Souares A, Lalou R, Sene I, Sow D, Le Hesran J Y
IRD, UR 10, Santé de la mère et de lénfant, BP 1386, 18524 Dakar, Sénégal.
Sante Publique. 2006 Jun;18(2):299-310. doi: 10.3917/spub.062.0299.
The emergence of increasing plasmodium falciparum resistance to chloroquine in Africa has prompted national malaria programmes to develop new policies regarding appropriate and essential treatment, moving from the use of chloroquine to a new set of bi-therapy methods. In Senegal, the malaria treatment policy has shifted from chloroquine to amodiaquine/sulfadoxine-pyrimethamine. The authors studied the availability of these new drugs and their use by the care providers in 10 rural health district dispensaries. Patient records were examined and nurses were interviewed on their knowledge about and implementation of the new policy. It was noted that the nurses have not yet mastered the proper use of these new medications, and the prescriptions given were not always in line with regulations and practice corresponding to the required or necessary doses. The families which were interviewed stated that they were not aware of the changes in treatment which had been recommended. The conclusion of this study was that it brought to the forefront the need to put specific emphasis on population information and awareness campaigns as well as that of ensuring that caregivers receive thorough training to secure the successful and sustainable implementation and maintenance of the new policy.
在非洲，恶性疟原虫对氯喹的耐药性日益增强，这促使各国疟疾防治项目制定有关适当和基本治疗的新政策，从使用氯喹转向一套新的联合治疗方法。在塞内加尔，疟疾治疗政策已从氯喹转向阿莫地喹/磺胺多辛-乙胺嘧啶。作者研究了这两种新药在10个农村卫生区药房的供应情况以及医护人员对它们的使用情况。检查了患者记录，并就护士对新政策的了解和实施情况对他们进行了访谈。结果发现，护士尚未掌握这些新药的正确用法，所开的处方并不总是符合规定以及与所需或必要剂量相对应的做法。接受访谈的家庭表示，他们并不知晓所推荐的治疗方法的变化。这项研究的结论是，它凸显了特别强调开展针对民众的宣传和提高认识活动的必要性，以及确保护理人员接受全面培训以成功且可持续地实施和维持新政策的必要性。
