Ansah E K, Gyapong J O, Agyepong I A, Evans D B
Dangme West District, Ministry of Health, Dodowa, Ghana.
Trop Med Int Health. 2001 Jul;6(7):496-504. doi: 10.1046/j.1365-3156.2001.00740.x.
Malaria is a major cause of morbidity and mortality among children under five in sub-Saharan Africa. Prompt diagnosis and adequate treatment of acute clinical episodes are essential to reduce morbidity and prevent complications and mortality. In many countries, chloroquine syrup is the mainstay of malaria treatment for children under five. Not only is syrup more expensive than tablets, adherence to the prescribed dose at home is a problem because mothers use wrongly sized measuring devices or have difficulty with the instructions. We investigated the impact of introducing pre-packed tablets for children on adherence to treatment and compared the total cost of the tablets with that of syrup. Children aged 0--5 years diagnosed with malaria at the clinic over a 6-week period received either pre-packed tablets or syrup by random assignment. The principal caregivers were interviewed at home on day 4 after attending the clinic. Of the 155 caregivers given pre-packed tablets, 91% (n=141) adhered to the recommended dosage, while only 42% (n=61) of 144 who were provided syrup did. Only 20% of caregivers who received syrup used an accurate 5 ml measure. The cost of treatment with tablets was about one-quarter that of syrup and 62% (n=96) of caregivers preferred tablets. Pre-packed chloroquine tablets are a viable alternative to syrup.
疟疾是撒哈拉以南非洲地区五岁以下儿童发病和死亡的主要原因。对急性临床发作进行及时诊断和充分治疗对于降低发病率、预防并发症和死亡至关重要。在许多国家，氯喹糖浆是五岁以下儿童疟疾治疗的主要药物。糖浆不仅比片剂更昂贵，而且在家中按规定剂量服药是个问题，因为母亲们使用的量具尺寸不对，或者看不懂说明书。我们调查了引入儿童预包装片剂对治疗依从性的影响，并将片剂的总成本与糖浆的总成本进行了比较。在六周内，在诊所被诊断为疟疾的0至5岁儿童通过随机分配接受预包装片剂或糖浆。主要照顾者在就诊后第4天在家中接受访谈。在155名获得预包装片剂的照顾者中，91%（n=141）坚持了推荐剂量，而在144名获得糖浆的照顾者中，只有42%（n=61）做到了。接受糖浆治疗的照顾者中只有20%使用了准确的5毫升量具。片剂治疗的成本约为糖浆的四分之一，62%（n=96）的照顾者更喜欢片剂。预包装氯喹片剂是糖浆的一个可行替代品。
