Guyatt Helen L, Snow Robert W
KEMRI-Wellcome Trust Collaborative Programme, GPO 00100, Nairobi, PO Box 43640, Kenya.
Trans R Soc Trop Med Hyg. 2004 Feb;98(2):111-5. doi: 10.1016/s0035-9203(03)00016-6.
This study investigates the source, timing and types of treatment for fevers across all ages in a low malaria-transmission area of Kenya. The period prevalence for fever, and subsequent treatment seeking behaviour, was similar across all ages. The use of the informal retail sector was common (47% of first actions), though most visits to shops and chemists (77%) resulted in treatment with an antipyretic not an antimalarial. The major source of the first line recommended drug, sulfadoxine-pyrimethamine (SP), was at the formal health sector, and 32% of fevers made at least one visit to a health care facility. Although only 7% of fevers received SP within 24 hours of fever onset, 27% ultimately received treatment with this antimalaria. It is estimated that of the total amount of SP consumed in this population, only 20% is administered to children less than 5 years old. In this area of Kenya disease risks decline with increasing age, however, adult populations consume over 40% of prescribed or purchased anti-malarial drugs. In light of the proposed new, more costly anti-malarial drug combinations these findings have major implications for the effective allocation of limited financial resources at household and government levels.
本研究调查了肯尼亚一个低疟疾传播地区各年龄段发热的治疗来源、时间和类型。各年龄段的发热期间患病率及随后的就医行为相似。非正规零售部门的使用很普遍（47%的首要行动），不过大多数去商店和药店的就诊（77%）导致使用退烧药而非抗疟药进行治疗。一线推荐药物磺胺多辛 - 乙胺嘧啶（SP）的主要来源是正规卫生部门，32%的发热患者至少去过一次医疗机构。虽然只有7%的发热患者在发热 onset 后24小时内接受了SP治疗，但最终有27%接受了这种抗疟治疗。据估计，在该人群消耗的SP总量中，只有20%用于5岁以下儿童。在肯尼亚的这个地区，疾病风险随年龄增长而下降，然而，成年人群消耗了超过40%的处方或购买的抗疟药物。鉴于提议的新的、更昂贵的抗疟药物组合，这些发现对家庭和政府层面有限财政资源的有效分配具有重大影响。
