title: Administrative practices of health professionals and use of artesunate-amodiaquine by community members for treating uncomplicated malaria in southern Ghana: implications for artemisinin-based combination therapy deployment.
abstract: OBJECTIVE
  To investigate the use of artemisinin-based combination and monotherapy by community members and the administrative practices of health professionals in treating malaria in Ghana.
  
  
  METHODS
  This study is a community-based cross-sectional survey in 11 rural and urban areas in southern Ghana. Using the interviewer method, close-ended questionnaires were administered to community members. Similar questionnaires were also administered in health facilities, community pharmacies and licensed chemical shops.
  
  
  RESULTS
  A total of 1085 individuals comprising 959 non-health professionals and 126 health professionals were interviewed. Fifty-seven per cent of the community members visit pharmacies/drug stores as the first point of call when they suspect malaria. According to the participating drug sellers, artemether-lumefantrine (AL) is the most prescribed/sold anti-malarial drug (59.2%), followed by dihydroartemisinin (35%), sulfadoxine-pyrimethamine (33.0%) and artesunate-amodiaquine (AS-AQ) (27.2%). The majority of customers who visit pharmacies or drug stores without prescription have their anti-malarial drug selected by the shop attendant; in situations like that, dihydroartemisinin and artesunate monotherapies are sold just as AS-AQ and AL. Chloroquine is still sold by some drug vendors, 5 years after its proscription.
  
  
  CONCLUSIONS
  Whereas the use of AS-AQ and AL are acceptable, the frequent use of dihydroartemisinin and artesunate monotherapy threatens the future of ACTs.
authors: Section of Environmental Parasitology, Tokyo Medical and Dental University, Tokyo, Japan.
authors: Bethel
authors: B
authors: Kwansa-Bentum
authors: Irene
authors: I
authors: Ayi
authors: Takashi
authors: T
authors: Suzuki
authors: Joseph
authors: J
authors: Otchere
authors: Takashi
authors: T
authors: Kumagai
authors: William K
authors: WK
authors: Anyan
authors: Hiroko
authors: H
authors: Asahi
authors: Nobuaki
authors: N
authors: Akao
authors: Michael D
authors: MD
authors: Wilson
authors: Daniel A
authors: DA
authors: Boakye
authors: Nobuo
authors: N
authors: Ohta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000655:Amodiaquine / Q000008:administration & dosage*; D000962:Antimalarials / Q000008:administration & dosage*; D037621:Artemisinins / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D055812:Community-Based Participatory Research; D004338:Drug Combinations; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005869:Ghana / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000706:statistics & numerical data*; D010595:Pharmacists / Q000706:statistics & numerical data*; D010596:Pharmacy Technicians / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; C515299:amodiaquine, artesunate drug combination; D000655:Amodiaquine; C039060:artenimol; C031327:artemisinin