Ogouyemi-Hounto A, Kinde-Gazard D, Nahum A, Abdillahi A, Massougbodji A
Faculté des sciences de la santé, Cotonou, Bénin.
Med Trop (Mars). 2009 Dec;69(6):561-4.
In 2004 the policy for malaria management in Benin changed when the National Malaria Coordination Program (NMCP) introduced artemisinin-based combination therapy (ACT) for treatment of uncomplicated malaria. Up to that time, chloroquine had been used for first-line therapy against uncomplicated malaria and sulfadoxine pyrimethamine had been used in case of failure. Artemisinin derivatives have been used for monotherapy in Benin since 2002. The purpose of this transverse study carried out among public and private centers in Cotonou from March 16 to May 17, 2005 was to determine the impact of the switch to ACT on the practices of healthcare professionals. Medical centers were randomly selected from each stratum after identification and stratification of all facilities in the healthcare pyramid. A survey questionnaire was sent to healthcare workers. A total of 690 health workers responded to the questionnaire. Most responders (95.5%) were familiar with artemisinin but a lower percentage (89.6%) prescribed them. Responders were less knowledgable about ACT drugs and Coartem was the best known combination in the minds of prescribers. Biological diagnosis was available for 50% of patients. Artemisinine (derivates) were mainly prescribed as a second choice treatment and as monotherapy whether for severe or uncomplicated malaria. They were prescribed to pregnant women in 34.6% of the cases. Dosage was incorrect in 26.1% of cases in adults and 20.9% of cases in children. These findings indicate that more effort is needed to inform healthcare workers. This is especially urgent since the country is now considering revising its malaria management policy to make ACT available at all levels of the healthcare system. An effective information campaign must be set up to ensure that health workers and drug retailers throughout the country are duly informed of the new malaria treatment policy.
2004年，贝宁的疟疾管理政策发生了变化，当时国家疟疾协调项目（NMCP）引入了以青蒿素为基础的联合疗法（ACT）来治疗非复杂性疟疾。在此之前，氯喹一直被用作治疗非复杂性疟疾的一线疗法，而在治疗失败的情况下则使用磺胺多辛-乙胺嘧啶。自2002年以来，青蒿素衍生物在贝宁一直被用作单一疗法。这项于2005年3月16日至5月17日在科托努的公立和私立医疗中心开展的横断面研究的目的是确定改用ACT对医护人员医疗行为的影响。在对医疗体系金字塔中的所有机构进行识别和分层后，从每个阶层中随机选取医疗中心。向医护人员发放了调查问卷。共有690名医护人员回复了问卷。大多数回复者（95.5%）熟悉青蒿素，但开出处方的比例较低（89.6%）。回复者对ACT药物的了解较少，在开处方者心目中，科泰复是最知名的复方药物。50%的患者能够进行生物学诊断。青蒿素（衍生物）主要作为二线治疗药物以及单一疗法被开出处方，无论是用于重症还是非复杂性疟疾。在34.6%的病例中，该药物被开给孕妇。26.1%的成人病例和20.9%的儿童病例存在用药剂量不正确的情况。这些研究结果表明，需要做出更多努力来让医护人员了解相关信息。鉴于该国目前正在考虑修订其疟疾管理政策，以便在医疗体系的各个层面都能提供ACT药物，这一点尤为紧迫。必须开展有效的宣传活动，以确保全国的医护人员和药品零售商都能及时了解新的疟疾治疗政策。
