Administrative practices of health professionals and use of artesunate-amodiaquine by community members for treating uncomplicated malaria in southern Ghana: implications for artemisinin-based combination therapy deployment
Administrative practices of health professionals and use of artesunate-amodiaquine by community members for treating uncomplicated malaria in southern Ghana: implications for artemisinin-based combination therapy deployment
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DOI：
10.1111/j.1365-3156.2011.02833.x
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发表时间：
2011-10-01
影响因子：
3.3
通讯作者：
Ohta, Nobuo
中科院分区：
文献类型：
--
作者：
Kwansa-Bentum, Bethel;Ayi, Irene;Ohta, Nobuo
目的探讨使用青蒿素为基础的组合和单一疗法的社区成员和卫生专业人员在治疗疟疾的行政惯例在Ghana.METHOD本研究是一个以社区为基础的横断面调查在加纳南部的11个农村和城市地区。使用访谈方法，封闭式问卷调查管理的社区成员。类似的问卷调查也管理在卫生设施，社区药房和持牌chemical shops.Results共1085人，包括959非卫生专业人员和126卫生专业人员进行了采访。57%的社区成员在怀疑有疟疾时首先去药房/药店。根据参与调查的药物销售商的资料，蒿甲醚-苯芴醇是处方/销售最多的抗疟疾药物（59.2%），其次是双氢青蒿素（35%）、磺胺甲基嘧啶（33.0%）及青蒿琥酯-阿莫地喹（27.2%）。大多数顾客在没有处方的情况下到药房或药店购买抗疟药物，由店员挑选;在这种情况下，双氢青蒿素和青蒿琥酯单药疗法就像AS-AQ和AL一样出售。氯喹在被禁止5年后仍被一些药品供应商出售。结论尽管AS-AQ和AL的使用是可以接受的，双氢青蒿素和青蒿琥酯单一疗法的频繁使用威胁到青蒿素综合疗法的未来。
OBJECTIVE To investigate the use of artemisinin-based combination and monotherapy by community members and the administrative practices of health professionals in treating malaria in Ghana.METHOD This study is a community-based cross-sectional survey in 11 rural and urban areas in southern Ghana. Using the interviewer method, close-ended questionnaires were administered to community members. Similar questionnaires were also administered in health facilities, community pharmacies and licensed chemical shops.RESULTS A total of 1085 individuals comprising 959 non-health professionals and 126 health professionals were interviewed. Fifty-seven per cent of the community members visit pharmacies/drug stores as the first point of call when they suspect malaria. According to the participating drug sellers, artemether-lumefantrine (AL) is the most prescribed/sold anti-malarial drug (59.2%), followed by dihydroartemisinin (35%), sulfadoxine-pyrimethamine (33.0%) and artesunate-amodiaquine (AS-AQ) (27.2%). The majority of customers who visit pharmacies or drug stores without prescription have their antimalarial drug selected by the shop attendant; in situations like that, dihydroartemisinin and artesunate monotherapies are sold just as AS-AQ and AL. Chloroquine is still sold by some drug vendors, 5 years after its proscription.CONCLUSION Whereas the use of AS-AQ and AL are acceptable, the frequent use of dihydroartemisinin and artesunate monotherapy threatens the future of ACTs.