@article{fdi:010046112,
  title = {{A}nti-malarial prescriptions in three health care facilities after the emergence of chloroquine resistance in {N}iakhar, {S}enegal (1992-2004)},
  author = {{M}unier, {A}line and {D}iallo, {A}ldiouma and {C}ot, {M}ichel and {N}diaye, {O}usmane and {A}rduin, {P}ascal and {C}hippaux, {J}ean-{P}hilippe},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}n the rural zone of {N}iakhar in {S}enegal, the first therapeutic failures for chloroquine ({CQ}) were observed in 1992. {I}n 2003, the national policy regarding first-line treatment of uncomplicated malaria was modified, replacing {CQ} by a transitory bi-therapy amodiaquine/sulphadoxine-pyrimethamine ({AQ}/{SP}), before the implementation of artemisinin-based combination therapy ({ACT}) in 2006. {T}he aims of the study were to assess the evolution of anti-malarial prescriptions in three health care facilities between 1992 and 2004, in parallel with increasing {CQ} resistance in the region. {M}ethods: {T}he study was conducted in the area of {N}iakhar, a demographic surveillance site located in a sahelo-sudanese region of {S}enegal, with mesoendemic and seasonal malaria transmission. {H}ealth records of two public health centres and a private catholic dispensary were collected retrospectively to cover the period 1992-2004. {R}esults: {R}ecords included 110,093 consultations and 292,965 prescribed treatments. {T}wenty-five percent of treatments were anti-malarials, prescribed to 49% of patients. {T}hey were delivered all year long, but especially during the rainy season, and 20% of patients with no clinical malaria diagnosis received anti-malarials. {C}hloroquine and quinine represented respectively 55.7% and 34.6% of prescribed anti-malarials. {O}verall, chloroquine prescriptions rose from 1992 to 2000, in parallel with clinical malaria; then the {CQ} prescription rate decreased from 2000 and was concomitant with the rise of {SP} and the persistence of quinine use. {AQ} and {SP} were mainly used as bi-therapy after 2003, at the time of national treatment policy change. {C}onclusion: {T}he results show the overall level of anti-malarial prescription in the study area for a considerable number of patients over a large period of time. {E}ven though resistance to {CQ} rapidly increased from 1992 to 2001, no change in {CQ} prescription was observed until the early 2000s, possibly due to the absence of an obvious decrease in {CQ} effectiveness, a lack of therapeutic options or a blind follow-up of national guidelines.},
  keywords = {},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {8},
  numero = {},
  pages = {83},
  ISSN = {1475-2875},
  year = {2009},
  DOI = {10.1186/1475-2875-8-83},
  URL = {https://www.documentation.ird.fr/hor/fdi:010046112},
}