olumoko, Inimuvie Ekada, Amos Oladunni
Source: PLOS One • DOI 10.1371/journal.pone.0347554
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Inappropriate use of antimalarial medications can accelerate the development of antimicrobial resistance (AMR), undermining treatment efficacy and public health goals. Artemether-lumefantrine (A/L) is the first-line treatment for uncomplicated malaria in Nigeria, yet its misuse persists, particularly among young adults. This study assessed knowledge gaps in A/L use among university students in Southwestern Nigeria to identify opportunities for targeted intervention. A cross-sectional online survey was conducted among undergraduate students from three universities in Southwestern Nigeria. Respondents’ knowledge of A/L was categorized as good (≥70%), fair (50–69%), or poor (<50%). Associations between knowledge and demographic or experiential variables were analysed using independent sample t-tests and one-way ANOVA, with significance set at p < 0.05. Data analysis was performed using SPSS version 27. A total of 392 students participated, with a mean age of 19.5 years; 58.4% were female. While 64.5% knew the correct timing for the second dose of A/L, only 22.2% correctly identified appropriate storage methods. About 94.9% preferred swallowing the drug with water after food, but many were unaware of common side effects or appropriate responses. Overall, 44.6% of students demonstrated poor knowledge of A/L use. Knowledge scores differed significantly by level of study (p = 0.001) and previous use of antimalarials (p = 0.04). Substantial knowledge gaps and misconceptions about A/L use exist among university students in Southwestern Nigeria. These findings underscore the urgent need for health education initiatives targeting young adults to promote safe and effective use of antimalarial medications and may inform health education strategies aimed at promoting rational antimalarial use and strengthening malaria control efforts.
Introduction
In sub-Saharan Africa, malaria remains the foremost cause of morbidity and mortality. It accounts for 40−45% of visits to physicians, 57% of hospitalization days, and 40% of under-5 mortality [1]. According to the WHO World Malaria Report 2022, there were an estimated 619,000 malaria deaths globally in 2021, a slight decrease from 625,000 in 2020, but still significantly higher than the 568,000 deaths in 2019 [2]. Consequently, the increased hospitalisation rate, diagnostic cost and unnecessary medicine use severely affects the economy of these countries [2]. These statistics reveal the extent to which malaria remains a public health emergency and the need for a concerted effort in curbing its effect in health care and the economy at large. The discovery of synthetic antimalarial agent has since been the cornerstone of malaria chemotherapy. This innovation reduced the mortality caused by malaria while increasing the average life expectancy of those in malaria-endemic regions [3]. Ultimately, the success of these antimalarial medications stems from their ability to prevent the resistance from the parasite (Plasmodium spp.). Hence, measures need to be put in place to safeguard these drugs to prevent their inefficacy.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Edidiong Orok, Oluwaseun Olumoko, Inimuvie Ekada, Amos Oladunni. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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