Early treatment of childhood fevers with pre-packaged antimalarial drugs in the home reduces severe malaria morbidity in Burkina Faso
| Autor: | Sodiomon B. Sirima, Alfred B. Tiono, Simon Cousens, A. T. Konate, Nathalie Convelbo, Franco Pagnoni |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Time Factors Fever Cross-sectional study Home Nursing Population Mothers Rural Health Self Medication Antimalarials Pharmacotherapy Risk Factors Epidemiology Burkina Faso Medicine Humans Malaria Falciparum education Drug Packaging education.field_of_study Aspirin business.industry Incidence (epidemiology) Anti-Inflammatory Agents Non-Steroidal Public Health Environmental and Occupational Health Infant Newborn Infant Chloroquine Patient Acceptance of Health Care medicine.disease Infectious Diseases Cross-Sectional Studies Treatment Outcome Relative risk Child Preschool Disease Progression Parasitology Drug Therapy Combination Female business Malaria Self-medication |
| Zdroj: | Tropical medicineinternational health : TMIH. 8(2) |
| ISSN: | 1360-2276 |
| Popis: | In rural, malaria-endemic Burkina Faso, we evaluated the impact of the use of pre-packaged antimalarial drugs (PPAM), by mothers in the home, on the progression of disease in children from uncomplicated fever to severe malaria. In each village of one province, a core group of opinion leaders (mainly older mothers) was trained in the management of uncomplicated malaria, including the administration of PPAM. Full courses of antimalarial (chloroquine) and antipyretic (aspirin) drugs were packaged in age-specific bags and made widely available through community health workers who were supplied through the existing drug distribution system. Drugs were sold under a cost-recovery scheme. Local schoolteachers conducted surveys in a random sample of 32 villages at the end of the high transmission seasons in 1998 and 1999. Disease history and the treatment received were investigated for all children under the age of 6 years having suffered from a fever episode in the previous 4 weeks. 'Uncomplicated malaria' was defined as every episode of fever and 'severe malaria' as every episode of fever followed by convulsions or loss of consciousness. During the study period, 56%[95% confidence interval (CI) 50-62%] of 3202 fever episodes in children under 6 years of age were treated promptly by mothers with the pre-packaged drugs made available by the study. A total of 59% of children receiving PPAM were reported to have received the drugs over the prescribed 3-day period, while 52% received the correct age-specific dose. PPAM use was similar among literate (61%) and non-literate mothers (55%) (P = 0.08). The overall reported risk of developing severe malaria was 8%. This risk was lower in children treated with PPAM (5%) than in children not treated with PPAM (11%) (risk ratio = 0.47; 95% CI 0.37, 0.60; P < 0.0001). This estimate of the impact of PPAM was largely unchanged when account was taken of potential confounding by age, sex, maternal literacy status, year or village. Our findings support the view that, after appropriate training and with adequately packaged drugs made available, mothers can recognize and treat promptly and correctly malarial episodes in their children and, by doing so, reduce the incidence of severe disease. |
| Databáze: | OpenAIRE |
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