期刊论文详细信息
BMC Public Health
Irrational use of antimalarial drugs in rural areas of eastern Pakistan: a random field study
Najma Arshad2  Khawaja Raees Ahmad1  Muhammad Khalid Mukhtar1  Hafiz Muhammad Tahir1  Muhammad Arshad1  Ahmad Khan1  Shafaat Yar Khan1 
[1] Department of Biological Sciences, University of Sargodha, Sargodha, Pakistan;Department of Zoology, University of Punjab, Lahore, Pakistan
关键词: Blood Examination Rate (BER);    Diagnosis;    Mosquito vectors;    Antimalarial drugs;    Eastern Pakistan;    Plasmodium;    Malaria;   
Others  :  1162890
DOI  :  10.1186/1471-2458-12-941
 received in 2011-08-09, accepted in 2012-10-16,  发布年份 2012
PDF
【 摘 要 】

Background

Prescription of antimalarial drugs in the absence of malarial disease is a common practice in countries where malaria is endemic. However, unwarranted use of such drugs can cause side effects in some people and is a financial drain on local economies. In this study, we surveyed the prevalence of malaria parasites in humans, and the prevalence of the malaria transmitting mosquito vectors in the study area. We also investigated the use of antimalarial drugs in the local people. We focused on randomly selected rural areas of eastern Pakistan where no malaria cases had been reported since May 2004.

Methods

Mass blood surveys, active case detection, passive case detection, and vector density surveys were carried out in selected areas of Sargodha district from September 2008 to August 2009. Data pertaining to the quantities and types of antimalarial drugs used in these areas were collected from health centers, pharmacies, and the district CDC program of the Health Department of the Government of the Punjab.

Results

Seven hundred and forty four blood samples were examined, resulting in a Blood Examination Rate (BER) of 3.18; microscopic analysis of blood smears showed that none of the samples were positive for malaria parasites. Investigation of the mosquito vector density in 43 living rooms (bedrooms or rooms used for sleeping), 23 stores, and 32 animal sheds, revealed no vectors capable of transmitting malaria in these locations. In contrast, the density of Culex mosquitoes was high. Substantial consumption of a variety of antimalarial tablets, syrups, capsules and injections costing around 1000 US$, was documented for the region.

Conclusion

Use of antimalarial drugs in the absence of malarial infection or the vectors that transmit the disease was common in the study area. Continuous use of such drugs, not only in Pakistan, but in other parts of the world, may lead to drug-induced side effects amongst users. Better training of health care professionals is needed to ensure accurate diagnoses of malaria and appropriate prescription of antimalarial drugs delivered to communities.

【 授权许可】

   
2012 Khan et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413082935966.pdf 213KB PDF download
Figure 1. 43KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Technical Assistance Management Agency and Directorate of Malaria Control (TAMA and DOMC): Malarial Microscopy Training Manual Skill Level One. Pakistan: Technical Management Agency and Directorate of Malaria Control; 2007.
  • [2]Van GJ, Thomas F, Erhart A, D’Alessandro U: The contribution of malaria in pregnancy to perinatal mortality. Am J Trop Med Hyg 2004, 71(2 Suppl):35-40.
  • [3]Project Document (PC-I): Directorate of Malaria Control Pakistan. 2001-02/2005-06
  • [4]DOMC (Directorate of Malaria Control): Malarial control program in Pakistan. 2012. Available on http://www.dmc.gov.pk/index webcite
  • [5]Bacon P, Spalton DJ, Smith SE: Blindness from quinine toxicity. Br J Ophthalmo 1988, 72(3):219-224.
  • [6]Ter KFO, Nosten F, Thieren M, Luxemburger C, Edstein MD, Chongsuphajaisiddhi T, Phaipun L, Webster HK, White NJ: High-dose mefloquine in the treatment of multidrug-resistant falciparum malaria. J Infect Dis 1992, 166(6):1393-1400.
  • [7]Schneider P, Korolenko TA, Busch U: A review of drug-induced lysosomal disorders of the liver in man and laboratory animals. Case Reports Microsc Res Tech 1997, 36(4):253-275.
  • [8]Prasad RS, Kodali VR, Khuraijam GS, Cho M, Travers JP: Acute confusion and blindness from quinine toxicity. Eur J Emerg Med 2003, 10(4):353-356.
  • [9]Inoue T, Tanaka E, Sakuramoto M, Minakuchi M, Maeda Y, Maniwa K, Terada K, Goto S, Takeda T, Noma S, Taguchi Y: Case of drug-induced pneumonia possibly due to mefloquine (antimalarial drug. Nihon Kokyuki Gakkai Zasshi 2005, 43(2):103-107.
  • [10]Alisky JM, Cherpkova EL, Iczkowski KA: Drug interaction and pharmacogenetic reactions are the basis for chloroquine and Mefloquine-induced psychosis. Med Hypothesis 2006, 67(5):1090-1094.
  • [11]Barrocas AM, Cymet T: Cinchonism in a ptients takeing Quinine for leg cramps. Sinai Hospital of Baltimore: Johns Hopkins University, Baltimore, MD, USA; 2007.
  • [12]Carrara VI, Phyo AP, Nwee P, Soe M, Htoo H, Arunkamomkiri J, Singhasivanon P, Nosten F: Auditory assessment of patients with acute uncomplicated Plasmodium falciparum malaria treated with three-day mefloquine-artesunate on the north-western border of Thailand. Malar J 2008, 6(7):233.
  • [13]Abdo-Rabbo A: Patients care regarding consultation and dispensing in some of the public hospitals in Sana’a. INRUD news 1995, 2(4):22-23.
  • [14]Abdo-Rabbo A: Baseline prescribing and health facility indicators in Yeman. J Fac Med Bagh 2000, 42(4):824-829.
  • [15]Laing R, Hogerziel H, Ross-Degnan D: Ten recommendations to improve use of medicines in developing countries. Health Policy and Planning 2001, 16(1):13-20.
  • [16]Nsimba SE, Massele AY, Eriksen J, Gustaffson LL, Tomson G, Warsame M: Case management of malaria in under five at primary health care facilities in a Tanznian district. Trop Med Int Health 2002, 7(3):201-209.
  • [17]Mannan AA, Malik EM, Ali KM: Antimalarial prescribing and dispensing practices in health centers of Khartoum state. East Mediter Health J 2009, 15(1):122-128.
  • [18]World Health Organization: Entomological field techniques for malarial control. Part 1 learner's guide. Geneva; 1992.
  • [19]World Health Organization: Malaria entomology and vector control. Part I, Learner’s guide, trial edition. 2003. WHO/CDS/CPE/SMT/2002.18 Rev.1. http://www.who.int/malaria/publications/atoz/who_cds_cpe_smt_2002_18_rev_1/en/index.htm webcite
  • [20]Abdo-Rabbo A: Prescribing rationality and availability of antimalarial drugs in Hajjah, Yeman. East Mediter Health J 2003, 9(4):607-617.
  文献评价指标  
  下载次数:15次 浏览次数:22次