title: Use of antimalarial drugs in Mali: policy versus reality.
abstract: Inappropriate use of antimalarial drugs undermines therapeutic efficacy and promotes the emergence and spread of drug-resistant malaria. Strategies for improving compliance require accurate information about current practices. Here we describe Knowledge-Attitude-Practice surveys conducted among health providers and consumers in two Malian villages, one rural and one periurban. All sanctioned providers limited their first choices of antimalarial drug to those recommended by the national malaria control program and reported using correct dosing regimens. However, the majority of consumers in the two villages chose non-recommended treatments for malaria and reported suboptimal treatment regimens when they did use recommended drugs. Antimalarial drugs were also widely available from unsanctioned sources, often accompanied by erroneous advice on dosing regimens. This study demonstrates that even when the most peripheral health providers are well-trained in correct use of antimalarial drugs, additional measures directly targeting consumers will be required to improve drug use practices.
authors.affiliation: Division of Geographic Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
authors.forename: A
authors.initials: A
authors.lastname: Djimde
authors.forename: C V
authors.initials: CV
authors.lastname: Plowe
authors.forename: S
authors.initials: S
authors.lastname: Diop
authors.forename: A
authors.initials: A
authors.lastname: Dicko
authors.forename: T E
authors.initials: TE
authors.lastname: Wellems
authors.forename: O
authors.initials: O
authors.lastname: Doumbo
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D002738:Chloroquine / Q000008:administration & dosage / Q000627:therapeutic use; D003258:Consumer Behavior; D003625:Data Collection; D004338:Drug Combinations; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008288:Malaria / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D008302:Mali; D008519:Medicine, Traditional; D008875:Middle Aged; D002727:Proguanil / Q000008:administration & dosage / Q000627:therapeutic use; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use; D011803:Quinine / Q000008:administration & dosage / Q000627:therapeutic use; D012424:Rural Population; D013383:Suburban Population; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D013413:Sulfadoxine; D002738:Chloroquine; D011803:Quinine; D002727:Proguanil; D011739:Pyrimethamine