Adherence and effectiveness of drug combination in curative treatment among children suffering uncomplicated malaria in rural Senegal.
نویسندگان
چکیده
Increased Plasmodium falciparum resistance to chloroquine has prompted national malaria programs to develop new policies in several African countries. Less than a year after the introduction of amodiaquine/sulfadoxine-pyrimethamine (AQ/SP) as first-line treatment in Senegal, we examined adherence rates to therapy and its efficacy among children. The study was conducted in five dispensaries in rural Senegal. Children aged 2-10 years with a presumptive diagnosis of malaria were prescribed AQ/SP. Thick blood film analyses were carried out on days 0, 3, 7, 14 and 28. Blood and urine samples were collected on day 3 for drug level measurements. The principal caregivers were questioned on treatment adherence. Among the 289 recruited children, 144 had a parasitemia >2500/microl. The results demonstrated markedly good efficacy for the treatment, as no detectable parasitemia was observed on day 28 for 97.9% of the children. However, we noticed that 35.3% of children did not comply with the recommended doses and 62.3% did not exactly adhere to the drug schedule. Despite the good efficacy of the drugs, adherence to the therapeutic scheme was poor. Strategies to promote patient adherence would improve drug performance and thus might help to prevent the rapid emergence of drug resistance.
منابع مشابه
Adherence to Artesunate-Amodiaquine Therapy for Uncomplicated Malaria in Rural Ghana: A Randomised Trial of Supervised versus Unsupervised Drug Administration
Introduction. To enhance effective treatment, african nations including Ghana changed its malaria treatment policy from monotherapy to combination treatment with artesunate-amodiaquine (AS+AQ). The major challenge to its use in loose form is adherence. Objective. The objectives of this study were to investigate adherence and treatment outcome among patients treated with AS+AQ combination therap...
متن کاملEffectiveness of quinine versus artemether-lumefantrine for treating uncomplicated falciparum malaria in Ugandan children: randomised trial
OBJECTIVE To compare the effectiveness of oral quinine with that of artemether-lumefantrine in treating uncomplicated malaria in children. DESIGN Randomised, open label effectiveness study. SETTING Outpatient clinic of Uganda's national referral hospital in Kampala. PARTICIPANTS 175 children aged 6 to 59 months with uncomplicated malaria. INTERVENTIONS Participants were randomised to re...
متن کاملClinical Pharmacology of the Antimalarial Artemisinin-Based Combination and other Artemisinins in Children
In 2010, there were estimated 219 million cases of malaria resulting in 666,000 deaths and two-thirds were children. Children are more vulnerable than adults to malaria parasites. In sub-Saharan African countries, maternal malaria is associated with up to 200,000 estimated infant deaths yearly. Malaria is caused by five Plasmodium parasites namely: Plasmodium falciparum, Plasmodium vivax, Plasm...
متن کاملMalaria Knowledge and Treatment Practices in Enugu State, Nigeria: A Qualitative Study
Background Malaria accounts for 60% of outpatient visits in Nigeria. The aim of the study was to assess the knowledge of malaria and its treatment practices in Enugu state, Nigeria. Methods Qualitative data was collected through the use of focus group discussions (FGDs), from six villages three each from urban and rural areas of Enugu state, Nigeria. A total of 18 FGDs involving 189 participa...
متن کاملEfficacy and effectiveness of the combination of sulfadoxine/pyrimethamine and a 3-day course of artesunate for the treatment of uncomplicated falciparum malaria in a refugee settlement in Zambia.
In the Maheba Refugee Settlement, in the clinics supported by Medecins Sans Frontieres, all children aged up to 5 years with a confirmed diagnosis of uncomplicated falciparum malaria are treated with the combination of sulfadoxine/pyrimethamine (SP) and artesunate (AS). We compared the treatment's efficacy and effectiveness. Patients were randomized in order to receive the treatment supervised ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Transactions of the Royal Society of Tropical Medicine and Hygiene
دوره 102 8 شماره
صفحات -
تاریخ انتشار 2008