Perceptions and utilization of the anti-malarials artemether-lumefantrine and dihydroartemisinin-piperaquine in young children in the Chikhwawa District of Malawi: a mixed methods study.
Perceptions and utilization of the anti-malarials artemether-lumefantrine and dihydroartemisinin-piperaquine in young children in the Chikhwawa District of Malawi: a mixed methods study.
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马拉维奇克瓦瓦（Chikhwawa）区的幼儿的抗疟疾人的感知和利用是肉眼素和二氢氨基氨酸蛋白酶素：一项混合方法研究。
DOI：
10.1186/s12936-014-0528-8
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发表时间：
2015-01-21
期刊：
影响因子：
3
通讯作者：
Lalloo DG
中科院分区：
文献类型：
--
作者：
Ewing VL;Terlouw DJ;Kapinda A;Pace C;Richards E;Tolhurst R;Lalloo DG
坚持抗疟疾给药时间表对于确保有效治疗至关重要。由于回忆问题和参与者对影响其行动或反应的期望行为的意识，衡量遵守情况具有挑战性。本研究采用定性方法，允许建立融洽的关系，探讨抗疟疾药物在幼儿中的使用问题，并使用结果来指导特定背景下的调查问卷的发展，对蒿甲醚-苯芴醇（AL）和双氢青蒿素-哌喹（DHA-PPQ）的看法和依从性。定性数据收集包括12个焦点小组讨论，探讨社区的看法，抗疟疾药物和管理药物的经验，以儿童。对22名护理人员进行了关键事件访谈，以探索在最近的发热事件中给予幼儿AL可分散或原始制剂的经验。采用结构化问卷调查，收集数据的经验，最近的治疗和坚持抗疟药在随访期间与218名照顾者，其子女最近接受分散AL或DHA-PPQ治疗。照顾者在给儿童用药时遇到很大困难。虽然可分散AL的甜味可能减少了儿童和护理人员之间的冲突，但由于药物损失导致的次优剂量仍然是一个问题，并且在接受DHA-PPQ的患者中，总体依从性更高，这需要更少的剂量。一些护理人员被发现根据他们是否认为药物太弱或太强而故意改变给药时间表。他们还提出了治疗效果不佳的理论，例如将其归因于药物与儿童之间缺乏相容性。应加强健康教育信息，以确保在分发过程中使用清晰的图片和口头说明，并解释剂量不足和过量的后果以及对可能的不良事件的适当反应。进一步优化儿童抗疟疾依从性需要开发具有药理学特性的抗疟疾药物，这些药物允许用户友好的给药和简化的给药方案。
Adherence to anti-malarial dosing schedules is essential to ensure effective treatment. Measuring adherence is challenging due to recall issues and the participants’ awareness of the desired behaviour influencing their actions or responses. This study used qualitative methods, which allow for rapport building, to explore issues around anti-malarial utilization in young children, and used the results to guide the development of a context specific questionnaire on perceptions and adherence to artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DHA-PPQ). Qualitative data collection included 12 focus group discussions which explored community perceptions of anti-malarials and experiences of administering medications to children. Critical incidence interviews were conducted with 22 caregivers to explore experiences of administering the dispersible or original formulation of AL to young children during recent febrile episodes. A structured questionnaire was used to gather data on experience of recent treatment and adherence to anti-malarials during follow-up visits with 218 caregivers whose child was recently treated with either dispersible AL or DHA-PPQ. Caregivers experience great difficulty in administering medication to children. While the sweet taste of dispersible AL may have reduced conflict between the child and caregiver, sub-optimal dosing due to medication loss remained a problem and overall adherence was greater among those receiving DHA-PPQ, which requires fewer doses. Some caregivers were found to deliberately alter the dosing schedule according to whether they perceived the medication to be too weak or strong. They also developed theories for poor treatment outcomes, such as attributing this to lack of compatibility between the medication and the child. Health education messages should be strengthened to ensure a combination of clear pictorial and verbal instructions are used during dispensing, and consequences of under and over-dosing are explained alongside appropriate responses to possible adverse events. Further optimizing of anti-malarial adherence among children requires the development of anti-malarials with pharmacological properties that allow user-friendly administration and simplified dosing schedules.
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影响因子：
3
作者：
Meremikwu, Martin;Alaribe, Ambrose;Ezedinachi, Emmanuel
通讯作者：
Ezedinachi, Emmanuel
影响因子：
3.3
作者：
Depoortere, E;Guthmann, JP;Legros, D
通讯作者：
Legros, D
影响因子：
3.3
作者：
Duarte, EC;Gyorkos, TW
通讯作者：
Gyorkos, TW
肯尼亚加里萨和布尼亚拉地区坚持以青蒿素为基础的联合疗法。
影响因子：
3
作者：
Lawford H;Zurovac D;O'Reilly L;Hoibak S;Cowley A;Munga S;Vulule J;Juma E;Snow RW;Allan R
通讯作者：
Allan R
影响因子：
3
作者：
Checchi, Francesco;Piola, Patrice;Guthmann, Jean-Paul
通讯作者：
Guthmann, Jean-Paul