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      Evaluation of anti-malarial drugs’ use in Fitche Hospital, North Shoa, Oromia Region, Ethiopia

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          Abstract

          Objective:

          Retrospective evaluation of anti-malarial drugs’ use in Fitche Hospital, North Shoa, Oromia Region, Ethiopia.

          Methods:

          Retrospective cross-sectional study design was conducted using selected patients cards of 1-year (January 2012–January 2013 G.C) with anti-malarial agents from January 18 to 30, 2013. The sample size was calculated by using Joint Commission on the Accreditation of Health care Organization criteria and sampling was done by using a systematic random sampling technique.

          Results:

          One hundred and twenty-five patient cards with anti-malarial drugs were reviewed of which 32.8%, 21.6%, 15.2% belongs to age range of 20–29, 10–19, and 30–39, respectively. Chloroquine prescription accounts for 50.4% from total anti-malarial drugs. 71.2% and 78.4% of patients received antibiotics and analgesics, respectively, with anti-malarial drugs. 77.6% of drugs were prescribed by generic name while the brand name was 22.39%.

          Conclusions:

          The study done in Fitche Hospital revealed that the use of anti-malarial agent was not in complete agreement with the current guideline of Ethiopia despite good practice.

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          Most cited references18

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          New developments in Plasmodium vivax malaria: severe disease and the rise of chloroquine resistance.

          Unlike Plasmodium falciparum, Plasmodium vivax rarely causes severe disease in healthy travellers or in temperate endemic regions and has been regarded as readily treatable with chloroquine. However, in tropical areas, recent reports have highlighted severe and fatal disease associated with P. vivax infection. We review the evidence for severe disease and the spread of drug-resistant P. vivax and speculate how these maybe related. Studies from Indonesia, Papua New Guinea, Thailand and India have shown that 21-27% of patients with severe malaria have P. vivax monoinfection. The clinical spectrum of these cases is broad with an overall mortality of 0.8-1.6%. Major manifestations include severe anaemia and respiratory distress, with infants being particularly vulnerable. Most reports of severe and fatal vivax malaria come from endemic regions where populations have limited access to healthcare, a high prevalence of comorbidity and where drug-resistant P. vivax strains and partially effective primaquine regimens significantly undermine the radical cure and control of this relapsing infection. The mechanisms underlying severe disease in vivax malaria remain poorly defined. Severe, fatal and multidrug-resistant vivax malaria challenge our perception of P. vivax as a benign disease. Strategies to understand and address these phenomena are needed urgently if the global elimination of malaria is to succeed.
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            How Patients Take Malaria Treatment: A Systematic Review of the Literature on Adherence to Antimalarial Drugs

            Background High levels of patient adherence to antimalarial treatment are important in ensuring drug effectiveness. To achieve this goal, it is important to understand levels of patient adherence, and the range of study designs and methodological challenges involved in measuring adherence and interpreting results. Since antimalarial adherence was reviewed in 2004, there has been a major expansion in the use of artemisinin-based combination therapies (ACTs) in the public sector, as well as initiatives to make them more widely accessible through community health workers and private retailers. These changes and the large number of recent adherence studies raise the need for an updated review on this topic. Objective We conducted a systematic review of studies reporting quantitative results on patient adherence to antimalarials obtained for treatment. Results The 55 studies identified reported extensive variation in patient adherence to antimalarials, with many studies reporting very high adherence (90–100%) and others finding adherence of less than 50%. We identified five overarching approaches to assessing adherence based on the definition of adherence and the methods used to measure it. Overall, there was no clear pattern in adherence results by approach. However, adherence tended to be higher among studies where informed consent was collected at the time of obtaining the drug, where patient consultations were directly observed by research staff, and where a diagnostic test was obtained. Conclusion Variations in reported adherence may reflect factors related to patient characteristics and the nature of their consultation with the provider, as well as methodological variations such as interaction between the research team and patients before and during the treatment. Future studies can benefit from an awareness of the impact of study procedures on adherence outcomes, and the identification of improved measurement methods less dependent on self-report.
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              Use of antimalarial drugs in Mali: policy versus reality.

              Inappropriate use of antimalarial drugs undermines therapeutic efficacy and promotes the emergence and spread of drug-resistant malaria. Strategies for improving compliance require accurate information about current practices. Here we describe Knowledge-Attitude-Practice surveys conducted among health providers and consumers in two Malian villages, one rural and one periurban. All sanctioned providers limited their first choices of antimalarial drug to those recommended by the national malaria control program and reported using correct dosing regimens. However, the majority of consumers in the two villages chose non-recommended treatments for malaria and reported suboptimal treatment regimens when they did use recommended drugs. Antimalarial drugs were also widely available from unsanctioned sources, often accompanied by erroneous advice on dosing regimens. This study demonstrates that even when the most peripheral health providers are well-trained in correct use of antimalarial drugs, additional measures directly targeting consumers will be required to improve drug use practices.
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                Author and article information

                Journal
                J Pharm Bioallied Sci
                J Pharm Bioallied Sci
                JPBS
                Journal of Pharmacy & Bioallied Sciences
                Medknow Publications & Media Pvt Ltd (India )
                0976-4879
                0975-7406
                Jan-Mar 2016
                : 8
                : 1
                : 39-42
                Affiliations
                [1]Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
                Author notes
                Address for correspondences: Mr. Eshetu Mulisa Bobasa, E-mail: mulisa2e@ 123456yahoo.co
                Article
                JPBS-8-39
                10.4103/0975-7406.164294
                4766777
                26957867
                55510d54-d77d-4388-928d-f6adda7a0ac8
                Copyright: © Journal of Pharmacy and Bioallied Sciences

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 31 March 2015
                : 04 May 2015
                : 16 June 2015
                Categories
                Original Article

                Pharmacology & Pharmaceutical medicine
                anti-malarial drugs,drug use,malaria,resistance
                Pharmacology & Pharmaceutical medicine
                anti-malarial drugs, drug use, malaria, resistance

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