Availability and prescription practice of anti-malaria drugs in the private health sector in Yemen

Ghouth, Abdulla Salim Bin

doi:10.3855/jidc.2528

Cited by 16 publications

(26 citation statements)

References 17 publications

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“…However, this new policy was only implemented four years later in 2009 after proper training and distribution of the national guideline for antimalaria drugs were carried out (WHO, 2012). Despite these efforts, previous studies conducted in Hadhramout province reported that CQ is still commonly prescribed (18 out of 42 prescriptions) and some clinicians were not aware and had poor knowledge about the new national drug policy (Bashrahil et al, 2010;Ghouth, 2013). Continued use of CQ sustains the selection of CQ resistant mutations leading to persistence of mutant parasite.…”

Section: Introductionmentioning

confidence: 93%

Survey of chloroquine-resistant mutations in the Plasmodium falciparum pfcrt and pfmdr-1 genes in Hadhramout, Yemen

2015

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Section: Introductionmentioning

confidence: 93%

Survey of chloroquine-resistant mutations in the Plasmodium falciparum pfcrt and pfmdr-1 genes in Hadhramout, Yemen

2015

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“…Unfortunately, however, this policy was not implemented in practice until 2009. 16,17 Nevertheless, regardless of current antimalarial treatment guidelines, CQ remains the second most common antimalarial drug prescribed by physicians in public and private health facilities in Yemen. 16 As such, the results of this study should be utilised to educate health workers and medication manufacturers in Yemen as to the potential risk of CQ co-administration among khat-chewing patients.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 Nevertheless, regardless of current antimalarial treatment guidelines, CQ remains the second most common antimalarial drug prescribed by physicians in public and private health facilities in Yemen. 16 As such, the results of this study should be utilised to educate health workers and medication manufacturers in Yemen as to the potential risk of CQ co-administration among khat-chewing patients. Current anti-malarial drug practices in Yemen should be modified accordingly and physicians should advise patients not to chew khat whilst undergoing CQ treatment.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 15 healthy males >18 years old and between 45-64 kg were recruited from Sana'a, the capital city of Yemen, which is free of malaria. 16 The healthy volunteers were selected from a group of respondents to an advertisement requesting participants for an unpaid pharmacological study. Volunteers with blood film examinations negative for malaria parasites, normal standard laboratory test results (including haemoglobin [Hb] levels, a complete blood count and kidney and liver function tests) and who were otherwise healthy with no history of clinical illness were included in the control group.…”

Section: Methodsmentioning

confidence: 99%

“…15 Chloroquine (CQ) is one of the most common antimalarial drugs prescribed by Yemeni physicians. 16 Consequently, determining whether khat-chewing has an effect on CQ is of great importance. This study was undertaken to investigate the effect of khat use on CQ bioavailability in both healthy volunteers and malaria patients.…”

mentioning

confidence: 99%

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Effect of Khat ( Catha edulis ) Use on the Bioavailability, Plasma Levels and Antimalarial Activity of Chloroquine

Issa

Al‐Habori

Chance

2016

SQUMJ

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abstract:Objectives: This study aimed to evaluate the effect of khat (Catha edulis) on chloroquine (CQ) bioavailability in healthy Yemeni adults and its effect on CQ plasma levels and parasite clearance among malaria patients. Methods: This study took place between January and April 2007 in Bajil and Sana'a, Yemen. Two CQ doses (600 mg each) were given to 15 healthy males on separate occasions; the first dose was followed by a khat-chewing session (phase one) while controls abstained from khat-chewing for the second (phase two). Additionally, 103 patients with Plasmodium falciparum-induced malaria, including both regular khat chewers (n = 57) and non-khat chewers (n = 46), were treated with CQ (25 mg/kg) over three days. Pharmacokinetic parameters were analysed among both controls and malaria patients. Parasite clearance was also investigated for the latter group. Results: The mean area under the concentration-time curve (AUC) was 2,108.9 versus 2,797.4 ng/hour/mL, mean peak plasma concentration (C max ) was 415.6 versus 508.7 ng/mL and mean time to reach C max was 3.8 versus 3.6 hours for controls in phase one versus phase two, respectively; both AUC and C max levels were significantly reduced by khat-chewing (P <0.050). For khat-versus non-khat-chewing malaria patients, mean plasma CQ concentrations were 266.4 ng/mL versus 427.5 ng/mL (P <0.001). Furthermore, CQ was effective in 71.7% and 75.4% of non-khat and khat-chewing malaria patients, respectively (P = 0.823). Conclusion: Khat-chewing was found to significantly reduce plasma CQ levels among healthy volunteers and malaria patients. While receiving CQ treatment, patients should be advised not to chew khat.

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Public stewardship of private for-profit healthcare providers in low- and middle-income countries

Wiysonge

Abdullahi

Ndze

et al. 2016

Cochrane Database of Systematic Reviews

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Background Governments use different approaches to ensure that private for‐profit healthcare services meet certain quality standards. Such government guidance, referred to as public stewardship, encompasses government policies, regulatory mechanisms, and implementation strategies for ensuring accountability in the delivery of services. However, the effectiveness of these strategies in low‐ and middle‐income countries (LMICs) have not been the subject of a systematic review. Objectives To assess the effects of public sector regulation, training, or co‐ordination of the private for‐profit health sector in low‐ and middle‐income countries. Search methods For related systematic reviews, we searched the Cochrane Database of Systematic Reviews (CDSR) 2015, Issue 4; Database of Abstracts of Reviews of Effectiveness (DARE) 2015, Issue 1; Health Technology Assessment Database (HTA) 2015, Issue 1; all part of The Cochrane Library , and searched 28 April 2015. For primary studies, we searched MEDLINE, Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations, MEDLINE Daily and MEDLINE 1946 to Present, OvidSP (searched 16 June 2016); Science Citation Index and Social Sciences Citation Index 1987 to present, and Emerging Sources Citation Index 2015 to present, ISI Web of Science (searched 3 May 2016 for papers citing included studies); Cochrane Central Register of Controlled Trials (CENTRAL), 2015, Issue 3, part of The Cochrane Library (including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register) (searched 28 April 2015); Embase 1980 to 2015 Week 17, OvidSP (searched 28 April 2015); Global Health 1973 to 2015 Week 16, OvidSP (searched 30 April 2015); WHOLIS, WHO (searched 30 April 2015); Science Citation Index and Social Sciences Citation Index 1975 to present, ISI Web of Science (searched 30 April 2015); Health Management, ProQuest (searched 22 November 2013). In addition, in April 2016, we searched the reference lists of relevant articles, WHO International Clinical Trials Registry Platform, Clinicaltrials.gov, and various electronic databases of grey literature. Selection criteria Randomised trials, non‐randomised trials, interrupted time series studies, or controlled before‐after studies. Data collection and analysis Two authors independently assessed study eligibility and extracted data, comparing their results and resolving discrepancies by consensus. We expressed study results as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI), where appropriate, and assessed the certainty of the evidence using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). We did not conduct meta‐analysis because of heterogeneity of interventions and study designs. Main results We identified 20,177 records, 50 of them potentially eligible. W...

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Availability and prescription practice of anti-malaria drugs in the private health sector in Yemen

Abstract: Introduction: Although the government of Yemen changed the national policy for treating malaria in November 2005 from chloroquine to

Cited by 16 publications

References 17 publications

Survey of chloroquine-resistant mutations in the Plasmodium falciparum pfcrt and pfmdr-1 genes in Hadhramout, Yemen

Survey of chloroquine-resistant mutations in the Plasmodium falciparum pfcrt and pfmdr-1 genes in Hadhramout, Yemen

Effect of Khat ( Catha edulis ) Use on the Bioavailability, Plasma Levels and Antimalarial Activity of Chloroquine

Public stewardship of private for-profit healthcare providers in low- and middle-income countries

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