Comparative study to assess the new malaria chemotherapy policy at Temeke District hospital

Abstract

A retrospective study on the management and outcome of malaria before and after introduction of a new National Guidelines for Malaria Diagnosis and Treatment was done at Temeke hospital, comparing the month of March 2001 and 2002 admissions. In March 2001, there were 551(52.6%) records of malaria, while in March 2002; there were 619 (46.8%) records of hospitalised cases due to malaria. Blood smears done were 350 (56.5%) in March 2002 lower than March 2001, which were 333 (60.4%). Overall, in March 2001 about 367 (66.6%) out of 551 patients diagnosed to have malaria, were complicated or severe malaria, whereas in March 2002, severe or complicated malaria cases were 411(66.4%) out of619 hospitalised cases due to malaria. Patients hospitalized due to malaria received antimalarial drugs on the basis of blood slides (60.4%) and on clinical grounds alone (39.6%) in March 2001, while in March 2002, were 56.5% and 43.5%, respectively. Again 32 (9.6%) of 333 hospitalised malaria cases with Blood slide done received antimalarial drugs despite negative blood smears in March 2001 while in March 2002, 23 (6.6%) out of 350 hospitalised malaria patients, received antimalarial drugs despite negative blood smears In March 2001, a total of 176(58.4) of the 301 hospitalised patients with blood smears positive were given quinine, and 71 (23.6%) were given CQ. While in March 2002 a total of 244 (74.6%) of the 327 hospitalised patients with blood smears positive were given quinine, and 28(8.6%) were given amodiaquine. This increase of Quinine was at the expense of lowering the rate of a first line drug (SP). Of the recorded cases due to malaria 472 (85.7%) were successfully managed (cured) and 26 (4.7%) patients died in March \.1

Vlll 2001.While in March 2002, 504 (81.4%) cases out of 619 hospitalised cases were successfully managed (cured) and 46 (7.4%) died. These differences were not significant. It is concluded that although the new policy has been adapted there is no improvement in management of malaria patients and outcome. These results er:nphasize the need to improve diagnosis by ensuring laboratory services available every day around the clock and operation research is done on training of health workers on malaria management.