Treatment of malaria from monotherapy to artemisinin-based combination therapy by health professionals in urban health facilities in Yaoundé, central province, Cameroon.

Abstract

BACKGROUND:

After adoption of artesunate-amodiaquine (AS/AQ) as first-line therapy for the treatment of uncomplicated malaria by the malaria control programme, this study was designed to assess the availability of anti-malarial drugs, treatment practices and acceptability of the new protocol by health professionals, in the urban health facilities and drugstores of Yaoundé city, Cameroon.

METHODS:

Between April and August 2005, retrospective and current information was collected by consulting registers and interviewing health practitioners in urban health facilities using a structured questionnaire.

RESULTS:

In 2005, twenty-seven trade-named drugs have been identified in drugstores; quinine tablets (300 mg) were the most affordable anti-malarial drugs. Chloroquine was restricted to food market places and no generic artemisinin derivative was available in public health centres. In public health facilities, 13.6% of health professionals were informed about the new guidelines; 73.5% supported the use of AS-AQ as first-line therapy. However, 38.6% apprehended its use due to adverse events attributed to amodiaquine. Malaria treatment was mainly based on the diagnosis of fever. Quinine (300 mg tablets) was the most commonly prescribed first-line anti-malarial drug in adults (44.5%) and pregnant women (52.5%). Artequin was the most cited artemsinin-based combination therapy (ACT) (9.9%). Medical sales representatives were the main sources of information on anti-malarials.

CONCLUSION:

The use of AS/AQ was not implemented in 2005 in Yaoundé, despite the wide range of anti-malarials and trade-named artemisinin derivatives available. Nevertheless, medical practitioners will support the use of this combination, when it is available in a paediatric formulation, at an affordable price. Training, information and participation of health professionals in decision-making is one of the key elements to improve adherence to new protocol guidelines. This baseline information will be useful to monitor progress in ACT implementation in Cameroon.

• Authors: Collins Sayang, Mathieu Gausseres, Nicole Vernazza-Licht, Denis Malvy, Daniel Bley, Pascal Millet
• Journal: Malaria journal (Malar J) Vol. 8 Pg. 176 (Jul 29 2009) ISSN: 1475-2875 [Electronic] England
• PMID: 19640292 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antimalarials
• Artemisinins
• Drug Combinations
• amodiaquine, artesunate drug combination
• Amodiaquine

Topics

• Adult
• Aged
• Aged, 80 and over
• Amodiaquine (therapeutic use)
• Antimalarials (therapeutic use)
• Artemisinins (therapeutic use)
• Cameroon
• Child, Preschool
• Drug Combinations
• Female
• Health Personnel
• Health Services Research
• Humans
• Infant
• Malaria (drug therapy)
• Male
• Middle Aged
• Practice Guidelines as Topic
• Pregnancy
• Surveys and Questionnaires
• Urban Health
• Young Adult