尼日利亚三角州医生对抗疟药政策的依从性：对疟疾控制的影响

Adherence to antimalarial drug policy among doctors in Delta State, Nigeria: implications for malaria control.

作者信息

Obiebi Irikefe P

机构信息

Department of Community Medicine, Delta State University Teaching Hospital, Oghara.

出版信息

Ghana Med J. 2019 Jun;53(2):109-116. doi: 10.4314/gmj.v53i2.5.

DOI:10.4314/gmj.v53i2.5

PMID:31481806

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6697767/

Abstract

BACKGROUND

Malaria is a public health problem compounded with a widespread emergence of drug-resistant Plasmodium falciparum which necessitated the formulation of a new antimalarial drug policy (AMP).

OBJECTIVE

This study was designed to assess adherence to the policy among physicians in health facilities in Delta state, Nigeria.

DESIGN

Cross-sectional, analytic study. Data were collected with a semi-structured questionnaire.

SETTING

Two secondary and one tertiary health facilities in Delta State, Nigeria.

PARTICIPANTS

Physicians selected with a simple random technique from the facilities.

MAIN OUTCOME MEASURES

Prescribing pattern of antimalarial drugs and adherence to WHO treatment guideline among doctors.

RESULTS

Majority (90.8%) of respondents believed the antimalarial policy (AMP) should be strictly adhered to, although three-fifth (61.0%) of them rated its performance as poor. The level of adherence to the national antimalarial drug policy was high (78.5%) as most doctors prescribed Arthemeter-Lumefantrine, AL for uncomplicated malaria however barely two-fifth (35.4%) adhered to prescribing injectable Artesunate for complicated malaria. AL, (71.9%) was the most prescribed antimalarial drug for uncomplicated malaria The most prescribed antimalarial drugs for complicated malaria was artesunate (40.0%) followed by quinine (27.6%) and artemether (26.7%); although, chloroquine was also prescribed.

CONCLUSION

The level of adherence to AMP among doctors was sub-optimal. Continuous education of doctors on the new AMP is needed to achieve malarial control.

FUNDING

No funding was received for this study.

摘要

背景

疟疾是一个公共卫生问题，恶性疟原虫耐药性的广泛出现使这一问题更加复杂，因此需要制定新的抗疟药物政策（AMP）。

目的

本研究旨在评估尼日利亚三角州医疗机构的医生对该政策的遵守情况。

设计

横断面分析研究。通过半结构化问卷收集数据。

地点

尼日利亚三角州的两家二级医疗机构和一家三级医疗机构。

参与者

从这些机构中采用简单随机技术选取医生。

主要观察指标

抗疟药物的处方模式以及医生对世界卫生组织治疗指南的遵守情况。

结果

大多数（90.8%）受访者认为应严格遵守抗疟政策（AMP），尽管其中五分之三（61.0%）的人认为该政策执行情况不佳。对国家抗疟药物政策的遵守程度较高（78.5%），因为大多数医生为非复杂性疟疾开了蒿甲醚-本芴醇（AL），然而，只有五分之二（35.4%）的医生坚持为复杂性疟疾开注射用青蒿琥酯。AL（71.9%）是治疗非复杂性疟疾最常开具的抗疟药物。治疗复杂性疟疾最常开具的抗疟药物是青蒿琥酯（40.0%），其次是奎宁（27.6%）和蒿甲醚（26.7%）；不过，也有医生开具氯喹。