Early diagnosis and treatment of uncomplicated malaria and patterns of health seeking in Vietnam
Early diagnosis and treatment of uncomplicated malaria and patterns of health seeking in Vietnam
复制标题
DOI：
10.1111/j.1365-3156.2005.01472.x
复制
发表时间：
2005-09-01
影响因子：
3.3
通讯作者：
Kager, PA
中科院分区：
文献类型：
--
作者：
Giao, PT;de Vries, PJ;Kager, PA
疟疾早期诊断和治疗(EDTM)是疟疾控制的一个关键组成部分。EDTM的成功取决于求医行为和卫生服务的质量。这项研究评估了自1993年引入EDTM后的自我诊断、治疗和治疗延迟。在越南南部，EDTM包括在公共卫生设施进行显微镜诊断和使用青蒿素衍生物进行免费治疗。截至2001年，参加无并发症疟疾随机治疗试验的患者共填写了1698份问卷。推定的自我诊断‘疟疾’从1993年的68%上升到2001年的100%，自我治疗下降，从74%下降到2000年的8%和2001年的24%。首次出现症状到到公共卫生机构寻求治疗之间的中位数(最大)延迟从3(23)天减少到1.3(3)天(P<；0.001)，同时疟疾相关死亡率、严重疟疾和无并发症疟疾的报告发病率显著下降。如果提供一套诱人的EDTM，患者就会对疟疾的可能性变得敏感，不太可能自我治疗。应尽快向所有有症状的患者提供EDTM，目的是将治疗延迟减少到最多2天。
Early diagnosis and treatment of malaria (EDTM) is a key component of malaria control. The success of EDTM depends on health seeking behaviour and the quality of the health service. This study assessed self-diagnosis, treatment and treatment delay after the introduction of EDTM in 1993. In southern Vietnam EDTM comprises microscopic diagnosis and free treatment with artemisinin derivatives at public health facilities. Until 2001, 1698 questionnaires had been completed by patients participating in randomized treatment trials of uncomplicated malaria. The presumptive self diagnosis 'malaria' increased from 68% in 1993 to 100% in 2001 and self-treatment decreased, from 74% to 8% in 2000 and 24% in 2001. The median (maximum) delay between first symptoms and seeking treatment at a public health facility decreased from 3 (23) to 1.3 (3) days (P < 0.001) Concomitant was a significant decline of reported incidence of malaria-associated mortality, severe malaria and uncomplicated malaria. If offered an attractive package of EDTM, patients become sensitized to the possibility of malaria and less likely to self-treat. EDTM should be provided as soon as possible to all symptomatic patients, aiming at reducing treatment delay to a maximum of 2 days.