Tr. Cullinan et C. Pieterick, PACKAGED TREATMENT FOR FIRST-LINE CARE IN CEREBRAL MALARIA AND MENINGITIS, Bulletin of the World Health Organization, 76(3), 1998, pp. 257-264
Described are the results of a trial carried out from January to June
1996 in southern Malawi to determine the effectiveness of a treatment
pack for infants and children under the age of 6 years, who presented
as emergencies to rural health centres with presumptive diagnoses of s
evere/cerebral malaria or meningitis. Each complete treatment pack (ap
proximate cost, US$ 6) contained, inter alia, intramuscular quinine, i
ntramuscular chloramphenicol, dextrose, paraldehyde, a nasogastric tub
e, prepacked syringes, and sterile water. A modified coma score and dr
ug dosage nomogram were also included in the package. Despite a consid
erable drop in overall mortality, problems arose with regard to the in
complete treatment of possible meningitis and in the development of a
rational referral policy.