Malaria morbidity, treatment-seeking behaviour, and mortality in a cohort of young children in rural Burkina Faso
Malaria morbidity, treatment-seeking behaviour, and mortality in a cohort of young children in rural Burkina Faso
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DOI：
10.1046/j.1365-3156.2003.01030.x
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发表时间：
2003-04-01
影响因子：
3.3
通讯作者：
Kouyaté, B
中科院分区：
文献类型：
--
作者：
Müller, O;Traoré, C;Kouyaté, B
目的描述布基纳法索农村疟疾全流行区幼儿的发热相关发病率、发热寻求治疗行为和病因特异性死亡率的模式。709名6-31个月的代表性儿童每天随访6个月以上结果在1848例发病中，1640例（89%）为发热，894例（55%）归因于疟疾（发热+ ≥ 5000个寄生虫/穆尔）。85%的发热病例得到了治疗，主要是用氯喹和扑热息痛治疗，69%的治疗在家庭进行，16%在地方保健中心，13%在村庄，1%在医院。在保健中心或医院寻求治疗与可及性和疾病严重程度有关。脑型疟疾和与营养不良有关的腹泻是最常诊断的死亡原因。虽然大多数儿童在死后被诊断为腹泻，但没有得到任何治疗，而死于疟疾的儿童往往没有得到充分的治疗。特别是，有一个缺乏适当的二线治疗后，氯喹治疗未能解决symptoms.CONCLUSIONS这些调查结果要求更有效地预防和治疗疟疾，营养不良和腹泻在非洲农村社区，以及更好地监督现有的疟疾治疗准则，在正式的卫生服务。
OBJECTIVE To describe the pattern of fever-associated morbidity, treatment-seeking behaviour for fever episodes, and cause-specific mortality in young children of a malaria-holoendemic area in rural Burkina Faso.METHODS In a longitudinal community-based intervention study, 709 representative children aged 6-31 months were followed daily over 6 months (including the main malaria transmission period) through village-based field staff.RESULTS Of 1848 disease episodes, 1640 (89%) were fever episodes, and of those, 894 (55%) were attributed to malaria (fever + greater than or equal to5000 parasites/mul). Eighty-five percent of fever episodes were treated, mainly with chloroquine and paracetamol, 69% of treatments took place in households, 16% in local health centres, 13% in villages, and 1% in hospitals. Treatment-seeking in a health centre or hospital was associated with accessibility and disease severity. Cerebral malaria and malnutrition-associated diarrhoea were the most frequently diagnosed causes of death. While most children with a post-mortem diagnosis of diarrhoea had not received any treatment, children who died of malaria had often received insufficient treatment. In particular, there was a lack of an appropriate second-line treatment at formal health services after chloroquine treatment had failed to resolve symptoms.CONCLUSIONS These findings call for more effective prevention and treatment of malaria, malnutrition and diarrhoea in rural African communities, as well as for better supervision of existing malaria treatment guidelines in formal health services.