Barriers to prompt and effective treatment of malaria in northern Sri Lanka.
AffiliationMedecins sans Frontieres, Colombo, Sri Lanka.
MetadataShow full item record
AbstractBACKGROUND: 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.
- Household responses to malaria and their costs: a study from rural Sri Lanka.
- Authors: Konradsen F, van der Hoek W, Amerasinghe PH, Amerasinghe FP, Fonseka KT
- Issue date: 1997 Mar-Apr
- Malaria treatment-seeking behaviour and drug prescription practices in an area of low transmission in Uganda: implications for prevention and control.
- Authors: Ndyomugyenyi R, Magnussen P, Clarke S
- Issue date: 2007 Mar
- A village treatment center for malaria: community response in Sri Lanka.
- Authors: Konradsen F, Amerasinghe PH, Perera D, Van der Hoek W, Amerasinghe FP
- Issue date: 2000 Mar
- Conquering the intolerable burden of malaria: what's new, what's needed: a summary.
- Authors: Breman JG, Alilio MS, Mills A
- Issue date: 2004 Aug
- Obstetrics during Civil War: six months on a maternity ward in Mallavi, northern Sri Lanka.
- Authors: Simetka O, Reilley B, Joseph M, Collie M, Leidinger J
- Issue date: 2002 Jul-Sep