Improving adherence to malaria treatment for children: the use of pre-packed chloroquine tablets vs. chloroquine syrup

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 .