E-drug: pre-packaged anti-malarials
(copied from the tdr-scientists@who.ch conference)
Herewith an other item of the new issue of TDR Newsletter which wil
be available in October 97.
Jocelyne Bruyere, TDR Communications
(bruyerej@who.ch)
TDR Newsletter 54 - October 1997
THE ADVANTAGES OF PRE-PACKAGED ANTIMALARIALS
Treatment of malaria is more cost-effective, in terms of both
time and money, when antimalarials are pre-packed in daily doses.
Dr K. Yeboah-Antwi, District Director of Health Services, Wenchi,
Ghana, presented the findings of a study on pre-packaging to
participants at the twentieth session of the TDR Joint
Coordinating Board in June.
The studies were part of a project to improve malaria control in
Ghana, within the context of the ongoing health reforms in that
country, co-sponsored by the Department for International Health
(UK), Liverpool School of Tropical Medicine, the Ministry of
Health in Ghana and TDR. Preliminary observations in six
districts indicated that some of the major problems in malaria
control programmes are:
- High cost of treatment.
- High chloroquine consumption in the form of syrup.
- Long waiting times at dispensaries.
A large number of untrained/unqualified dispensers who are unable
to give advice.
Two types of pre-packaging were used - plastic bottles for
chloroquine syrup and sealed plastic bags for chloroquine
tablets. The advantages of pre-packaged anti-malarials were
found to include:
- Reduced cost because of: reduction in number of drugs
prescribed; smaller volumes of syrup consumed; reduction in
number of injections given; reduction in excess chloroquine
consumption.
- Improved drug management - easier to balance books; easier to
monitor drugs issued; reduced contamination; less wastage.
- Improved case management - doses given according to weight.
- Improved compliance; easy to understand and easy to remember
instructions; more effective counselling.
- Reduced waiting times in dispensaries.
- Sustainability - materials are cheap and readily available.
- Acceptability - to both staff and patients.
Because of the clear advantages of pre-packaged antimalarials,
the District Medical Officers of Ghana are eager to extend the
practice to other commonly-used drugs.
Studies on improving the use of antimalarials in South-East Asia,
funded by TDR, have also shown similar advantages of pre-packaging of
antimalarials. For example, in China, blister
packaging of drugs for malaria produced 97% compliance compared
with 83% in the control group to whom drugs were handed out in
simple envelopes (which are often lost or disintegrate in the
rainy season associated with malaria).
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