Free Content Diagnosis and management of malaria by rural community health providers in the Lao People's Democratic Republic (Laos)

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Abstract:

Summary We assessed the knowledge of malaria diagnosis and management by community health providers in rural Vientiane and Savannakhet Provinces, Lao PDR. Sixty health providers (17 pharmacy owners/drug sellers and 43 village health volunteers) were interviewed. All diagnosed malaria using symptoms and signs only; 14% were aware of >2 criteria for the diagnosis of severe malaria. Although chloroquine and quinine, the then recommended Lao national policy for uncomplicated malaria treatment, were the most common antimalarials prescribed – 65% gave incorrect doses and 70% did not know the side effects. Although not recommended by the then national policy, 27% of the health providers used combinations of antimalarials as they considered monotherapy ineffective. This study strongly suggests that further training of Lao rural health providers in malaria diagnosis and management is needed to improve the quality of health services in areas remote from district hospitals.

French
Nous avons évalué la connaissance sur le diagnostic et la prise en charge de la malaria par des fournisseurs de santé de la communauté dans les provinces rurales de Vientiane et de Savannakhe dans la RDP du Laos. Soixante fournisseurs de santé (17 propriétaires de pharmacie/vendeurs de médicaments et 43 volontaires de santé du village) ont été interviewés. Tous ont diagnostiqué la malaria sur la seule base des symptômes et des signes; 14%étaient au courant de plus deux critères pour le diagnostic de la malaria sévère. Bien que la chloroquine et la quinine, alors recommandées pour le traitement de la malaria non compliqué selon la politique nationale laotienne, aient été les antipaludeéns les plus communément prescrits, 65% ont donné des doses incorrectes et 70% ignoraient les effets secondaires. Bien que non recommandées par la politique nationale, 27% des fournisseurs de santé utilisaient des combinaisons antipaludeéns car ils considéraient la monothérapie inefficace. Cette étude suggère fortement que davantage de formation est nécessaire pour les fournisseurs de santé ruraux laotiens pour le diagnostic et la prise en charge de malaria, afin d'améliorer la qualité des services de santé dans les régions éloignées des hôpitaux régionaux.

Keywords: Laos; Malaria; connaissance; conocimientos; diagnosis; diagnostic; diagnósticos; fournisseurs de santé; health providers; knowledge; malaria; management; manejo; prise en charge; proveedores sanitarios

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2007.01820.x

Affiliations: 1: Savannakhet Provincial Station of Malariology, Parasitology and Entomology, Lao PDR 2: Centre of Malariology, Parasitology and Entomology, Vientiane, Lao PDR

Publication date: April 1, 2007

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