Etuk E U, Egua M A, Muhammad A A
Department of Pharmacology, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria.
Ann Afr Med. 2008 Mar;7(1):24-8. doi: 10.4103/1596-3519.55688.
This study examines the diagnosis of malaria and pattern of prescription of antimalarial drugs in the most vulnerable age group (the under 5 children) in the study environment in order to identify the possible shortcomings and suggest solutions so as to improve the treatment outcome in future.
The hospital records of 430 children with malaria infection admitted for treatment in a chosen tertiary health facility between January to December 2005 were selected for study. Forty-eight case records were excluded due to incomplete information. Data on demographic, clinical features of disease, diagnostic procedures, drug administration and the treatment out come were collected from the patients' records.
Analysis of the data revealed that more male (213) than female (169) children were admitted for malaria treatment: Fever with convulsion (55.8%) was the commonest presenting symptoms, and anemia was the most frequent complications of malaria recorded. Chloroquine was found to be the most prescribed antimalarial agent and overall antemisinin-based drug was prescribed either as a first or second line treatment in only 18.2% of the cases. The death rate recorded was 16%.
The pattern of antimalarial drugs prescription in the study center in most cases did not meet the recommended guidelines. The prescriptions were predominantly chloroquine, instead of artemisinin based. The death rate was comparatively high. Measures to raise the level of awareness among the practitioners on the current National policy on malaria treatment through seminars and workshops were suggested.
本研究调查了研究环境中最脆弱年龄组(5岁以下儿童)的疟疾诊断情况和抗疟药物的处方模式,以找出可能存在的不足并提出解决方案,从而在未来改善治疗效果。
选取了2005年1月至12月期间在一家选定的三级医疗机构住院治疗的430例疟疾感染儿童的医院记录进行研究。由于信息不完整,排除了48份病例记录。从患者记录中收集了有关人口统计学、疾病临床特征、诊断程序、药物使用和治疗结果的数据。
数据分析显示,因疟疾治疗入院的男性儿童(213例)多于女性儿童(169例);伴有惊厥的发热(55.8%)是最常见的症状表现,贫血是记录到的最常见的疟疾并发症。发现氯喹是最常开具的抗疟药物,而基于青蒿素的药物仅在18.2%的病例中作为一线或二线治疗药物开具。记录的死亡率为16%。
研究中心的抗疟药物处方模式在大多数情况下不符合推荐指南。处方主要是氯喹,而非基于青蒿素的药物。死亡率相对较高。建议通过研讨会和讲习班提高从业者对当前国家疟疾治疗政策的认识水平。