Ndiaye Jean Louis A, Tine Roger C, Faye Babacar, Dieye El Hadj Lamine, Diack Pape Amadou, Lameyre Valérie, Gaye Oumar, Sow Husseyn Dembel
Service de Parasitologie, Faculté de Médecine, Université Cheikh Anta DIOP de Dakar, Senegal.
Malar J. 2007 Nov 15;6:152. doi: 10.1186/1475-2875-6-152.
Quinine injection is the reference treatment for malaria when oral administration is impossible. Quinine can also be administered by the intra-rectal route and, over the last ten years, a series of studies have been conducted in children to determine the ideal dose and dilution in the African situation. The aim of the present study was to evaluate the feasibility and usefulness of a kit for an immediate administration of quinine alkaloids (Quinimax) by community health workers, prior to transfer of the child to a more sophisticated health care establishment.
A prospective, open, descriptive community intervention study conducted in northern Senegal at six village Health Units in children fewer than ten years of age with non-per-os malaria. Controls were given the routine care prior to transfer to a Health Center, and cases were in addition administered Quinimax (20 mg/ml) via the intra-rectal route before transfer. Patients were followed through complete cure and parasitological tests were carried out on Days 0, 3 and 7.
134 patients (79 cases/55 controls) were recruited between November 2003 and May 2004 or October and November 2004. The two groups were comparable at inclusion. In the case group, oral drugs could be administered after a mean of 16.8 hours versus 33.6 hours in the control group. Time-to cure was shorter in cases than in controls. Complete parasite clearance was obtained in all patients by Day 7. The kit was well accepted by all concerned and more than 80% of community health workers judged the kit easy to use.
The emergency paediatric kit is a useful tool in the management of malaria in children who cannot be treated orally. It is feasible and easy to use for health workers in community-based Health Units where, according to the WHO, nearly 80% of malarial morbidity and mortality occurs.
当无法口服给药时，奎宁注射是疟疾的参考治疗方法。奎宁也可通过直肠途径给药，在过去十年中，针对非洲儿童情况开展了一系列研究以确定理想剂量和稀释度。本研究的目的是评估一种用于社区卫生工作者在将儿童转送至更高级医疗保健机构之前立即给予奎宁生物碱（Quinimax）的试剂盒的可行性和实用性。
在塞内加尔北部的六个乡村卫生单位对10岁以下无法口服给药的疟疾儿童进行了一项前瞻性、开放性、描述性社区干预研究。对照组在转至健康中心之前接受常规护理，病例组在转院之前还通过直肠途径给予Quinimax（20毫克/毫升）。对患者进行全程追踪直至完全治愈，并在第0、3和7天进行寄生虫学检测。
在2003年11月至2004年5月或2004年10月至11月期间招募了134名患者（79例病例/55例对照）。两组在纳入时具有可比性。病例组平均在16.8小时后可给予口服药物，而对照组为33.6小时。病例组的治愈时间比对照组短。到第7天所有患者的寄生虫均完全清除。该试剂盒受到所有相关人员的好评，超过80%的社区卫生工作者认为该试剂盒易于使用。
该儿科急救试剂盒是管理无法口服治疗的儿童疟疾的有用工具。对于社区卫生单位的卫生工作者来说，它是可行且易于使用的，而据世界卫生组织称，近80%的疟疾发病率和死亡率发生在这些社区卫生单位。
