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尽管有报道称疟疾发病率有所下降,但在坦桑尼亚基洛萨区的农村社区,自行服用抗疟药仍是一种常见做法。

Self-medication with anti-malarials is a common practice in rural communities of Kilosa district in Tanzania despite the reported decline of malaria.

作者信息

Chipwaza Beatrice, Mugasa Joseph P, Mayumana Iddy, Amuri Mbaraka, Makungu Christina, Gwakisa Paul S

机构信息

Nelson Mandela African Institute of Science and Technology, P,O, Box 447, Arusha, Tanzania.

出版信息

Malar J. 2014 Jul 3;13:252. doi: 10.1186/1475-2875-13-252.

Abstract

BACKGROUND

Self-medication has been widely practiced worldwide particularly in developing countries including Tanzania. In sub-Saharan Africa high incidences of malaria have contributed to self-medication with anti-malarial drugs. In recent years, there has been a gain in malaria control, which has led to decreased malaria transmission, morbidity and mortality. Therefore, understanding the patterns of self-medication during this period when most instances of fever are presumed to be due to non-malaria febrile illnesses is important. In this study, self-medication practice was assessed among community members and information on the habit of self-medication was gathered from health workers.

METHODS

Twelve focus group discussions (FGD) with members of communities and 14 in-depth interviews (IDI) with health workers were conducted in Kilosa district, Tanzania. The transcripts were coded into different categories by MaxQDA software and then analysed through thematic content analysis.

RESULTS

The study revealed that self-medication was a common practice among FGD participants. Anti-malarial drugs including sulphadoxine-pyrimethamine and quinine were frequently used by the participants for treatment of fever. Study participants reported that they visited health facilities following failure of self-medication or if there was no significant improvement after self-medication. The common reported reasons for self-medication were shortages of drugs at health facilities, long waiting time at health facilities, long distance to health facilities, inability to pay for health care charges and the freedom to choose the preferred drugs.

CONCLUSION

This study demonstrated that self-medication practice is common among rural communities in the study area. The need for community awareness is emphasized for correct and comprehensive information about drawbacks associated with self-medication practices. Deliberate efforts by the government and other stakeholders to improve health care services, particularly at primary health care facilities will help to reduce self-medication practices.

摘要

背景

自我药疗在全球范围内广泛存在,尤其是在包括坦桑尼亚在内的发展中国家。在撒哈拉以南非洲地区,疟疾的高发病率导致了抗疟药物的自我药疗现象。近年来,疟疾防控取得了进展,这使得疟疾传播、发病率和死亡率有所下降。因此,了解在这个大多数发热病例被认为是由非疟疾发热性疾病引起的时期的自我药疗模式很重要。在本研究中,对社区成员的自我药疗行为进行了评估,并从卫生工作者那里收集了有关自我药疗习惯的信息。

方法

在坦桑尼亚的基洛萨区,与社区成员进行了12次焦点小组讨论(FGD),并与卫生工作者进行了14次深入访谈(IDI)。通过MaxQDA软件将访谈记录编码为不同类别,然后通过主题内容分析进行分析。

结果

研究表明,自我药疗在焦点小组讨论参与者中是一种常见做法。参与者经常使用包括磺胺多辛 - 乙胺嘧啶和奎宁在内的抗疟药物来治疗发热。研究参与者报告说,在自我药疗失败或自我药疗后没有明显改善时,他们会前往医疗机构就诊。自我药疗的常见原因包括医疗机构药品短缺、在医疗机构等待时间长、距离医疗机构远、无力支付医疗费用以及能够自由选择首选药物。

结论

本研究表明,自我药疗行为在研究区域的农村社区中很常见。强调需要提高社区意识,以获取有关自我药疗行为相关弊端的正确和全面信息。政府和其他利益相关者为改善医疗服务,特别是初级医疗保健机构的服务而做出的刻意努力,将有助于减少自我药疗行为。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/249b/4087197/28c8fb7ef8fe/1475-2875-13-252-1.jpg

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