Malaria morbidity, treatment‐seeking behaviour, and mortality in a cohort of young children in rural Burkina Faso

Tropical Medicine and International Health - Tập 8 Số 4 - Trang 290-296 - 2003
Olaf Müller1, Corneille Traoré2, Heiko Becher3, Bocar Kouyaté2
1Department of Tropical Hygiene and Public Health of the Ruprecht-Karls-University, Heidelberg, Germany. [email protected]
2Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
3Department of Tropical Hygiene and Public Health of the Ruprecht‐Karls‐University, Heidelberg, Germany

Tóm tắt

SummaryObjective To describe the pattern of fever‐associated morbidity, treatment‐seeking behaviour for fever episodes, and cause‐specific mortality in young children of a malaria‐holoendemic area in rural Burkina Faso.Methods In a longitudinal community‐based intervention study, 709 representative children aged 6–31 months were followed daily over 6 months (including the main malaria transmission period) through village‐based field staff.results Of 1848 disease episodes, 1640 (89%) were fever episodes, and of those, 894 (55%) were attributed to malaria (fever + ≥5000 parasites/μl). Eighty‐five percent of fever episodes were treated, mainly with chloroquine and paracetamol, 69% of treatments took place in households, 16% in local health centres, 13% in villages, and 1% in hospitals. Treatment‐seeking in a health centre or hospital was associated with accessibility and disease severity. Cerebral malaria and malnutrition‐associated diarrhoea were the most frequently diagnosed causes of death. While most children with a post‐mortem diagnosis of diarrhoea had not received any treatment, children who died of malaria had often received insufficient treatment. In particular, there was a lack of an appropriate second‐line treatment at formal health services after chloroquine treatment had failed to resolve symptoms.conclusions These findings call for more effective prevention and treatment of malaria, malnutrition and diarrhoea in rural African communities, as well as for better supervision of existing malaria treatment guidelines in formal health services.

Từ khóa


Tài liệu tham khảo

10.1111/j.1365-3156.1997.tb00172.x

10.1016/S0277-9536(00)00049-6

Brinkmann U, 1991, Malaria and health in Africa: the present situation and epidemiological trends, Tropical Medicine and Parasitology, 42, 204

Dabis F, 1989, Monitoring selective components of primary health care: methodology and community assessment of vaccination, diarrhoea and malaria practices in Conakry, Guinea, Bulletin of the World Health Organization, 67, 675

De Francisco A, 1994, Comparison of mortality between villages with and without Primary Health Care workers in Upper River Division, The Gambia, Journal of Tropical Medicine and Hygiene, 97, 69

Deming M, 1989, Home treatment of febrile children with antimalarial drugs in Togo, Bulletin of the World Health Organisation, 67, 695

Dürrheim DN, 1999, Confidential inquiry into malaria deaths, Bulletin of the World Health Organization, 77, 263

10.1046/j.1365-3156.2001.00727.x

10.1093/tropej/46.3.183

10.1016/0035-9203(89)90599-3

10.1016/0035-9203(87)90170-2

10.1080/02724936.1987.11748482

10.1046/j.1365-3156.1997.d01-131.x

10.1016/S0140-6736(05)72659-3

Krause G, 2000, Community‐effectiveness of care – the example of malaria treatment in rural Burkina Faso, Annals of Tropical Paediatrics, 7, 99

10.1080/00034983.1995.11812947

McCombie SC, 1994, Treatment‐Seeking for Malaria: a Review and Suggestions for Future Research

10.1046/j.1365-3156.1999.00489.x

Molyneux ME, 1989, Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children, Quarterly Journal of Medicine, 71, 441

10.1136/bmj.322.7302.1567

10.1046/j.1365-3156.1996.d01-13.x

MüllerO TraoréC&KouyateB(2003)Clinical efficacy of chloroquine in young children with uncomplicated malaria – a community‐based study in rural Burkina Faso.Tropical Medicine and International Health8 202–203.

NdahEA(2001)Risk factors for childhood mortality in a rural area of Burkina Faso.MSc Thesis.Department of Tropical Hygiene and Public Health Ruprecht‐Karls‐University of Heidelberg.

10.1046/j.1365-3156.2002.00858.x

10.1046/j.1365-3156.2002.00847.x

10.1046/j.1365-3156.2002.00856.x

Quigley MA, 1996, Algorithms for verbal autopsies: a validation study in Kenyan children, Bulletin of the World Health Organization, 74, 147

10.1016/0277-9536(93)90282-9

Rogier C, 1999, Plasmodium falciparum malaria in Dielmo, a holoendemic area in Senegal: no influence of acquired immunity on initial symptomatology and severity of malaria attacks, American Journal of Tropical Medicine and Hygiene, 60, 410, 10.4269/ajtmh.1999.60.410

10.1016/0035-9203(92)90076-O

Ruebush T, 1995, Self‐treatment of malaria in a rural area of western Kenya, Bulletin of the World Health Organization, 73, 229

10.1093/ije/30.3.485

10.1016/0140-6736(92)91414-4

Snow RW, 1999, Estimating mortality, morbidity and disability due to malaria among Africa's non‐pregnant population, Bulletin of the World Health Organization, 77, 624

10.1016/S0277-9536(97)00195-0

10.1046/j.1365-3156.2000.00652.x

10.1080/02724936.1994.11747689

10.4269/ajtmh.2001.64.12

WHO, 1997, World malaria situation in 1994, Weekly Epidemiological Record, 72, 269

WHO, 2000, Severe falciparum malaria, Transactions of the Royal Society of Tropical Medicine and Hygiene, 94, 1, 10.1016/S0035-9203(00)90300-6

Thông tin
Thông tin xuất bản

Tropical Medicine and International Health

Tập 8 Số 4

290-296

Thông tin tác giả