Decreased availability of antimalarials in the private sector following the policy change from chloroquine to sulphadoxine-pyrimethamine in the Kilombero Valley, Tanzania
Decreased availability of antimalarials in the private sector following the policy change from chloroquine to sulphadoxine-pyrimethamine in the Kilombero Valley, Tanzania
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DOI：
10.1186/1475-2875-5-109
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发表时间：
2006-11-14
期刊：
影响因子：
3
通讯作者：
Mshinda, Hassan
中科院分区：
文献类型：
--
作者：
Hetzel, Manuel W.;Msechu, June J.;Mshinda, Hassan
背景：疟疾控制战略强调需要对疟疾发作进行及时有效的治疗。为了提高疗效，坦桑尼亚于2001年将其第一线治疗方法从氯喹改为磺胺乙胺嘧啶。这项政策的变化对抗疟药物的可用性的影响进行了研究，在农村东南Tanzan.Methods：在2001年和2004年，研究领域的商业网点销售药物和他们的股票被记录。结果：从2001年到2004年，普通商店的数量增加了15%，药店的数量增加了近一倍。但是，普通商店库存抗疟药的比例明显下降，导致抗疟药销售点减少近50%。这导致更多的家庭远离治疗源。在2004年，五个研究的25个村庄，总人口为13,506（18%）既没有卫生设施，也没有一个商店作为疟疾treatment.Conclusion来源：虽然改变SP导致更高的治疗效果，它也导致抗疟药物在研究区域的可用性下降。虽然对抗疟药物的总体使用没有明显影响，但获得治疗的机会减少可能对最贫穷和最偏远的群体产生了不成比例的影响。鉴于即将改变政策，改用青蒿素类复方疗法，如果要使这类新的抗疟药物的益处惠及全体人口，就必须紧急处理这些问题。
Background: Malaria control strategies emphasize the need for prompt and effective treatment of malaria episodes. To increase treatment efficacy, Tanzania changed its first-line treatment from chloroquine to sulphadoxine-pyrimethamine (SP) in 2001. The effect of this policy change on the availability of antimalarials was studied in rural south-eastern Tanzania.Methods: In 2001 and 2004, the study area was searched for commercial outlets selling drugs and their stocks were recorded. Household information was obtained from the local Demographic Surveillance System.Results: From 2001 to 2004, the number of general shops stocking drugs increased by 15% and the number of drug stores nearly doubled. However, the proportion of general shops stocking antimalarials dropped markedly, resulting in an almost 50% decrease of antimalarial selling outlets. This led to more households being located farther from a treatment source. In 2004, five out of 25 studied villages with a total population of 13,506 (18%) had neither a health facility, nor a shop as source of malaria treatment.Conclusion: While the change to SP resulted in a higher treatment efficacy, it also led to a decreased antimalarial availability in the study area. Although there was no apparent impact on overall antimalarial use, the decline in access may have disproportionately affected the poorest and most remote groups. In view of the imminent policy change to artemisinin-based combination therapy these issues need to be addressed urgently if the benefits of this new class of antimalarials are to be extended to the whole population.