USE OF ANTIMALARIAL-DRUGS IN MALI - POLICY VERSUS REALITY

Inappropriate use of antimalarial drugs undermines therapeutic efficac y and promotes the emergence and spread of drug-resistant malaria. Str ategies for improving compliance require accurate information about cu rrent practices. Here we describe Knowledge-Attitude-Practice surveys conducted among health providers and consumers in two Malian villages, one rural and one periurban. All sanctioned providers limited their f irst choices of antimalarial drug to those recommended by the national malaria control program and reported using correct dosing regimens. H owever, the majority of consumers in the two villages chose non-recomm ended treatments for malaria and reported suboptimal treatment regimen s when they did use recommended drugs. Antimalarial drugs were also wi dely available from unsanctioned sources, often accompanied by erroneo us advice on dosing regimens. This study demonstrates that even when t he most peripheral health providers are well-trained in correct use of antimalarial drugs, additional measures directly targeting consumers will be required to improve drug use practices.