title: [Evaluation of the quality of prescription and dispensing of artemisinin-based therapeutic combinations in the Bamako District, Mali].
abstract: The increasingly increasing resistance of the parasites of malaria to chloroquine pushed all the African countries almost to adopt the ACTs like treatment of first intention of uncomplicated malaria. However, correct use of the ACTs proves to be imperative to guarantee their effectiveness and to even delay the spread resistant parasites to these molecules. Thus, we have conducted this study in order to assess the quality of the prescription and the dispensation of ACTs in randomly selected health centers across Bamako. Our study was a cross-sectional study conducted between April and July 2008 with interview of patients received in clinic for malaria, a questionnaire was administered to physicians and other health workers who give prescription of antimalarials, and pharmacists and other people working in pharmacy or drugs deposit. In total, 52 prescribers, 72 dispensers and 92 patients were included. Our study has shown that the ACT constituted the treatment of first choice of malaria within prescribers (75%) and dispensers (78.8%). However, 57.61% of the prescriptions against malaria did not contain any ACTs. The ACTs recommended by the National Malaria Program (NMCP) were known by 59.7% of dispensers and 73.1% of prescribers. The majority of the prescribers (71.15%) and of the dispensers (84.72%) were favorable to the NMCP's recommendations. Many patients (41.30%) did not understand at all the dose of the prescribed ACTs. Almost all of the prescription containing ACT was a generic drug prescribed (97.72%; n = 44). The prices of the ACTs varied between 140 and 3,380 FCFA with an average of 750 FCFA. According to prescribers and dispensers, the ACT constitutes their first choice (75% of prescribers and 78.8% of the dispensers). However, 57.61% of the prescriptions against malaria did not contain any ACTs. The majority of prescribers (71.15%) and dispensers (84.72%) were favorable to the NMCP's recommendations of malaria treatment in Mali. The average cost of prescriptions containing ACT was 750 FCFA with the extreme ones going from 140 to 3,680 FCFA.
authors: Centre de Recherche et de Formation sur le Paludisme, Faculte de Medecine, de Pharmacie et d’Odontostomatologie, Universite de Bamako, BP, Mali.
authors: Sangaré
authors: S
authors: Eve
authors: Diop
authors: D
authors: Samba
authors: Dembélé
authors: D
authors: Benoît
authors: Sory I
authors: SI
authors: Diawara
authors: Diakité
authors: D
authors: Seidina
authors: Doumbia
authors: D
authors: Saibou
authors: Traore
authors: T
authors: Karim
authors: Konaté
authors: K
authors: Drissa
authors: Doumbia
authors: D
authors: Seydou
authors: Traore Sékou
authors: TS
authors: Fanta Mady
authors: Diakité
authors: D
authors: Mahamadou
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D037621:Artemisinins / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008288:Malaria / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D008297:Male; D008302:Mali / Q000453:epidemiology; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010594:Pharmacies / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy; D011306:Prescription Fees / Q000706:statistics & numerical data; D012494:Sampling Studies
chemical_list: D000962:Antimalarials; D037621:Artemisinins