Med Sante Trop. 2014 Oct 8. [Epub ahead of print]

Management of suspected cases of malaria before admission to a district hospital in Burkina Faso.

Yaméogo TM1, Kyelem CG1, Bamba S1, Savadogo LB1, Sombié I1, Traoré AZ2, Sanon D3, Ouédraogo SM1, Guiguemdé TG1.

After widespread use and misuse of antimalarial drugs led to the emergence of resistance, new guidelines for malaria treatment with artemisinine-based combination therapy (ACT) were introduced in Burkina Faso in 2005.

To describe the management (drug therapy and other practices) of patients with suspected malaria before their admission to the district hospital of Dô, seven years later. This cross-sectional study was conducted during admission to the district hospital, during the low season for malaria, from December 2010 to May 2011. It included all patients aged 6 months or older diagnosed with suspected malaria according to the criteria of the national malaria control program, excluding those with severe comorbidities.

The study included 476 suspected cases, 422 (88.7%) uncomplicated and 54 (11.3%) complicated.

They accounted for 7.9% of all admissions.

Their mean age was 14.4 years, and 35.3% (n = 168) were younger than 5 years.

Only 23 (4.8%) had first consulted in a primary health care facility; 346 (72.7%) had used initial self-medication (or, more precisely in some cases, parental administration of medication without medical consultation).

Overall, 435 (91.4%) came directly to the district hospital, 331 (76.1%) of them after self-medication; 10 (2.1%) had first consulted a traditional healer.

The practice of self-medication did not differ according to age, gender, or complications (p>0.05).

The drugs used for self-medication were mainly antipyretics (94.5%) and antimalarials (16.8%); the latter included ACT (39.6%), quinine (19.0%), and non-recommended antimalarial agents (41.4%).

During the malaria low season, the treatment itinerary of suspected malaria cases is marked by equal use of ACT and non-recommended antimalarials for self-medication and minimal use of the primary level of care.

A study underway of this management and these itineraries during the epidemic season may provide more data about use of ACT, the last armament against malaria in drug-resistant areas such as Burkina Faso.

KEYWORDS:

Burkina Faso; district hospital; drug therapy; dry season; malaria; practices

PMID:  25295883