Objective To examine the extent to which district health teams could reduce
the burden of malaria, a continuing major cause of mortality and morbidity
, in a situation where severe resource constraints existed and integrated c
are was provided.
Methods Antimalarial drugs were prepackaged into unit doses in an attempt t
o improve compliance with full courses of chemotherapy.
Findings Compliance improved by approximately 20% in both adults and childr
en. There were 50% reductions in cost to patients, waiting time at dispensa
ries and drug wastage at facilities. The intervention, which tended to impr
ove both case and drug management at facilities, was well accepted by healt
h staff and did not involve them in additional working time.
Conclusion The prepackaging of antimatarials at the district level offers t
he prospect of improved compliance and a reduction in the spread of resista
nce.