Feller-Dansokho E, Ki-Zerbo G, Badiane S
Service des Maladies Infectieuses, C.H.U. de Fann, Dakar, Sénégal.
Ann Soc Belg Med Trop. 1994 Dec;74(4):291-300.
A questionnaire survey was conducted in the Dakar region (Senegal) between August and October 1992 to investigate diagnosis and treatment practices for uncomplicated malaria attacks in the health care facilities. The sample consisted of 208 prescribers in the operational sense i.e. 20% of the following professional categories: medical doctors, health care technicians, birth attendants, qualified nurses, and auxiliary nurses. A thick smear was mentioned as a diagnostic element by 23% of the practitioners; chloroquine remained the first choice drug for 80% of the personnel but 13% declared prescribing parenteral quinine for uncomplicated malaria in patients without vomiting; halofantrine and the association sulfadoxine-pyrimethamine-mefloquine are prescribed by respectively 7 and 1% of the personnel, also in the public sector; chloroquine is prescribed in an effective dose (25-40 mg/kg) by 74% of the personnel for adults and by 43% for children; quinine base in a dose below 25 mg/kg by 100% of personnel for adults and by 99% for children; nearly half of the prescribers do not take into account the children's weight; 13% of the practitioners prescribe useless expensive symptomatic treatments and 45 to 73% ignore the price of the common antimalarials, allowing for a 10% error; health care workers have a bad knowledge of the results of chemosensitivity surveys. The development of a national malaria control programme that emphasises permanent training of the health care workers and control of therapeutic information seems mandatory.
