title: Identifying malaria control issues: a district hospital-based evaluation.
abstract: Chuk district hospital is centrally located in a rural malarious region in southern Cambodia. It was the site of a hospital-based evaluation (KAP assessment and in vivo i.v. quinine/oral tetracycline drug study) done to identify relevant issues for establishing a rational malaria control strategy. The KAP assessment identified the young, male forest worker as the highest risk group. Of 112 study patients, 73% were male and 82% reported various forest activities. The primary reason found for patient delay (8.9 days) in seeking hospital care was self-treatment at home (N = 102, 91%) with drugs purchased through private sellers (104/105). Using the 7-day WHO field test methodology, resistance rates were calculated (N = 22); S1/R1, 73%; R1, 9%; R2, 0%; R3, 18%. A modified version of the 7-day test was used to calculate its utility in this particular rural setting. It showed a negative predictive value of 93% and a positive predictive value of 71%. The case fatality rate for the study period was 2.7%. Information from this study, which correlates a confirmed malaria diagnosis with prior patient behavior and response to anti-malarial therapy, is intended for realizing the goals set forth by the national malaria control program.
authors.affiliation: MSF Holland-Belgium, Phnom Penh, Cambodia.
authors.forename: M E
authors.initials: ME
authors.lastname: Kimerling
authors.forename: H
authors.initials: H
authors.lastname: Houth
authors.forename: K
authors.initials: K
authors.lastname: Hilderbrand
authors.forename: L
authors.initials: L
authors.lastname: Goubert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000962:Antimalarials / Q000627:therapeutic use*; D002160:Cambodia; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D016468:Forestry; D007722:Health Knowledge, Attitudes, Practice; D006767:Hospitals, District; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011803:Quinine / Q000627:therapeutic use*; D012423:Rural Health; D013752:Tetracycline / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials; D011803:Quinine; D013752:Tetracycline