Private sector antimalarial sales a decade after "test and treat": A cross-sectional study of drug shop clients in rural Uganda.
Private sector antimalarial sales a decade after "test and treat": A cross-sectional study of drug shop clients in rural Uganda.
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DOI：
10.3389/fpubh.2023.1140405
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发表时间：
2023
影响因子：
5.2
通讯作者：
Boyce, Ross M.
中科院分区：
文献类型：
--
作者：
Shelus, Victoria;Mumbere, Nobert;Mulogo, Edgar M.;Barrington, Clare;Baguma, Emmanuel;Muhindo, Rabbison;Herrington Jr, James E.;Emch, Michael;Maman, Suzanne;Boyce, Ross M.
自2010年以来，世界卫生组织一直在推广疟疾“检测和治疗”指南，建议所有疑似疟疾病例在接受抗疟疾药物治疗前进行寄生虫学检测，通常是快速诊断检测(RDT)。然而，乌干达私人药店的许多发烧仍然被推定为疟疾，没有诊断测试。这项研究的目的是通过对Bugoye县药店客户的横断面调查，记录乌干达农村地区私营部门疟疾病例的管理情况。药店供应商(n=46)记录了与报告发烧或要求抗疟疾药物的客户的销售互动信息，并从购买药物而不使用RDT的客户那里收集毛细血管血样。我们估计了购买RDT、坚持RDT结果并在没有实验室确认疟疾的情况下接受抗疟疾药物治疗的客户的比例。大部分药店是无牌经营(96%)，并售卖无牌药房(98%)。在数据收集期间访问研究药店的934名疑似疟疾患者中，只有25%购买了RDT。由于一些客户报告了公共部门以前的RDTs，40%的客户在药店知道他们的疟疾状况。在那些检测呈阴性的人中，36%的人仍然购买了抗疟疾药物。在购买了抗疟药但没有RDT的客户中，65%的人后来检测呈阴性。尽管有国家的指导方针，但从布戈耶药店购买抗疟疾药物的药店客户在治疗前往往没有接受测试以确认疟疾诊断。大多数被推定接受抗疟疾药物治疗的患者没有患疟疾。需要采取干预措施，以改善疟疾病例管理和私营部门的合理用药。
The World Health Organization has promoted “test and treat” guidelines for malaria since 2010, recommending all suspected malaria cases be confirmed with a parasitological test, typically a rapid diagnostic test (RDT), prior to treatment with antimalarial medications. However, many fevers at private drug shops in Uganda continue to be treated presumptively as malaria without diagnostic testing. The purpose of this study was to document private sector malaria case management in rural Uganda through a cross-sectional survey of drug shop clients in Bugoye sub-county. Drug shop vendors (n = 46) recorded information about sales interactions with clients reporting fever or requesting antimalarials and collected capillary blood samples from clients who purchased medications without an RDT. We estimated the proportion of clients who purchased an RDT, adhered to the RDT result, and received antimalarials without having laboratory-confirmed malaria. Most drug shops were unlicensed (96%) and sold RDTs (98%). Of 934 clients with suspected malaria who visited study drug shops during the data collection period, only 25% bought an RDT. Since some clients reported previous RDTs from the public sector, 40% of clients were aware of their malaria status at the drug shop. Among those with negative tests, 36% still purchased antimalarials. Sixty-five percent of clients who purchased an antimalarial without an RDT subsequently tested negative. Despite national guidelines, drug shop clients who purchase antimalarials from drug shops in Bugoye are often not tested to confirm a malaria diagnosis prior to treatment. Most clients treated presumptively with antimalarials did not have malaria. Interventions are needed to improve malaria case management and rational drug use in the private sector.
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影响因子：
3
作者：
Boyce RM;Muiru A;Reyes R;Ntaro M;Mulogo E;Matte M;Siedner MJ
通讯作者：
Siedner MJ
影响因子：
3.7
作者：
Boyce RM;Collins M;Muhindo R;Nakakande R;Ciccone EJ;Grounds S;Espinoza D;Zhu Y;Matte M;Ntaro M;Nyehangane D;Juliano JJ;Mulogo EM
通讯作者：
Mulogo EM
影响因子：
2.8
作者：
Mayora C;Kitutu FE;Kandala NB;Ekirapa-Kiracho E;Peterson SS;Wamani H
通讯作者：
Wamani H
影响因子：
3
作者：
Kitutu, Freddy Eric;Kalyango, Joan Nakayaga;Wamani, Henry
通讯作者：
Wamani, Henry
DOI：
10.4269/ajtmh.2012.11-0791
发表时间：
2012-11-01
影响因子：
3.3
作者：
Awor, Phyllis;Wamani, Henry;Peterson, Stefan
通讯作者：
Peterson, Stefan