title: Availability of antimalarial drugs and evaluation of the attitude and practices for the treatment of uncomplicated malaria in Bangui, Central African Republic.
abstract: National malaria management policy is based upon the availability of effective and affordable antimalarial drugs. This study was undertaken to evaluate the quality of the treatment of uncomplicated malaria cases in Bangui, an area with multi-drug resistant parasites, at a time preceding implementation of a new therapeutic policy relying on the artemisinin derivative combined treatment artemether-lumefantrine. A cross-sectional study was carried out in Bangui city to assess availability of antimalarial drugs and the performances of health workers in the management of uncomplicated malaria. Availability of drugs was recorded in all drugs wholesalers (n=3), all Pharmacies in health facilities (n=14), private drugstores (n=15), and on 60 non official drug shops randomly chosen in the city. Despite a limited efficacy at the time of the survey, chloroquine remained widely available in the official and non official markets. Artemisinin derivatives used in monotherapy or in combination were commonly sold. In health care facilities, 93% of the uncomplicated malaria cases were treated in the absence of any laboratory confirmation and the officially recommended treatment, amodiaquine-sulfadoxine/pyrimethamine was seldom prescribed. Thus, the national guidelines for the treatment of uncomplicated malaria are not followed by health professionals in Bangui. Its use should be implemented while a control of importation of drug has to be reinforced.
authors.affiliation: Epidemiology Unit, Institut Pasteur de Bangui, Central Africa Republic. amanirak@yahoo.fr
authors.forename: Alexandre
authors.initials: A
authors.lastname: Manirakiza
authors.forename: Siméon Pierre
authors.initials: SP
authors.lastname: Njuimo
authors.forename: Alain
authors.initials: A
authors.lastname: Le Faou
authors.forename: Denis
authors.initials: D
authors.lastname: Malvy
authors.forename: Pascal
authors.initials: P
authors.lastname: Millet
mesh_terms: D000962:Antimalarials / Q000600:supply & distribution* / Q000627:therapeutic use; D002488:Central African Republic; D003430:Cross-Sectional Studies; D006268:Health Facilities / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006291:Health Policy; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D000962:Antimalarials