Treatment-seeking patterns for malaria in pharmacies in five sub-Saharan African countries.
Treatment-seeking patterns for malaria in pharmacies in five sub-Saharan African countries.
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五个撒哈拉以南非洲国家的药房的疟疾寻求治疗模式。
DOI：
10.1186/s12936-017-1997-3
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发表时间：
2017-08-29
期刊：
影响因子：
3
通讯作者：
Saba J
中科院分区：
文献类型：
--
作者：
Ladner J;Davis B;Audureau E;Saba J
在撒哈拉以南非洲国家，建议将青蒿素综合疗法作为一线抗疟疾治疗策略。世卫组织的政策建议，在治疗前对所有疑似疟疾病例进行显微镜检查或快速诊断试验（RDT）的寄生虫学确认。在了解私营部门影响病人求医行为和抗疟疾药物购买决定的因素方面仍存在差距。本研究的目的是确定加纳、肯尼亚、尼日利亚、坦桑尼亚和乌干达的患者寻求治疗的行为。在五个国家的208个随机选择的零售店进行了面对面的患者访谈。在每个诊所，对5名表示前来寻求抗疟疾治疗的病人进行了离职面谈。调查问卷在五个国家是匿名和标准化的，收集了不同因素的数据，包括社会人口特征、病史、诊断实践（即显微镜或RDT）、处方实践和治疗购买。治疗的价格也是从经销商那里收取的。共纳入来自这五个国家的994例患者。疟疾诊断的地点在这五个国家有显著差异。共进行了484次血液诊断试验（72.3%采用显微镜检查，27.7%采用RDT）。72.5%的接受过血液检查的患者和86.5%的未接受血液检查的患者购买了ACT，无论检查结果是阳性还是阴性（p < 10−4）。共有531名患者（53.4%）接受了抗疟疾药物处方，其中82.9%为ACT处方。不同国家的处方存在显著差异。共有923名患者（92.9%）在销售点购买了抗疟疾药物，其中79.1%的患者购买了ACT药物：加纳为98.0%，肯尼亚为90.5%，尼日利亚为80.4%，坦桑尼亚为69.2%，乌干达为57.7%（p < 10−4）。拥有药物处方不是与ACT药物购买相关的重要预测因素（肯尼亚除外）。在肯尼亚、尼日利亚和坦桑尼亚，凭处方购买的青蒿素综合疗法药物的数量大于无处方购买的数量。这项研究突出了撒哈拉以南非洲五个国家在药物处方和购买模式方面的差异。私营部门在撒哈拉以南非洲的发热病例管理中发挥着越来越重要的作用。了解私人零售店的特点及其在提供抗疟疾药物方面所发挥的作用可能有助于设计有效的疟疾干预措施。
Artemisinin-based combination therapy (ACT) is recommended as the first-line anti-malarial treatment strategy in sub-Saharan African countries. WHO policy recommends parasitological confirmation by microscopy or rapid diagnostic test (RDT) in all cases of suspected malaria prior to treatment. Gaps remain in understanding the factors that influence patient treatment-seeking behaviour and anti-malarial drug purchase decisions in the private sector. The objective of this study was to identify patient treatment-seeking behaviour in Ghana, Kenya, Nigeria, Tanzania, and Uganda. Face-to-face patient interviews were conducted at a total of 208 randomly selected retail outlets in five countries. At each outlet, exit interviews were conducted with five patients who indicated they had come seeking anti-malarial treatment. The questionnaire was anonymous and standardized in the five countries and collected data on different factors, including socio-demographic characteristics, history of illness, diagnostic practices (i.e. microscopy or RDT), prescription practices and treatment purchase. The price paid for the treatment was also collected from the outlet vendor. A total of 994 patients were included from the five countries. Location of malaria diagnosis was significantly different in the five countries. A total of 484 blood diagnostic tests were performed, (72.3% with microscopy and 27.7% with RDT). ACTs were purchased by 72.5% of patients who had undergone blood testing and 86.5% of patients without a blood test, regardless of whether the test result was positive or negative (p < 10−4). A total of 531 patients (53.4%) had an anti-malarial drug prescription, of which 82.9% were prescriptions for an ACT. There were significant differences in prescriptions by country. A total of 923 patients (92.9%) purchased anti-malarial drugs in an outlet, including 79.1% of patients purchasing an ACT drug: 98.0% in Ghana, 90.5% in Kenya, 80.4% in Nigeria, 69.2% in Tanzania, and 57.7% in Uganda (p < 10−4). Having a drug prescription was not a significant predictive factor associated with an ACT drug purchase (except in Kenya). The number of ACT drugs purchased with a prescription was greater than the number purchased without a prescription in Kenya, Nigeria and Tanzania. This study highlights differences in drug prescription and purchase patterns in five sub-Saharan African countries. The private sector is playing an increasingly important role in fever case management in sub-Saharan Africa. Understanding the characteristics of private retail outlets and the role they play in providing anti-malaria drugs may support the design of effective malaria interventions.
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影响因子：
3
作者：
Davis B;Ladner J;Sams K;Tekinturhan E;de Korte D;Saba J
通讯作者：
Saba J
影响因子：
3.7
作者：
Engel, Nora;Ganesh, Gayatri;Pai, Madhukar
通讯作者：
Pai, Madhukar
影响因子：
3
作者：
Ikwuobe, John O.;Faragher, Brian E.;Lalloo, David G.
通讯作者：
Lalloo, David G.
DOI：
10.4269/ajtmh.2009.80.737
发表时间：
2009-05-01
影响因子：
3.3
作者：
Kangwana, Beth B.;Njogu, Julius;Snow, Robert W.
通讯作者：
Snow, Robert W.
影响因子：
3
作者：
Maloney, Kathleen;Ward, Abigail;Mkude, Sigsbert
通讯作者：
Mkude, Sigsbert