[Assessing the application of Rwanda's national protocol for uncomplicated malaria treatment in healthcare institutions in Kigali City, Rwanda].
In November 2001, the National Health Ministry of Rwanda advocated a new therapeutic protocol replacing chloroquine by an amodiaquine+sulfadoxine-pyrimethamine combination for the treatment of uncomplicated malaria.


OBJECTIVE
This study had for aim to assess the application of this new protocol in Kigali healthcare institutions.


METHODS
A knowledge, attitudes and practices study (KAP) was carried out between June and August 2003. A questionnaire was answered by 120 care providers working in 15 healthcare institutions selected randomly in health facilities treating uncomplicated malaria. Antimalarial treatments prescribed to 150 patients were also reviewed from consultation files and analyzed.


RESULTS
After analysis, 63.3% prescriptions were in line with the national protocol. Factors associated to the nonobservance of the national protocol were: the carer's ignorance of any recommended treatment, his doubt of efficacy of recommended drugs, and his fear of adverse effects.


CONCLUSIONS
The authors recommend informing the care providers about the national protocol. Findings also demonstrate the need to include care providers in any modifications of the national policy in terms of drug efficacy and potential adverse effects of the new strategy.
Nzayirambaho
M
M
Ecole de Santé Publique, Université Nationale du Rwanda, Kigali, Rwanda. nzayirambahoma@yahoo.fr
Freund
R J
RJ
Millet
P
P
Lombrail
P
P
Malvy
D
D
Potel
G
G
D000328:Adult; D000655:Amodiaquine / Q000008:administration & dosage / Q000627:therapeutic use; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006268:Health Facilities / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D008288:Malaria / Q000188:drug therapy*; D008297:Male; D009313:National Health Programs; D009740:Nursing Staff / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015397:Program Evaluation; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use; D012432:Rwanda; D012494:Sampling Studies; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use; D014504:Urban Health
D000962:Antimalarials; D000655:Amodiaquine; D013413:Sulfadoxine; D011739:Pyrimethamine