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Free Content Adoption of the new antimalarial drug policy in Tanzania – a cross-sectional study in the community

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Summary Objective 

To assess the diffusion of the change of first line antimalarial drug from chloroquine (CQ) to sulphadoxine/pyrimethamine (SP) at household level in a rural district of Tanzania less than a year after the policy implementation. Methods 

Caretakers in 729 households were interviewed on knowledge of the new policy, home stocking of antimalarials, home-treatment practices of children younger than 5 years with fever, health-seeking behaviour and experience of SP. SP and CQ levels in blood were analysed from 328 children younger than 5 years in the households. Twelve focus group discussions (FGD) were performed with mothers, fathers and health workers. Results 

About 51% of the population knew that SP was the first line antimalarial. Only 8% of mothers stocked antimalarials, and only 4% stated self-treatment as the first action. We estimated that 84% of the children who had had fever during the last 4 weeks sought care at public health facilities. SP was detectable in 18% of the total child population and in 32% of those with reported fever, CQ in only 5% and 7%, respectively. The FGDs revealed negative perceptions of SP and fear of severe adverse reactions with mass media reported as key informant. Conclusion 

The policy had diffused to the communities in the sense that CQ had been changed to SP, which was well known as first line treatment. Moreover, there was a reported dramatic change from self-treatment with CQ to seeking care at public health facilities where SP was given under observation.
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Keywords: Tanzania; artemisinin-based combination therapy; chloroquine; policy change; policy cycle; sulphadoxine/pyrimethamine

Document Type: Research Article

Affiliations: 1: Department of Clinical Pharmacology, Muhimbili University College of Health Sciences (MUCHS), Dar-es-Salaam, Tanzania 2: Department of Clinical Pharmacology, MUCHS, Dar-es-Salaam, Tanzania 3: Department of Sociology, University of Dar-es-Salaam, Dar-es-Salaam, Tanzania 4: Nordic School of Public Health, Gothenburg, Sweden and Division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden 5: Division of Clinical Pharmacology, Department of Laboratory Medicine, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden 6: Division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden

Publication date: October 1, 2005

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