尼日利亚部分农村专利和专利药品经销商（PPMV）疟疾检测和治疗知识。
Malaria testing and treatment knowledge among selected rural patent and proprietary medicine vendors (PPMV) in Nigeria.
机构信息
Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Community Medicine, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.
出版信息
Malar J. 2019 Mar 27;18(1):103. doi: 10.1186/s12936-019-2732-z.
BACKGROUND
Malaria is a leading cause of illness and death in Nigeria, but access of poor people to quality anti-malarial services remains low especially in the rural areas. Patent and proprietary medicine vendors (PPMVs) provide the majority of malaria treatment in rural areas, but little is known about their knowledge of malaria testing and treatment of uncomplicated malaria as recommended in the 2011 National Malaria Control Programme policy.
METHODS
A cross-sectional survey was conducted in two purposively selected states (Oyo and Bayelsa) in Nigeria with each state representing a different geographic and linguistic-ethnic region in the southern part of the country. Two rural LGAs were randomly selected from each state and data were collected from 160 randomly selected PPMVS (40 per LGA) using a structured questionnaire. Data were analysed using descriptive statistics.
RESULTS
The 2011 National Policy on Malaria Diagnosis and Treatment is mostly unknown to PPMVs. Although most PPMVs (89%) knew that artemisinin-based combination therapy (ACT) is recommended in the national policy, 91% also thought non-ACT were endorsed. The proportion of PPMVs who stated they would treat a malaria case with an artemisinin-based combination at the correct dose was 33% for a child under five, 47% for an adult male and 14% for a pregnant woman in her second trimester. The proportion of PPMVs who reported they would diagnose a case of malaria prior to treatment using a malaria rapid diagnostic test (RDT) kit was 1.9% for children under five, 7.5% for adult males and 3.1% for pregnant women in their first trimester due to lack of knowledge. Almost two-thirds (65.6%) would correctly refer children with severe malaria to health facility.
CONCLUSIONS
Substantial knowledge gaps on the use of RDTs and treatment with artemisinin-based combinations exist among rural PPMVs. Given existing evidence regarding the effectiveness of private retail outlets in malaria case management, PPMVs should be provided with competency-based training and supervision to improve the quality of care they provide.
背景
疟疾是尼日利亚导致发病和死亡的主要原因，但贫困人口获得高质量抗疟服务的机会仍然很低，尤其是在农村地区。专利药品和专利药品供应商（PPMVs）在农村地区提供了大部分疟疾治疗，但对于他们对疟疾检测以及按照 2011 年国家疟疾控制规划政策推荐治疗无并发症疟疾的知识知之甚少。
方法
在尼日利亚两个有针对性选择的州（奥约州和巴耶尔萨州）进行了一项横断面调查，每个州代表该国南部不同的地理和语言-民族区域。从每个州随机选择两个农村地方政府区，从每个地方政府区随机选择 160 名专利药品和专利药品供应商（每个地方政府区 40 名），使用结构化问卷收集数据。使用描述性统计分析数据。
结果
PPMVs 对 2011 年国家疟疾诊断和治疗政策大多不了解。尽管大多数 PPMV（89%）知道国家政策中推荐使用青蒿素为基础的联合疗法（ACT），但 91%的人也认为非 ACT 也得到了认可。PPMV 中表示他们将用正确剂量的青蒿素为基础的联合疗法治疗五岁以下儿童疟疾病例的比例为 33%，成年男性为 47%，怀孕中期的孕妇为 14%。PPMV 中报告他们将在治疗前使用疟疾快速诊断检测（RDT）试剂盒诊断疟疾病例的比例为 5 岁以下儿童为 1.9%，成年男性为 7.5%，怀孕初期的孕妇为 3.1%，原因是缺乏知识。将近三分之二（65.6%）的人会正确地将患有严重疟疾的儿童转介到医疗机构。
结论
农村专利药品和专利药品供应商在使用 RDT 和青蒿素为基础的联合治疗方面存在大量知识差距。鉴于私营零售药店在疟疾病例管理方面的有效性已有现有证据，应向专利药品和专利药品供应商提供基于能力的培训和监督，以提高他们提供的护理质量。
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