Okeke Theodora A, Uzochukwu Benjamin S C
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Enugu, P,O, Box 3295, Nigeria.
Malar J. 2009 Nov 20;8:260. doi: 10.1186/1475-2875-8-260.
Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC) from untrained drug vendors. Self-medication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendors to improve access to early effective malaria treatment, which underscores the need for interventions to improve treatment obtained from these outlets. This study aimed to determine the feasibility and impact of training rural drug vendors on community-based malaria treatment and advice with referral of severe cases to a health facility.
A drug vendor-training programme was carried out between 2003 and 2005 in Ugwuogo-Nike, a rural community in south-east Nigeria. A total of 16 drug vendors were trained and monitored for eight months. The programme was evaluated to measure changes in drug vendor practice and knowledge using exit interviews. In addition, home visits were conducted to measure compliance with referral.
The intervention achieved major improvements in drug selling and referral practices and knowledge. Exit interviews confirmed significant increases in appropriate anti-malarial drug dispensing, correct history questions asked and advice given. Improvements in malaria knowledge was established and 80% compliance with referred cases was observed during the study period,
The remarkable change in knowledge and practices observed indicates that training of drug vendors, as a means of communication in the community, is feasible and strongly supports their inclusion in control strategies aimed at improving prompt effective treatment of malaria with referral of severe cases.
疟疾仍是尼日利亚五岁以下儿童发病和死亡的主要原因。大多数针对发热和疟疾的早期治疗是通过从未经培训的药品供应商处购买非处方抗疟药进行自我治疗。通过药品供应商进行自我治疗可能无效，且药物毒性风险和耐药性增加。全球疟疾控制倡议强调了药品供应商在改善早期有效疟疾治疗可及性方面的潜在作用，这突出了采取干预措施以改善从这些渠道获得的治疗的必要性。本研究旨在确定培训农村药品供应商进行基于社区的疟疾治疗并将重症病例转诊至医疗机构的可行性和影响。
2003年至2005年期间，在尼日利亚东南部的一个农村社区乌古奥戈 - 耐克开展了一项药品供应商培训计划。共培训了16名药品供应商，并对其进行了八个月的监测。通过离职访谈对该计划进行评估，以衡量药品供应商行为和知识的变化。此外，还进行了家访以衡量转诊的依从性。
该干预措施在药品销售、转诊行为和知识方面取得了重大改善。离职访谈证实，适当抗疟药的配药、正确的病史询问和提供的建议显著增加。疟疾知识得到了提高，在研究期间观察到80%的转诊病例得到了依从。
观察到的知识和行为的显著变化表明，培训药品供应商作为社区沟通的一种方式是可行的，并有力支持将他们纳入旨在通过转诊重症病例改善疟疾及时有效治疗的控制策略。
