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    Jan 16, 2021
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    Barriers to prompt and effective treatment of malaria in northern Sri Lanka.

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    Authors
    Reilley, B
    Abeyasinghe, R
    Pakianathar, M V
    Affiliation
    Medecins sans Frontieres, Colombo, Sri Lanka.
    Issue Date
    2002-09
    
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    Journal
    Tropical Medicine & International Health
    Abstract
    BACKGROUND: For the past 18 years, northern Sri Lanka has been affected by armed ethnic conflict. This has had a heavy impact on displacement of civilians, health delivery services, number of health professionals in the area and infrastructure. The north of Sri Lanka has a severe malaria burden, with less than 5% of the national population suffering 34% of reported cases. Health care providers investigated treatment-seeking behaviour and levels of treatment failure believed to be the result of lack of adherence to treatment. METHODS: Pre- and post-treatment interviews with patients seeking treatment in the outpatient department (OPD) and focus groups. RESULTS: A total of 271 persons completed interviews: 54.4% sought treatment within 2 days of the onset of symptoms, and 91.9% self-treated with drugs with prior to seeking treatment, mainly with paracetamol. Self-treatment was associated with delaying treatment (RR 3.55, CI 1.23-10.24, P=0.002). In post-treatment interviews, self-reported default was 26.1%. The main reasons for not taking the entire regimen were side-effects (57.6%) and disappearance of symptoms (16.7%). Focus groups indicated some lack of confidence in chloroquine treatment and prophylaxis, and scant enthusiasm for prevention methods. CONCLUSIONS: A number of factors contribute to a lack of access and a lower quality of care for malaria: lack of medical staff and facilities because of the fighting; lack of confidence in treatment, and perception of malaria as a routine illness. Prevention efforts need to take into account certain beliefs and practices to be successful.
    Publisher
    Wiley-Blackwell
    URI
    http://hdl.handle.net/10144/16899
    PubMed ID
    12225504
    Additional Links
    http://www.blackwell-synergy.com/loi/tmi
    Language
    en
    ISSN
    1360-2276
    Collections
    Malaria

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