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dc.contributor.authorReilley, B
dc.contributor.authorAbeyasinghe, R
dc.contributor.authorPakianathar, M V
dc.date.accessioned2008-01-25T15:50:15Z
dc.date.available2008-01-25T15:50:15Z
dc.date.issued2002-09
dc.identifier.citationBarriers to prompt and effective treatment of malaria in northern Sri Lanka. 2002, 7 (9):744-9 Trop. Med. Int. Healthen
dc.identifier.issn1360-2276
dc.identifier.pmid12225504
dc.identifier.urihttp://hdl.handle.net/10144/16899
dc.description.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.
dc.language.isoenen
dc.publisherWiley-Blackwell
dc.relation.urlhttp://www.blackwell-synergy.com/loi/tmi
dc.rightsArchived on this site with the kind permission of Wiley-Blackwellen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCommunication Barriersen
dc.subject.meshFemaleen
dc.subject.meshFocus Groupsen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshInterviews as Topicen
dc.subject.meshMalariaen
dc.subject.meshMaleen
dc.subject.meshMedically Underserved Areaen
dc.subject.meshMiddle Ageden
dc.subject.meshPatient Acceptance of Health Careen
dc.subject.meshSri Lankaen
dc.subject.meshWaren
dc.titleBarriers to prompt and effective treatment of malaria in northern Sri Lanka.en
dc.contributor.departmentMedecins sans Frontieres, Colombo, Sri Lanka.en
dc.identifier.journalTropical Medicine & International Healthen
refterms.dateFOA2019-03-04T08:56:00Z
html.description.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.


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