ArticleMalaria journal2010
Prescribing practice for malaria following introduction of artemether-lumefantrine in an urban area with declining endemicity in West Africa.
Article in Malaria journal, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Diagnosing acute and prevalent HIV-1 infection in young African adults seeking care for fever: a systematic review and audit of current practice.International health · 2014Pooled it
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
- Malaria rapid diagnostic tests for the case management of febrile children in Nigerian primary healthcare settings: a cross-sectional study.The Journal of the Egyptian Public Health Association · 2022Article
- Assessment of the knowledge, attitude and practices of prescribers regarding malaria diagnosis: a cross sectional study among Ghanaian prescribers.The Pan African medical journal · 2019Article
- Challenges for achieving safe and effective radical cure of Plasmodium vivax: a round table discussion of the APMEN Vivax Working Group.Malaria journal · 2017Review
- Adherence to malaria diagnosis and treatment guidelines among healthcare workers in Ogun State, Nigeria.BMC public health · 2016Article
- Provider compliance to artemisinin-based combination therapy at primary health care facilities in the middle belt of Ghana.Malaria journal · 2015Article
- Article
- Predictors of antibiotics co-prescription with antimalarials for patients presenting with fever in rural Tanzania.BMC public health · 2013Article
- Malaria diagnosis and treatment practices following introduction of rapid diagnostic tests in Kibaha District, Coast Region, Tanzania.Malaria journal · 2013Article
- Article
- Prevalence of malaria among patients attending public health facilities in Maputo City, Mozambique.The American journal of tropical medicine and hygiene · 2011Article
- Article
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe decline in malaria coinciding with the introduction of newer, costly anti-malarials has prompted studies into the overtreatment for malaria mostly in East Africa. The study presented here describes prescribing practices for malaria at health facilities in a West African country.
methodsCross-sectional surveys were carried out in two urban Gambian primary health facilities (PHFs) during and outside the malaria transmission season. Facilities were comparable in terms of the staffing compliment and capability to perform slide microscopy. Patients treated for malaria were enrolled after consultations and blood smears collected and read at a reference laboratory. Slide reading results from the PHFs were compared to the reference readings and the proportion of cases treated but with a negative test result at the reference laboratory was determined.
resultsSlide requests were made for 33.2% (173) of those enrolled, being more frequent in children (0-15 yrs) than adults during the wet season (p = 0.003). In the same period, requests were commoner in under-fives compared to older children (p = 0.022); however, a positive test result was 4.4 times more likely in the latter group (p = 0.010). Parasitaemia was confirmed for only 4.7% (10/215) and 12.5% (37/297) of patients in the dry and wet seasons, respectively. The negative predictive value of a PHF slide remained above 97% in both seasons.
conclusionsThe study provides evidence for considerable overtreatment for malaria in a West African setting comparable to reports from areas with similar low malaria transmission in East Africa. The data suggest that laboratory facilities may be under-used, and that adherence to negative PHF slide results could significantly reduce the degree of overtreatment. The "peak prevalence" in 5-15 year olds may reflect successful implementation of malaria control interventions in under-fives, but point out the need to extend such interventions to older children.
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