ABSTRACT
Sudanese health authority adopted a new antimalarial drug policy in response to the reported high level of chloroquine resistance. "Artesunate+ sulfadoxine/pyrimethamine" [ASP] and "artemether/lumefantrine" [A/L] are recommended as first and second lines for the treatment of uncomplicated falciparum malaria respectively. This study aims to evaluate the clinical andparasitological response to A/L and to report any side effects related to the drug in children living in high transmission areas. This evaluation of the clinical and parasitological response to directly observed treatment with 6 doses A/L following WHO protocol for monitoring antimalarial drugs efficacy. Giemsa-stained thick and thin blood smears were examined microscopically on days 0, 2, 3, 7, 14, 21 and 28, or at other times if a patient felt unwell The primary end point was the 28-day cure rate and the secondary end points were time to parasite clearance. A total of 75 [40.8%] patients met the inclusion criteria, of them 70 [97.2%] patients showed adequate clinical and parasitological response [radical cure], 2 [2.8%] patients were classified as early treatment failure and 3 [4%] patients were lost to be followed-up by day 3. No progression to severe illness or danger signs occurred for any patient during the study. The main outcome of study was that A/L was found to be highly effective against Plasmodium falciparum uncomplicated malaria, well tolerated by children with no reported serious side effects. Dramatic decrease in parasites density and fever were observed in most of the cases by day 3 of treatment
ABSTRACT
To develop effective measures of reducing the proportion of severe malaria presentation and deaths attributed to malaria, an adequate understanding of beliefs and practices in households and at the level of primary health care is necessary. The objectives of this paper are to explore beliefs and practices related to the management of severe malaria, and to identify barriers to early consultation. A cross-sectional hospital-based study was conducted in five hospitals in Sudan in 2003. All malaria cases admitted, or their care givers were interviewed by a medical doctor using pre-coded and pre-tested questionnaire. Enrolled in this study, were a total of 482 patients, 62.9% of whom were female. Almost 75.0% of the respondents perceived that malaria had serious complications. Anaemia as a complication was mentioned by 115 [32.0%] respondents. A total of 418 [86.7%] patients sought advice from health personnel. Of these, 305 [73.0%] did so more than 24 hours after the onset of the illness. Distance, lack of money, unavailability of transportation or all were the reasons mentioned as barriers to seeking care at hospitals. More than 70.0% of the patients received anti-malarial drugs before admission with a clear preference for the injectable form of chloroquine. Multivariate analysis revealed that "cost of services" and "not seeking help from health personnel" were the determinants for late consultation. The study revealed that late consultation was a feature in many parts of Sudan. Among the barriers mentioned by the respondents, the cost of services was of the greatest concern