Ek. Ansah et al., Improving adherence to malaria treatment for children: the use of pre-packed chloroquine tablets vs. chloroquine syrup, TR MED I H, 6(7), 2001, pp. 496-504
Malaria is a major cause of morbidity and mortality among children under fi
ve in sub-Saharan Africa. Prompt diagnosis and adequate treatment of acute
clinical episodes are essential to reduce morbidity and prevent complicatio
ns and mortality. In many countries, chloroquine syrup is the mainstay of m
alaria treatment for children under five. Not only is syrup more expensive
than tablets, adherence to the prescribed dose at home is a problem because
mothers use wrongly sized measuring devices or have difficulty with the in
structions. We investigated the impact of introducing pre-packed tablets fo
r children on adherence to treatment and compared the total cost of the tab
lets with that of syrup. Children aged 0-5 years diagnosed with malaria at
the clinic over a 6-week period received either pre-packed tablets or syrup
by random assignment. The principal caregivers were interviewed at home on
day 4 after attending the clinic. Of the 155 caregivers given pre-packed t
ablets, 91% (n = 141) adhered to the recommended dosage, while only 42% (n
= 61) of 144 who were provided syrup did. Only 20% of caregivers who receiv
ed syrup used an accurate 5 mi measure. The cost of treatment with tablets
was about one-quarter that of syrup and 62% (n = 96) of caregivers preferre
d tablets. Pre-packed chloroquine tablets are a viable alternative to syrup
.