Souares Aurélia, Moulin Patricia, Sarrassat Sophie, Carlotti Marie-Paule, Lalou Richard, Le Hesran Jean-Yves
Institut de Recherche pour le Développement, UR10, Faculté de pharmacie, 4 av de l'Observatoire, 75006 Paris, France.
Malar J. 2009 Nov 17;8:257. doi: 10.1186/1475-2875-8-257.
Although there are many methods available for measuring compliance, there is no formal gold standard. Different techniques used to measure compliance were compared among children treated by the anti-malarial amodiaquine/sulphadoxine-pyrimethamine (AQ/SP) combination therapy, in use in Senegal between 2004 and 2006.
The study was carried out in 2004, in five health centres located in the Thies region (Senegal). Children who had AQ/SP prescribed for three and one day respectively at the health centre were recruited. The day following the theoretical last intake of AQ, venous blood, and urine samples were collected for anti-malarial drugs dosage. Caregivers and children above five years were interviewed concerning children's drug intake.
Among the children, 64.7% adhered to 80% of the prescribed dose and only 37.7% were strict full adherent to the prescription. There was 72.7% agreement between self-reported data and blood drug dosage for amodiaquine treatment. Concerning SP, results found that blood dosages were 91.4% concordant with urine tests and 90% with self-reported data based on questionnaires.
Self-reported data could provide useful quantitative information on drug intake and administration. Under strict methodological conditions this method, easy to implement, can be used to describe patients' behaviors and their use of new anti-malarial treatment. Self-reported data is a major tool for assessing compliance in resource poor countries. Blood and urine drug dosages provide qualitative results that confirm any drug intake. Urine assays for SP could be useful to obtain public health data, for example on chemoprophylaxis among pregnant women.
尽管有多种测量依从性的方法，但尚无正式的金标准。在2004年至2006年期间于塞内加尔使用的抗疟疾阿莫地喹/磺胺多辛-乙胺嘧啶（AQ/SP）联合疗法治疗的儿童中，对用于测量依从性的不同技术进行了比较。
该研究于2004年在位于捷斯地区（塞内加尔）的五个卫生中心开展。招募了分别在卫生中心被开具三日和一日AQ/SP处方的儿童。在理论上最后一次服用AQ后的第二天，采集静脉血和尿液样本用于抗疟疾药物剂量测定。就儿童的药物服用情况对照顾者和五岁以上儿童进行了访谈。
在这些儿童中，64.7%的儿童服用了规定剂量的80%，只有37.7%的儿童严格完全依从处方。在阿莫地喹治疗的自我报告数据与血液药物剂量之间存在72.7%的一致性。关于SP，结果发现血液剂量与尿液检测的一致性为91.4%，与基于问卷的自我报告数据的一致性为90%。
自我报告数据可为药物服用和给药提供有用的定量信息。在严格的方法学条件下，这种易于实施的方法可用于描述患者的行为及其对新型抗疟疾治疗的使用情况。自我报告数据是评估资源匮乏国家依从性的主要工具。血液和尿液药物剂量提供定性结果，可证实是否有药物摄入。SP的尿液检测对于获取公共卫生数据可能有用，例如关于孕妇化学预防的数据。
