E-drug: Wrong diagnosis and poor nursing
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Dear all,
Here is a summary of the reasons to why we need to address poor
diagnostic and nursing techniques, if you are to talk rationally about
management of essential drugs.
You see with HIV/AIDS, we have equipment that is used to detect
the problem and we struggle to get testing facilities for the disease,
but treatment is too expensive for the poor in my country.
With malaria, however, the diagnosis is defined here in Uganda by
the presence of fever. And research has proved here, that without
epidemics, malaria is responsible for only thirty per cent of fevers. It
is only in epidemics that seventy per cent of fevers are due to
malaria, so treating malaria in patients who present with fever is
reasonable -- that is, during epidemics. But, outside epidemics,
seventy per cent of fevers must be diagnosed before treating and
therefore, taking malaria medicine for every fever is inappropriate. It
wastes resources and causes delay in seeking the right diagnosis.
If malaria medicine is given to all patients with fever, and who
report to governmental health facilities, then there is a major
problem. Why don't we seek to address this? And stop saying,
"Take malaria medicine for every fever, joint ache and body
weakness." I have seen people who have wasted much money by
such action and I know that viral infections (new and undefined, or
known) can cause that too. We know that there are good
diagnostic methods; so why don't we seek to have these in place?
Nursing staff, in our governmental facilities, is rotated very
frequently. But they often administer four hourly drugs only once or
twice a day. And this practice happens even when drugs are
sufficiently available! Many patients even prefer to stay away from
public health facilities because nurses are "rude". This is poor
nursing practice. Why don't you seek to address this too?
Regards,
George Kibumba, MPS
COMMUNITY AND Drug Information Pharmacist
Drug Information Desk,
Joint Medical Store,
P.O.BOX 4501, KAMPALA, Uganda(E.A)
Official address: did.jms@imul.com
Personal address: kibumba@yahoo.com
Mobile: 071 81 54 28
Tel: +256-41-268482
fax: +256-41-267298
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