Ntamabyaliro Nsengi Y, Burri Christian, Lula Yves N, Nzolo Didier B, Engo Aline B, Ngale Mireille A, Situakibanza Hippolyte N, Mukomena Eric S, Mesia Gauthier K, Mampunza Samuel M, Tona Gaston L
Unité de Pharmacologie Clinique, Faculté de Médecine, Université de Kinshasa, Kinshasa P.O. Box 834, Democratic Republic of the Congo.
Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland.
Trop Med Infect Dis. 2022 Jul 18;7(7):138. doi: 10.3390/tropicalmed7070138.
(1) Background: Malaria heavily affects the Democratic Republic of the Congo (DRC) despite the use of effective drugs. Poor adherence to malaria treatment may contribute to this problem. (2) Methods: In one rural and one urban health area in each of the 11 former provinces of the DRC, all households with a case of malaria in the 15 days preceding the survey were selected and the patients or caregivers were interviewed. Adherence to malaria treatment was assessed by self-declaration about its completion. Logistic regression was used to assess predictors. (3) Results: 1732 households participated. Quinine was the most used drug; adherence to artesunate-amodiaquine was the lowest and the main reason for treatment discontinuation was adverse reactions. Predictors of adherence were residence in an urban area, university education, catholic religion, and adoption of recommended behaviour towards a malaria case. Adherence was significantly lower for responders who obtained information on antimalarials from Community Health Workers (CHW). (4) Conclusions: Usage of recommended drugs and adherence to malaria treatment need to be promoted, especially in rural areas, and CHW involvement needs to be improved. Awareness messages need to be made accessible and comprehensible to poorly educated populations and churches need to be involved.
(1) 背景：尽管使用了有效药物，但疟疾仍严重影响刚果民主共和国（DRC）。对疟疾治疗的依从性差可能是导致这一问题的原因之一。(2) 方法：在刚果民主共和国11个前省份的每个省份各选取一个农村和一个城市卫生区，选择在调查前15天内有疟疾病例的所有家庭，并对患者或照料者进行访谈。通过自我申报治疗完成情况来评估对疟疾治疗的依从性。采用逻辑回归分析来评估预测因素。(3) 结果：1732户家庭参与。奎宁是使用最多的药物；对青蒿琥酯 - 阿莫地喹的依从性最低，治疗中断的主要原因是不良反应。依从性的预测因素包括居住在城市地区、受过大学教育、信奉天主教以及对疟疾病例采取推荐行为。从社区卫生工作者（CHW）处获取抗疟药信息的应答者的依从性显著较低。(4) 结论：需要推广推荐药物的使用和对疟疾治疗的依从性，尤其是在农村地区，并且需要改善社区卫生工作者的参与情况。需要使宣传信息对受教育程度低的人群易于获取和理解，并且需要教会的参与。
