Institute for Public Health, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
Malar J. 2009 Nov 24;8:266. doi: 10.1186/1475-2875-8-266.
Effective and timely treatment is an essential aspect of malaria control, but remains a challenge in many parts of sub-Saharan Africa. The objective of this study was to describe young children's access to malaria treatment in Nouna Health District, Burkina Faso.
In February/March 2006, a survey was conducted in a representative sample of 1,052 households.
Overall 149/1052 (14%) households reported the current possession of anti-malarial medicine, which was significantly associated with urban area, literacy of household head, having young children, and high socio-economic status. Out of a total of 802 children under five years, at least one malaria episode was reported for 239 (30%) within the last month. Overall 95% of children received treatment, either modern (72%), traditional (18%) or mixed (5%). Most of the medicines were provided as home treatment by the caregiver and half of children received some type of modern treatment within 24 hours of the occurrence of first symptoms. Despite a recent policy change to artemisinin-based combination therapy, modern anti-malarials consisted mainly of chloroquine (93%). Modern drugs were obtained more often from a health facility in localities with a health facility compared to those without (60% vs. 25.6%, p < 0.001). In contrast, beside informal providers, volunteer community health workers (CHW) were the main source of modern medicine in localities without a health centre (28% vs. 3%, p < 0.001).
Access to modern health services providing quality controlled effective combination therapies against malaria needs to be strengthened in rural Africa, which should include a re-investigation of the role of CHW 30 years after Alma Ata.
有效的及时治疗是疟疾控制的一个重要方面，但在撒哈拉以南非洲的许多地区仍然是一个挑战。本研究的目的是描述布基纳法索努纳卫生区的儿童获得疟疾治疗的情况。
2006 年 2 月/3 月，对 1052 户具有代表性的家庭进行了调查。
总体而言，149/1052（14%）户报告目前拥有抗疟药物，这与城市地区、家庭主妇的文化程度、有年幼子女和较高的社会经济地位显著相关。在总共 802 名五岁以下儿童中，有 239 名（30%）在过去一个月内报告至少发生过一次疟疾发作。总体而言，95%的儿童接受了治疗，无论是现代（72%）、传统（18%）还是混合（5%）治疗。大多数药物是由护理人员在家中治疗，并且一半的儿童在出现首次症状后 24 小时内接受了某种现代治疗。尽管最近的政策发生了变化，采用了以青蒿素为基础的联合疗法，但现代抗疟药物主要还是氯喹（93%）。在有卫生设施的地方，与没有卫生设施的地方相比，现代药物更多地是从卫生设施获得的（60%比 25.6%，p < 0.001）。相比之下，除了非正式提供者外，志愿社区卫生工作者（CHW）是没有卫生中心的地方获得现代药物的主要来源（28%比 3%，p < 0.001）。
在非洲农村地区，需要加强获得提供质量控制有效联合疗法的现代卫生服务的机会，其中应包括在阿拉木图 30 年后重新调查 CHW 的作用。
