Marsh V M, Mutemi W M, Willetts A, Bayah K, Were S, Ross A, Marsh K
Kenya Medical Research Institute-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya.
Trop Med Int Health. 2004 Apr;9(4):451-60. doi: 10.1111/j.1365-3156.2004.01223.x.
Recent global malaria control initiatives highlight the potential role of drug retailers to improve access to early effective malaria treatment. We report on the findings and discuss the implications of an educational programme for rural drug retailers and communities in Kenya between 1998 and 2001 in a study population of 70,000. Impact was evaluated through annual household surveys of over-the-counter (OTC) drug use and simulated retail client surveys in an early (1999) and a late (2000) implementation area. The programme achieved major improvements in drug selling practices. The proportion of OTC anti-malarial drug users receiving an adequate dose rose from 8% (n = 98) to 33% (n = 121) between 1998 and 1999 in the early implementation area. By 2001, and with the introduction of sulphadoxine pyrimethamine group drugs in accordance with national policy, this proportion rose to 64% (n = 441) across the early and late implementation areas. Overall, the proportion of shop-treated childhood fevers receiving an adequate dose of a recommended anti-malarial drug within 24 h rose from 1% (n = 681) to 28% (n = 919) by 2001. These findings strongly support the inclusion of private drug retailers in control strategies aiming to improve prompt effective treatment of malaria.
近期的全球疟疾控制倡议突出了药品零售商在改善早期有效疟疾治疗可及性方面的潜在作用。我们报告了1998年至2001年期间针对肯尼亚农村药品零售商和社区开展的一项教育项目的研究结果，并讨论了其影响，研究对象为7万人。通过对非处方（OTC）药品使用情况进行年度家庭调查以及在一个早期实施地区（1999年）和一个后期实施地区（2000年）进行模拟零售客户调查来评估项目影响。该项目在药品销售行为方面取得了重大改善。在早期实施地区，1998年至1999年期间接受足量剂量的非处方抗疟药使用者比例从8%（n = 98）升至33%（n = 121）。到2001年，随着按照国家政策引入磺胺多辛-乙胺嘧啶类药物，这一比例在早期和后期实施地区升至64%（n = 441）。总体而言，到2001年，在药店接受治疗的儿童发热患者中，在24小时内接受足量推荐抗疟药治疗的比例从1%（n = 681）升至28%（n = 919）。这些发现有力地支持将私营药品零售商纳入旨在改善疟疾及时有效治疗的控制策略。
