Clarke Siân E, Rowley Jane, Bøgh Claus, Walraven Gijs E L, Lindsay Steven W
Danish Bilharziasis Laboratory, Charlottenlund, Denmark.
Trop Med Int Health. 2003 Oct;8(10):884-94. doi: 10.1046/j.1365-3156.2003.01095.x.
Home treatment with antimalarials is a common practice in many countries, and may save lives by ensuring that more malaria cases receive prompt treatment. Through retrospective surveys we found that home treatment of young children with antimalarials was uncommon in rural Gambia. Few families kept medicines in the home in case of illness, 28% kept paracetamol and only 8% kept chloroquine. Less than 10% of cases of childhood 'malaria' had been treated with chloroquine at home, and 69% of those giving home medication did not know the correct dosage for a child. The most common course of treatment was the use of paracetamol and/or tepid sponging to reduce fever, before the child was taken to a government health facility. Treating a child with antimalarials at home was more costly than other forms of treatment. The low cost associated with the use of health services for children and the limited availability of antimalarials outside major towns contribute to the high use of government health services. This shows that that home treatment cannot be assumed to be the predominant mode of malaria treatment throughout Africa, and highlights the need for country-specific policies based on accurate local knowledge of treatment practices in both rural and urban areas.
在许多国家，使用抗疟药进行家庭治疗是一种常见做法，通过确保更多疟疾病例得到及时治疗，这可能挽救生命。通过回顾性调查，我们发现，在冈比亚农村地区，用抗疟药对幼儿进行家庭治疗并不常见。很少有家庭在家中备有药品以防生病，28%的家庭备有对乙酰氨基酚，只有8%的家庭备有氯喹。不到10%的儿童“疟疾”病例在家中接受过氯喹治疗，而且69%进行家庭用药的人不知道儿童的正确剂量。最常见的治疗方法是在孩子被送往政府卫生机构之前，使用对乙酰氨基酚和/或用温水擦身来退烧。在家中用抗疟药治疗儿童比其他治疗方式成本更高。儿童使用卫生服务的低成本以及主要城镇以外抗疟药供应有限，导致政府卫生服务的高使用率。这表明，不能认为家庭治疗是整个非洲疟疾治疗的主要方式，并突出了基于农村和城市地区治疗实践的准确当地知识制定国别政策的必要性。
