Prescription d’antipaludiques dans le service de pédiatrie de l’Hôpital national de Lamordé, à Niamey

Abstract

In Niger, malaria is a major public health problem, due to the high number of deaths that are attributable to it and because of its heavy weight and socioeconomic status. The objective of this study was to contribute to the inventory of medical practices to rationalize the use of medicines and minimize the resistance phenomenon. This is a prospective study, which took place from May 1 to July 31, 2009, in the pediatric ward of the National Hospital of Lamordé. It concerned children aged from 0 to 14 years hospitalized and having received one or more antimalarial drugs during at least 24 h. During the 3 months of the study, 1,248 children had been admitted in the department. Among them, 881 children received antimalarial treatment, i.e., 70.5% with prescriptions. Malaria was confirmed by microscopy in 410 children, i.e., 46.5% of the sick children received antimalarial treatment. Prescription control was deemed noncompliant in 258 patients, i.e., 29.3% of the total. Treatments based on microscopic diagnosis are one of the strategies that will help to streamline the use of antimalarial drugs to improve their effectiveness and efficiency and also to reduce the risk of emergence of resistance.

Prescription of antimalarials at Kisangani University Clinics, Democratic Republic of Congo

“…The patients included in this study came from 4 out of the 6 communes of the city of Kisangani. Unlike other authors who have reported a predominance of children under 5 years of age in the population of patients with malaria (Djire, 2009;Soumana et al, 2016), in this study, 2/3 of the patients were adults (69%). This difference could be due to the fact that the present study was carried out in 3 departments of KisUC namely internal medicine, pediatrics and gynecology, whereas the abovementioned authors conducted their studies in the pediatric department and targeted children aged 0 months to 15 years.…”

“…The under dosing was due to the fact that the prescribers did not take the patient's weight into account. Compared to the 18.6% of prescriptions with inadequate doses found by Soumana et al (2016) and at 9.8% reported in our previous study (Nsuadi-Manga et al, 2020), the percentage of prescriptions with inadequate dose found in the present study is relatively low. However, there is still room for improvement because to cure malaria a sufficient dose of antimalarials is recommended.…”

“…This was artesunate prescribed for 3 days without being followed by ACT treatment. This proportion is low compared to that found by Soumana et al (10.46%) and that in our previous study (8.8%) (Soumana et al, 2016;Nsuadi-Manga et al, 2020); it indicates that the vast majority of prescribers of KisUC respect the duration of antimalarial treatment. This should be encouraged because non-compliance can be at the origin of resistance and repeated crises of malaria.…”

“…Regarding the type of malaria, 61% of patients consulted for uncomplicated malaria and 39% for severe malaria. Our results are close to those of Soumana et al who reported 86% cases of uncomplicated malaria cases and 24% cases of severe malaria in their study carried out in Niger (Soumana et al, 2016). However, they are far different from those reported in our previous study carried out at the Makiso-Kisangani General Referral Hospital (GRH/Makiso-Kisangani), where the number of severe malaria cases was higher than that of uncomplicated malaria, respectively 71.5 and 28.5%.…”

“…In developing countries, only 30 to 40% of patients are treated according to official guidelines. In addition, only 50% of people suffering from malaria receive the recommended first-line antimalarials (Soumana et al, 2016). The study conducted by Kangudia et al (2017) in Kinshasa has shown, concerning the prescription of antimalarials in early pregnancy, that many doctors ignore and/or do not respect the recommendations of the NMCP.…”