Bilal Jalal A, Gasim Gasim I, Abdien Mohamed T, Elmardi Khalid A, Malik Elfatih M, Adam Ishag
College of Medicine, Qassim University, Qassim, Saudi Arabia.
Faculty of Medicine, University of Khartoum, PO Box 102, Khartoum, Sudan.
Malar J. 2015 Jan 28;14:34. doi: 10.1186/s12936-015-0575-9.
In spite of the World Health Organization recommendations for the treatment of malaria, febrile patients are still infrequently tested and erroneously treated for malaria. This study aimed to investigate the adherence to malaria national protocol for the management of malaria among under five years old children.
A cross sectional hospital-based study was conducted during the period from September through December 2013 among febrile children below the age of five years attending the outpatient department of Omdurman Children Hospital, Sudan. Demographic, clinical and laboratory data [blood film, rapid diagnostic test (RDTs), haemoglobin, WBCs and chest X ray] and anti-malarials and/or antibiotics prescription were recorded.
A total of 749 febrile children were enrolled. The mean (SD) age was 37.51 (41.6) months. Less than a half, (327, 43.7%) of children were investigated for malaria using microscopy (271, 82.9%), RDT (4, 1.2%) or both (52, 15.9%). Malaria was not investigated for more than a half, (422, 56.3%) however investigations targeting other causes of fever were requested for them. Malaria was positive in 72 (22%) of the 327 investigated children. Five (1.6%) out of 255 with negative malaria tests were treated by an anti-malarials. Quinine was the most frequently prescribed anti-malarials (65, 72.2%) then artemisinin-based combination therapy (ACT) (2, 27.8%). The majority of the 749 children (655, 87.4%) were prescribed an antibiotic.
There is a poor adherence to malaria management protocol in Sudan among physicians treating children below five years of age. There was a high rate of antibiotic prescription needs.
尽管世界卫生组织对疟疾治疗有相关建议，但发热患者接受疟疾检测的频率仍然很低，且常被错误地当作疟疾进行治疗。本研究旨在调查五岁以下儿童疟疾国家管理方案的执行情况。
2013年9月至12月期间，在苏丹恩图曼儿童医院门诊部对五岁以下发热儿童开展了一项基于医院的横断面研究。记录了人口统计学、临床和实验室数据[血涂片、快速诊断试验（RDTs）、血红蛋白、白细胞和胸部X光]以及抗疟药和/或抗生素的处方情况。
共纳入749名发热儿童。平均（标准差）年龄为37.51（41.6）个月。不到一半（327名，43.7%）的儿童接受了疟疾检测，其中使用显微镜检测的有271名（82.9%），使用RDT检测的有4名（1.2%），两种方法都使用的有52名（15.9%）。超过一半（422名，56.3%）的儿童未接受疟疾检测，但针对他们进行了其他发热原因的检查。在327名接受检测的儿童中，72名（22%）疟疾检测呈阳性。255名疟疾检测阴性的儿童中有5名（1.6%）接受了抗疟药治疗。奎宁是最常开具的抗疟药（65名，72.2%），其次是青蒿素联合疗法（ACT）（2名，27.8%）。749名儿童中的大多数（655名，87.4%）都开具了抗生素。
在苏丹，治疗五岁以下儿童的医生对疟疾管理方案的依从性较差。抗生素处方需求率很高。
