Poor knowledge on new malaria treatment guidelines among drug dispensers in private pharmacies in Tanzania: the need for involving the private sector in policy preparations and implementation.

OBJECTIVE: To assess the knowledge of dispensers in private pharmacies on new malaria treatment guidelines which involved switching from chloroquine (CQ) to sulfadoxine pyrimethamine (SP) and from SP to artemether-lumefantrine. METHODS: A structured questionnaire was used for data collection and the questions focused on whether the subjects were involved in the preparation or implementation of the guidelines or had undertaken any training on how to dispense new antimalarial medicines as recommended in the introduced new treatment guidelines. RESULTS: The study revealed that none of the participants had been involved in the preparation of the treatment guidelines, nor had they undertaken any training on their implementation. As many as 49% of the visited private pharmacies were found to continue stocking and selling CQ tablets and injections. Only 30% and 7% knew the correct dose regimen of SP and ALU respectively and none of them knew the condition of taking ALU with a fatty meal for improved absorption. CONCLUSION: Lack of involvement of the pharmaceutical personnel working in the private pharmacies, from the preparation of new malaria treatment guidelines to their implementation, contributed to their poor knowledge and skill on how to correctly dispense the medicines.

Poor Knowledge on New Malaria Treatment Guidelines among Drug Dispensers in Private Pharmacies in Tanzania: the Need for Involving the Private Sector in Policy Preparations and Implementation

Objective: To assess the knowledge of dispensers in private pharmacies on new malaria treatment guidelines which involved switching from chloroquine (CQ) to sulfadoxine pyrimethamine (SP) and from SP to artemether-lumefantrine. Methods: A structured questionnaire was used for data collection and the questions focused on whether the subjects were involved in the preparation or implementation of the guidelines or had undertaken any training on how to dispense new antimalarial medicines as recommended in the introduced new treatment guidelines. Results: The study revealed that none of the participants had been involved in the preparation of the treatment guidelines; nor had they undertaken any training on their implementation. As many as 49of the visited private pharmacies were found to continue stocking and selling CQ tablets and injections. Only 30 and 7knew the correct dose regimen of SP and ALU respectively and none of them knew the condition of taking ALU with a fatty meal for improved absorption. Conclusion: Lack of involvement of the pharmaceutical personnel working in the private pharmacies; from the preparation of new malaria treatment guidelines to their implementation; contributed to their poor knowledge and skill on how to correctly dispense the medicines

Evaluation of quality of hydrogen peroxide-based antiseptic solutions available in Dar es Salaam, Tanzania.

BACKGROUND: Hydrogen peroxide solutions of low concentrations are important antiseptics and deodorants used in hospitals and as home-remedies. The preparations have the disadvantage of being unstable when exposed to sunlight and when stored for a long time. They decompose slowly, releasing oxygen and water thus decreasing the available hydrogen peroxide for antimicrobial action. OBJECTIVE: To assess the quality of hydrogen peroxide solution-based antiseptics available in Dar es Salaam. METHODOLOGY: One hundred and sixty-five samples were collected at random from pharmacies and medical stores, and analysed. One hundred and forty samples were hydrogen peroxide solutions intended for wound cleansing and 25 samples were eardrops. Among these samples, 116 were from manufacturer A, 24 from manufacturer B and 25 samples of eardrops were from manufacturer C. RESULTS: Eighteen (26%) of the samples from medical stores failed to meet specifications. Of the 70 samples from pharmacies, 20 (29%) failed to meet the BP 2005 specifications. All the 25 samples of eardrops failed to comply with specifications. The average hydrogen peroxide contents (+/-SD) of the samples from medical stores and pharmacies were 6.6 +/- 0.6%, 6.8 +/- 0.4% w/v respectively. The difference was statistically significant (P < 0.05). CONCLUSION: A significant proportion of hydrogen peroxide products in the Dar es Salaam market is of poor quality. There is a need for continuous monitoring of the quality of hydrogen peroxide available in the city.

Lack of impact of artesunate on the disposition kinetics of sulfadoxine/pyrimethamine when the two drugs are concomitantly administered.

OBJECTIVE: To determine the effect of artesunate (AT) on the disposition kinetics of sulfadoxine/pyrimethamine (SP) in humans. METHODS: In a randomized cross-over study, 16 healthy volunteers were given a dose of three SP tablets containing 500 mg of sulfadoxine (SDX) and 25 mg of pyrimethamine (PYR) (=SP group), while the second arm received three SP tablets + two AT tablets of 200 mg in total followed by 100 mg AT for the next 4 days (SP+AT group). Blood samples (100 microl) were collected by means of a finger prick and dried on filter paper. The blood spots were wrapped in polythene folders and stored at room temperature until analysis. The samples were assayed using high-performance liquid chromatographic methods. RESULTS: The peak concentration C(max)), time required to attain peak concentration (T(max)), half-life (t ((1/2))) and area under the plasma concentration-time curve (AUC) were determined. The C(max) of SDX were 92.9 and 98.9 microg/ml for the SP and SP+AT arms, respectively; for PYR, these were 0.86 and 0.79 microg/ml, respectively. The T(max) of SDX were 10 and 8 h for the SP and SP+AT arms, respectively; for PYR, these were 4.0 and 3.0 h, respectively. The AUC(0-288) of SDX were 15,840 and 18,876 microg/ml h for the SP and SP+AT arms, respectively; for PYR, they were 124 and 112 microg/ml h, respectively. The t ((1/2)) of values for SDX were 165 and 180 h for the SP and SP+AT arms, respectively; for PYR, these were 158 and 177 h, respectively. There was no statistically significant difference between the C(max), T(max), AUC(0-288) and t ((1/2)) between the two arms (p > 0.05). CONCLUSION: Taking AT concomitantly with SP does not have any impact in the disposition of SP.