Curative and preventive treatment of uncomplicated malaria in public health institutions in Cameroon.

Chloroquine-resistant Plasmodium strains are found in certain foci in Cameroon. We do not know what contribution drug prescriptions and drug pressure had in bringing this about. We contacted 66 persons (39 doctors and 27 nurses) who prescribe antimalarial drugs in Cameroon regarding their prescription habits; 46 (69.7%) responded. The three most prescribed drugs for uncomplicated malaria were quinine (84.4%), chloroquine (80.4%) and amodiaquine (80.4%). The most common reason for prescribing the drugs was availability. The drug of choice for the treatment of uncomplicated malaria was chloroquine with amodiaquine and quinine being second best for doctors and nurses, respectively. The form of treatment preferred by most doctors (ie 46%) was tablets while most nurses (42%) preferred injections. Prophylatic antimalarials were prescribed by 73% of the doctors and by 83% of the nurses. Doctors prescribed mainly to children and pregnant women while nurses prescribed to everyone. The drugs used were chloroquine, amodiaquine, quinine and pyrimethamine. Ten doctors and four nurses had encountered at least one case of drug resistant malaria. The most common evidence on which the diagnosis had been based was the absence of improvement on the treatment prescribed. The implicated drugs were chloroquine, amodiaquine and quinine. There was evidence of major differences in the practice of the respondents regarding treatment, prophylaxis and the diagnosis of drug resistance. These results indicate an urgent need for a national antimalarial drug policy in Cameroon.