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|Title:||Barriers to prompt and effective treatment of malaria in northern Sri Lanka.|
|Authors:||Reilley, Brigg;Abeyasinghe, R;Pakianathar, M Vincent|
|subject:||Adolescent;Adult;Aged;Aged, 80 and over;Children;Child, Preschool;Communication Barriers;Female;Focus Groups;Humans;Infant;Interviews as Topic;Malaria;Male;Medically Underserved Area;Middle Aged;Patient Acceptance of Health Care;Sri Lanka;War|
|Description:||BACKGROUND: 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.|
|Standard no:||Barriers to prompt and effective treatment of malaria in northern Sri Lanka. 2002, 7 (9):744-9 Trop. Med. Int. Health|
Tropical Medicine & International Health
|Appears in Collections:||Malaria|
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