The use of paediatric artemisinin combinations in sub-Saharan Africa: a snapshot questionnaire survey of health care personnel

Malaria Journal

Research

Raquel González¹  Gondo Kizito²  Lorenz Auer-Hackenberg³  Pembe I Mayengue⁴  Bertrand Lell⁵  Jose F Fernandes⁵  Solange S Soulanoudjingar⁵  Selidji T Agnandji⁵  Ghyslain Mombo-Ngoma⁵  Arti Basra⁵  Saadou Issifou⁵  Beatrice P Abossolo⁵  Florian Kurth⁶  Michael Ramharter⁷  Ayola A Adegnika⁸ 

[1] Barcelona Centre for International Health Research (CRESIB), University of Barcelona, Barcelona, Spain;Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria;Fondation Congolaise pour la Recherche Médicale/Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, République du Congo;Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon;Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany;Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon;Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany;Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany;Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon;Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany;Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria;Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon;Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany;Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands;

关键词: Artemisinin based combinations therapy;    Paediatric drug formulation;    Artemether;    Lumefantrine;    Amodiaquine;    Dihydroartemisinin;    Piperaquine;    Mefloquine;   

DOI  :  10.1186/1475-2875-10-365

 received in 2011-10-05, accepted in 2011-12-14,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundPaediatric drug formulations for artemisinin combination therapy (P-ACT) have been developed over the past few years and have been shown to improve the therapeutic management of young children with uncomplicated falciparum malaria. This process was however not equally paralleled by a timely adoption of P-ACT in national and international treatment recommendations. National malaria programmes in sub-Saharan Africa have not yet widely embraced this new therapeutic tool. To which extent P-ACT is used in the field in sub-Saharan Africa is not known to date.MethodsThis snapshot questionnaire survey aimed to provide an overview on the current routine practices for the availability and use of P-ACT as anti-malarial treatment for young children in sub-Saharan Africa. Health care personnel in seven countries in West-, Central, and East-Africa were invited to answer a structured questionnaire assessing use and availability of P-ACT.ResultsA total of 71 respondents including doctors, nurses and pharmacy personnel responsible for the anti-malarial treatment of young children were interviewed. P-ACT was used by 83% (95% confidence interval: 73-90%; n = 59) as first-line treatment for young children. Use of 15 different P-ACT products was reported among which only two have received WHO prequalification status and approval by a stringent registration authority. Use of a specific P-ACT product was not linked to consumer prices or availability of supporting clinical trial data, but may depend more on the marketing capacity of the manufacturer. Major differences in frequency and dosing of anti-malarial regimens with identical anti-malarial compounds and the marketing of loose combinations were recorded.ConclusionPaediatric ACT is widely used for the treatment of uncomplicated malaria in young children. However, the majority of P-ACT formulations in use do not meet highest international quality standards evoking concerns for patients' safety and the induction of drug resistance. Improving the quality of currently marketed P-ACT should constitute a public health priority besides their adoption into official treatment recommendations.

【 授权许可】

Unknown   
© Agnandji et al.; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.