Eve Sangaré, Samba Diop, Benoît Dembélé, Diawara Sory I, Seidina Diakité, Saibou Doumbia, Karim Traore, Drissa Konaté, Seydou Doumbia, Fanta Mady Traore Sékou, Mahamadou Diakité
Centre de Recherche et de Formation sur le Paludisme, Faculte de Medecine, de Pharmacie et d’Odontostomatologie, Universite de Bamako, BP, Mali.
Mali Med. 2010;25(3):31-40.
The increasingly increasing resistance of the parasites of malaria to chloroquine pushed all the African countries almost to adopt the ACTs like treatment of first intention of uncomplicated malaria. However, correct use of the ACTs proves to be imperative to guarantee their effectiveness and to even delay the spread resistant parasites to these molecules. Thus, we have conducted this study in order to assess the quality of the prescription and the dispensation of ACTs in randomly selected health centers across Bamako. Our study was a cross-sectional study conducted between April and July 2008 with interview of patients received in clinic for malaria, a questionnaire was administered to physicians and other health workers who give prescription of antimalarials, and pharmacists and other people working in pharmacy or drugs deposit. In total, 52 prescribers, 72 dispensers and 92 patients were included. Our study has shown that the ACT constituted the treatment of first choice of malaria within prescribers (75%) and dispensers (78.8%). However, 57.61% of the prescriptions against malaria did not contain any ACTs. The ACTs recommended by the National Malaria Program (NMCP) were known by 59.7% of dispensers and 73.1% of prescribers. The majority of the prescribers (71.15%) and of the dispensers (84.72%) were favorable to the NMCP's recommendations. Many patients (41.30%) did not understand at all the dose of the prescribed ACTs. Almost all of the prescription containing ACT was a generic drug prescribed (97.72%; n = 44). The prices of the ACTs varied between 140 and 3,380 FCFA with an average of 750 FCFA. According to prescribers and dispensers, the ACT constitutes their first choice (75% of prescribers and 78.8% of the dispensers). However, 57.61% of the prescriptions against malaria did not contain any ACTs. The majority of prescribers (71.15%) and dispensers (84.72%) were favorable to the NMCP's recommendations of malaria treatment in Mali. The average cost of prescriptions containing ACT was 750 FCFA with the extreme ones going from 140 to 3,680 FCFA.
疟疾寄生虫对氯喹的耐药性日益增强，这使得几乎所有非洲国家都采用以青蒿素类复方疗法（ACTs）作为非复杂性疟疾的一线治疗方案。然而，事实证明正确使用ACTs对于确保其有效性乃至延缓耐药寄生虫对这些药物的传播至关重要。因此，我们开展了这项研究，旨在评估巴马科随机选取的各健康中心开具和配发ACTs的质量。我们的研究是一项横断面研究，于2008年4月至7月间进行，对诊所中接受疟疾治疗的患者进行了访谈，并向开具抗疟药处方的医生及其他医护人员、药剂师以及在药房或药品存放处工作的其他人员发放了问卷。总共纳入了52名开处方者、72名配发者和92名患者。我们的研究表明，在开处方者（75%）和配发者（78.8%）中，ACTs构成了疟疾的首选治疗药物。然而，57.61%的抗疟处方中并未包含任何ACTs。国家疟疾防治项目（NMCP）推荐的ACTs，59.7%的配发者和73.1%的开处方者知晓。大多数开处方者（71.15%）和配发者（84.72%）赞同NMCP的建议。许多患者（41.30%）完全不明白所开ACTs的剂量。几乎所有含ACT的处方开具的都是非专利药（97.72%；n = 44）。ACTs的价格在140至3380非洲法郎之间，平均为750非洲法郎。根据开处方者和配发者的说法，ACTs是他们的首选（75%的开处方者和78.8%的配发者）。然而，57.61%的抗疟处方中并未包含任何ACTs。大多数开处方者（71.15%）和配发者（84.72%）赞同NMCP在马里的疟疾治疗建议。含ACT的处方平均费用为750非洲法郎，价格区间为140至3680非洲法郎。
