Compliance to correct dose of chloroquine in uncomplicated malaria correlates with improvement in the condition of rural Nigerian children
Compliance to correct dose of chloroquine in uncomplicated malaria correlates with improvement in the condition of rural Nigerian children
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DOI：
10.1016/s0035-9203(01)90252-4
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发表时间：
2001-05-01
影响因子：
2.2
通讯作者：
Nwaiwu, O
中科院分区：
文献类型：
--
作者：
Okonkwo, PO;Akpala, CO;Nwaiwu, O
不遵守正确的剂量被认为是氯喹在儿童疟疾家庭管理中治疗失败的主要原因之一。关于治疗热带疾病药物的依从性的研究很少。为了研究在农村环境中的依从性，氯喹糖浆包装有一个新的图片插入，以遵守正确的剂量。1996年9月至1997年12月，在尼日利亚Udi地方政府地区进行了一项现场试验，对632名患有单纯性疟疾的儿童进行了依从性评估。在儿童入组研究之前，获得母亲/监护人的书面知情同意书。试验有3组：对照村（第一组）接受氯喹糖浆，不进行进一步干预，第二组接受氯喹糖浆的图片插入，第三组接受氯喹糖浆，图片插入和口头指示。每个小组由3个保健中心组成。通过测量30 mL瓶装氯喹糖浆的体积和向儿童的母亲/助手发放问卷来评估依从性。对照组村庄记录的完全遵守率为36.5 +/- 4.4%，第二组为51.9 +/- 7.9%，第三组为73.3 +/-4.2%。完全依从性、病情改善与病情改善时间呈显著相关（P < 0.0001）。这项研究被认为是重要的，因为它侧重于儿童，他们承担着最大的疟疾负担。它的独特之处在于引入了一种插图，不识字的村民可能不理解在配药时使用年龄或体重，可以将其用作替代品。
Non-compliance to correct dosing is thought to be one of the main causes of treatment failure of chloroquine in the home management of childhood malaria. There are few studies of compliance to drugs used for tropical diseases. In order to study compliance in the rural setting, chloroquine syrup was packaged with a novel pictorial insert for compliance to correct dosing. Compliance was assessed in a field trial in September 1996-December 1997, involving 632 children with uncomplicated malaria in Udi local government area in Nigeria. Written informed consent was obtained from mothers/guardians before children were enrolled in the study. There were 3 arms to the trial: control villages (group I) received chloroquine syrup without further intervention, group II received a pictorial insert with chloroquine syrup, and group III received chloroquine syrup, the pictorial insert and verbal instructions. Each group was made up of 3 health centres. Compliance was assessed by volumetric measurement of the chloroquine syrup left in 30-mL bottles and by questionnaires administered to mothers/helpers of the children. Control villages recorded full compliance for 36.5 +/- 4.4% of the children, group II for 51.9 +/- 7.9% and group III for 73.3 +/- 4.2%. There was a significant correlation (P < 0.0001) between full compliance, improvement and time for improvement of the condition. This study is deemed important because it focuses on children, who bear the greatest burden of malaria. It is unique for introducing a pictorial insert that illiterate villagers, who may not understand the use of age or weight in drug dispensing, may utilize as a substitute.