尼日利亚中北部夸拉州季节性疟疾化学预防指南的遵守情况。

Compliance With Guidelines on Seasonal Malaria Chemoprevention in Kwara State, Northcentral Nigeria.

机构信息

Department of Medical Laboratory Science, College of Medicine of the University of Lagos, Lagos, Nigeria Email:

National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.

出版信息

West Afr J Med. 2024 Jan 31;41(1):55-64.

PMID:38412205

Abstract

BACKGROUND

Seasonal malaria chemoprevention (SMC) is an effective strategy for reducing malaria morbidity and mortality in children aged 3-59 months in areas with seasonal malaria transmission. Sulphadoxine-pyrimethamine plus amodiaquine is given to an eligible child at monthly intervals during the peak malaria transmission season. The aim of this study was to determine the level of compliance with SMC guidelines by community drug distributors during SMC implementation in Kwara State.

METHOD

Caregivers of eligible children from six Local Government Areas were interviewed using a structured questionnaire on the KoboCollect app downloaded on hand-held android devices. The questionnaire was composed of questions on caregiver's demographics, SMC drug administration, and adherence to SMC protocol.

RESULTS

A total of 1,314 caregivers were interviewed, most of them were female 1076 (81.9%), married 1200 (91.3%) and literate 795 (60.5%). The mean SMC coverage for the 4 cycles was 1183(88.5%). SMC information was received by 1166 (88.7%) of caregivers. Most of the caregivers 1166 (88.7%) heard about SMC. Overall, SPAQ administration was directly observed in most cases 1169 (91.5%), second dose was given 1226 (96.0%) and drugs were fully ingested 1140(89.3%). Poor compliance was observed in home visits by lead mothers 988 (77.4%). The report of adverse drug reactions was low 132 (10.3% [95% CI: 8.8-12.3%]), the commonest being severe vomiting 50 (37.9%). There were significant (P<0.05) variations in SMC implementation across the 6 LGAs in virtually all the performance indicators. SPAQ administration to over-age children was low 128 (10.0%).

CONCLUSION

Overall, the compliance with SMC implementation guidelines in Kwara state was good though significant differences in performance were observed across the six LGAs. Home visits by lead mothers were generally poor. The self-reported coverage of SMC by caregivers was commendable.

摘要

背景

季节性疟疾化学预防（SMC）是减少季节性疟疾传播地区 3-59 月龄儿童疟疾发病率和死亡率的有效策略。在疟疾传播高峰期，每月为符合条件的儿童服用磺胺多辛-乙胺嘧啶加阿莫地喹。本研究旨在确定在实施 SMC 期间，社区药剂师对 SMC 指南的遵守程度。

方法

使用 KoboCollect 应用程序对六个地方政府地区符合条件的儿童的照顾者进行了问卷调查。该问卷由关于照顾者人口统计学、SMC 药物管理和遵守 SMC 方案的问题组成。

结果

共访谈了 1314 名照顾者，他们大多数是女性（1076 名，81.9%）、已婚（1200 名，91.3%）和识字（795 名，60.5%）。4 个周期的平均 SMC 覆盖率为 1183（88.5%）。SMC 信息已收到 1166 名（88.7%）的照顾者。大多数照顾者（1166 名，88.7%）听说过 SMC。总体而言，大多数情况下 SPAQ 管理是直接观察到的（1169 名，91.5%），第二剂给药（1226 名，96.0%），药物完全摄入（1140 名，89.3%）。主要母亲的家访次数少（988 名，77.4%）。不良药物反应报告率低（132 名，10.3%[95%CI：8.8-12.3%]），最常见的是严重呕吐（50 名，37.9%）。在 6 个地方政府地区的几乎所有表现指标中，都存在 SPAQ 管理对超龄儿童的差异。