Treatment of paediatric malaria during a period of drug transition to artemether-lumefantrine in Zambia: cross sectional study.
OBJECTIVE: To evaluate treatment practices for uncomplicated malaria after the policy change from chloroquine to sulfadoxine-pyrimethamine and to artemether-lumefantrine in Zambia. DESIGN: Cross sectional survey. SETTING: Outpatient departments of all government and mission facilities in four distr...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Sprog: | English |
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2005
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| _version_ | 1826273229850804224 |
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| author | Zurovac, D Ndhlovu, M Rowe, A Hamer, D Thea, D Snow, R |
| author_facet | Zurovac, D Ndhlovu, M Rowe, A Hamer, D Thea, D Snow, R |
| author_sort | Zurovac, D |
| collection | OXFORD |
| description | OBJECTIVE: To evaluate treatment practices for uncomplicated malaria after the policy change from chloroquine to sulfadoxine-pyrimethamine and to artemether-lumefantrine in Zambia. DESIGN: Cross sectional survey. SETTING: Outpatient departments of all government and mission facilities in four districts in Zambia. PARTICIPANTS: 944 children with uncomplicated malaria seen by 103 health workers at 94 health facilities. MAIN OUTCOME MEASURES: Antimalarial prescriptions in accordance with national guidelines and influence of factors on health workers' decision to prescribe artemether-lumefantrine. RESULTS: Artemether-lumefantrine, sulfadoxine-pyrimethamine, and chloroquine were available, respectively, at 48 (51%), 94 (100%), and 71 (76%) of the 94 facilities. Of 944 children with uncomplicated malaria, only one child (0.1%) received chloroquine. Among children weighing less than 10 kg, sulfadoxine-pyrimethamine was commonly prescribed in accordance with guidelines (439/550, 79.8%). Among the children weighing 10 kg or more, sulfadoxine-pyrimethamine was commonly prescribed (266/394, 68%), whereas recommended artemether-lumefantrine was prescribed for only 42/394 (11%) children. Among children weighing 10 kg or more seen at facilities where artemether-lumefantrine was available, the same pattern was observed: artemether-lumefantrine was prescribed for only 42/192 (22%) children and sulfadoxine-pyrimethamine remained the drug of choice (103/192, 54%). Programmatic activities such as in-service training and provision of job aids did not seem to influence the prescribing of artemether with lumefantrine. CONCLUSION: Although the use of chloroquine for uncomplicated malaria was successfully discontinued in Zambia, the change of drug policy towards artemether-lumefantrine does not necessarily translate into adequate use of this drug at the point of care. |
| first_indexed | 2024-03-06T22:25:01Z |
| format | Journal article |
| id | oxford-uuid:566211ba-db52-405b-a223-979eea46f64d |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:25:01Z |
| publishDate | 2005 |
| record_format | dspace |
| spelling | oxford-uuid:566211ba-db52-405b-a223-979eea46f64d2022-03-26T16:49:51ZTreatment of paediatric malaria during a period of drug transition to artemether-lumefantrine in Zambia: cross sectional study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:566211ba-db52-405b-a223-979eea46f64dEnglishSymplectic Elements at Oxford2005Zurovac, DNdhlovu, MRowe, AHamer, DThea, DSnow, R OBJECTIVE: To evaluate treatment practices for uncomplicated malaria after the policy change from chloroquine to sulfadoxine-pyrimethamine and to artemether-lumefantrine in Zambia. DESIGN: Cross sectional survey. SETTING: Outpatient departments of all government and mission facilities in four districts in Zambia. PARTICIPANTS: 944 children with uncomplicated malaria seen by 103 health workers at 94 health facilities. MAIN OUTCOME MEASURES: Antimalarial prescriptions in accordance with national guidelines and influence of factors on health workers' decision to prescribe artemether-lumefantrine. RESULTS: Artemether-lumefantrine, sulfadoxine-pyrimethamine, and chloroquine were available, respectively, at 48 (51%), 94 (100%), and 71 (76%) of the 94 facilities. Of 944 children with uncomplicated malaria, only one child (0.1%) received chloroquine. Among children weighing less than 10 kg, sulfadoxine-pyrimethamine was commonly prescribed in accordance with guidelines (439/550, 79.8%). Among the children weighing 10 kg or more, sulfadoxine-pyrimethamine was commonly prescribed (266/394, 68%), whereas recommended artemether-lumefantrine was prescribed for only 42/394 (11%) children. Among children weighing 10 kg or more seen at facilities where artemether-lumefantrine was available, the same pattern was observed: artemether-lumefantrine was prescribed for only 42/192 (22%) children and sulfadoxine-pyrimethamine remained the drug of choice (103/192, 54%). Programmatic activities such as in-service training and provision of job aids did not seem to influence the prescribing of artemether with lumefantrine. CONCLUSION: Although the use of chloroquine for uncomplicated malaria was successfully discontinued in Zambia, the change of drug policy towards artemether-lumefantrine does not necessarily translate into adequate use of this drug at the point of care. |
| spellingShingle | Zurovac, D Ndhlovu, M Rowe, A Hamer, D Thea, D Snow, R Treatment of paediatric malaria during a period of drug transition to artemether-lumefantrine in Zambia: cross sectional study. |
| title | Treatment of paediatric malaria during a period of drug transition to artemether-lumefantrine in Zambia: cross sectional study. |
| title_full | Treatment of paediatric malaria during a period of drug transition to artemether-lumefantrine in Zambia: cross sectional study. |
| title_fullStr | Treatment of paediatric malaria during a period of drug transition to artemether-lumefantrine in Zambia: cross sectional study. |
| title_full_unstemmed | Treatment of paediatric malaria during a period of drug transition to artemether-lumefantrine in Zambia: cross sectional study. |
| title_short | Treatment of paediatric malaria during a period of drug transition to artemether-lumefantrine in Zambia: cross sectional study. |
| title_sort | treatment of paediatric malaria during a period of drug transition to artemether lumefantrine in zambia cross sectional study |
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