PACKAGED TREATMENT FOR FIRST-LINE CARE IN CEREBRAL MALARIA AND MENINGITIS

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.