Adoption of the new antimalarial drug policy in Tanzania--a cross-sectional study in the community.

Jaran Eriksen; Stephen ED Nsimba; Omary MS Minzi; Anku J Sanga; Max Petzold; Lars L Gustafsson; Marian Y Warsame; Göran Tomson; (2005) Adoption of the new antimalarial drug policy in Tanzania--a cross-sectional study in the community. Tropical medicine & international health, 10 (10). pp. 1038-1046. ISSN 1360-2276 DOI: 10.1111/j.1365-3156.2005.01486.x
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OBJECTIVE: To assess the diffusion of the change of first line antimalarial drug from chloroquine (CQ) to sulphadoxine/pyrimethamine (SP) at household level in a rural district of Tanzania less than a year after the policy implementation. METHODS: Caretakers in 729 households were interviewed on knowledge of the new policy, home stocking of antimalarials, home-treatment practices of children younger than 5 years with fever, health-seeking behaviour and experience of SP. SP and CQ levels in blood were analysed from 328 children younger than 5 years in the households. Twelve focus group discussions (FGD) were performed with mothers, fathers and health workers. RESULTS: About 51% of the population knew that SP was the first line antimalarial. Only 8% of mothers stocked antimalarials, and only 4% stated self-treatment as the first action. We estimated that 84% of the children who had had fever during the last 4 weeks sought care at public health facilities. SP was detectable in 18% of the total child population and in 32% of those with reported fever, CQ in only 5% and 7%, respectively. The FGDs revealed negative perceptions of SP and fear of severe adverse reactions with mass media reported as key informant. CONCLUSION: The policy had diffused to the communities in the sense that CQ had been changed to SP, which was well known as first line treatment. Moreover, there was a reported dramatic change from self-treatment with CQ to seeking care at public health facilities where SP was given under observation.

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