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Utilization patterns of malaria chemoprophylaxis among Tanzanian children attending sickle cell clinic in Dar es Salaam tertiary hospitals
BACKGROUND: Malaria is among the leading cause of infection in individuals with sickle cell disease (SCD) living in sub-Saharan Africa, including Tanzania. However, after 2005 the standard treatment guidelines (STGs) on malaria chemoprevention for SCD patients were non-existent, and at present no me...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888899/ https://www.ncbi.nlm.nih.gov/pubmed/31796035 http://dx.doi.org/10.1186/s12936-019-3029-y |
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author | Ndegeulaya, Esther J. Bwire, George M. Sangeda, Raphael Z. Mloka, Doreen Tungaraza, Faustine Kahere, Augustino S. Manyaki, Fidelis F. Felician, Fatuma F. Kilonzi, Manase Mikomangwa, Wigilya P. Mlyuka, Hamu J. Marealle, Alphonce I. Mutagonda, Ritah Mwita, Liberata Mwambete, Kennedy D. |
author_facet | Ndegeulaya, Esther J. Bwire, George M. Sangeda, Raphael Z. Mloka, Doreen Tungaraza, Faustine Kahere, Augustino S. Manyaki, Fidelis F. Felician, Fatuma F. Kilonzi, Manase Mikomangwa, Wigilya P. Mlyuka, Hamu J. Marealle, Alphonce I. Mutagonda, Ritah Mwita, Liberata Mwambete, Kennedy D. |
author_sort | Ndegeulaya, Esther J. |
collection | PubMed |
description | BACKGROUND: Malaria is among the leading cause of infection in individuals with sickle cell disease (SCD) living in sub-Saharan Africa, including Tanzania. However, after 2005 the standard treatment guidelines (STGs) on malaria chemoprevention for SCD patients were non-existent, and at present no medicine is recommended for SCD patients. Since several anti-malarials have been approved for the treatment of malaria in Tanzania, it is important to establish if there is a continued use of chemoprevention against malaria among SCD children. METHODS: A cross-sectional, hospital-based study was conducted between January and June 2019 at tertiary hospitals in Dar es Salaam. Data were collected using a semi-questionnaire and analysed using SPSS software version 25. The descriptive statistics were summarized using proportions, while factors associated with the use of chemoprophylaxis were analysed using multivariate logistic regression. Statistical significance of p < 0.05 was accepted. RESULTS: A total of 270 SCD children were involved. The median age of SCD children was 6 years (interquartile range (IQR): 3–11 years). Of 270 SCD children, 77% (number (n) = 218) of children with SCD had not been diagnosed with malaria in the previous year, whereas 12.6% (n = 34) of children were admitted because of malaria in the previous year. Regarding the use of chemoprophylaxis in SCD children, 32.6% (n = 88) of parents were aware that, chemoprophylaxis against malaria is recommended in SCD children. Of the 270 participants, 17% (n = 46) were using malaria chemoprophylaxis. A majority used artemisinin combination therapy (ACT), 56.8% (n = 26). Of 223 parents who did not give chemoprophylaxis, the majority (n = 142, 63.7%) indicated unavailability at clinics as the reason. Children whose parents were primary level educated were 9.9 times more likely to not use chemoprophylaxis (adjusted odds ratio (AOR); 9.9, 95% CI 1.8–56.5, P = 0.01) compared to those whose parents had tertiary education. CONCLUSION: Despite the lack of STGs, a small proportion of children with SCD were using malaria chemoprophylaxis where the majority used ACT, i.e., dihydroartemisinin-piperaquine. |
format | Online Article Text |
id | pubmed-6888899 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-68888992019-12-11 Utilization patterns of malaria chemoprophylaxis among Tanzanian children attending sickle cell clinic in Dar es Salaam tertiary hospitals Ndegeulaya, Esther J. Bwire, George M. Sangeda, Raphael Z. Mloka, Doreen Tungaraza, Faustine Kahere, Augustino S. Manyaki, Fidelis F. Felician, Fatuma F. Kilonzi, Manase Mikomangwa, Wigilya P. Mlyuka, Hamu J. Marealle, Alphonce I. Mutagonda, Ritah Mwita, Liberata Mwambete, Kennedy D. Malar J Research BACKGROUND: Malaria is among the leading cause of infection in individuals with sickle cell disease (SCD) living in sub-Saharan Africa, including Tanzania. However, after 2005 the standard treatment guidelines (STGs) on malaria chemoprevention for SCD patients were non-existent, and at present no medicine is recommended for SCD patients. Since several anti-malarials have been approved for the treatment of malaria in Tanzania, it is important to establish if there is a continued use of chemoprevention against malaria among SCD children. METHODS: A cross-sectional, hospital-based study was conducted between January and June 2019 at tertiary hospitals in Dar es Salaam. Data were collected using a semi-questionnaire and analysed using SPSS software version 25. The descriptive statistics were summarized using proportions, while factors associated with the use of chemoprophylaxis were analysed using multivariate logistic regression. Statistical significance of p < 0.05 was accepted. RESULTS: A total of 270 SCD children were involved. The median age of SCD children was 6 years (interquartile range (IQR): 3–11 years). Of 270 SCD children, 77% (number (n) = 218) of children with SCD had not been diagnosed with malaria in the previous year, whereas 12.6% (n = 34) of children were admitted because of malaria in the previous year. Regarding the use of chemoprophylaxis in SCD children, 32.6% (n = 88) of parents were aware that, chemoprophylaxis against malaria is recommended in SCD children. Of the 270 participants, 17% (n = 46) were using malaria chemoprophylaxis. A majority used artemisinin combination therapy (ACT), 56.8% (n = 26). Of 223 parents who did not give chemoprophylaxis, the majority (n = 142, 63.7%) indicated unavailability at clinics as the reason. Children whose parents were primary level educated were 9.9 times more likely to not use chemoprophylaxis (adjusted odds ratio (AOR); 9.9, 95% CI 1.8–56.5, P = 0.01) compared to those whose parents had tertiary education. CONCLUSION: Despite the lack of STGs, a small proportion of children with SCD were using malaria chemoprophylaxis where the majority used ACT, i.e., dihydroartemisinin-piperaquine. BioMed Central 2019-12-03 /pmc/articles/PMC6888899/ /pubmed/31796035 http://dx.doi.org/10.1186/s12936-019-3029-y Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Ndegeulaya, Esther J. Bwire, George M. Sangeda, Raphael Z. Mloka, Doreen Tungaraza, Faustine Kahere, Augustino S. Manyaki, Fidelis F. Felician, Fatuma F. Kilonzi, Manase Mikomangwa, Wigilya P. Mlyuka, Hamu J. Marealle, Alphonce I. Mutagonda, Ritah Mwita, Liberata Mwambete, Kennedy D. Utilization patterns of malaria chemoprophylaxis among Tanzanian children attending sickle cell clinic in Dar es Salaam tertiary hospitals |
title | Utilization patterns of malaria chemoprophylaxis among Tanzanian children attending sickle cell clinic in Dar es Salaam tertiary hospitals |
title_full | Utilization patterns of malaria chemoprophylaxis among Tanzanian children attending sickle cell clinic in Dar es Salaam tertiary hospitals |
title_fullStr | Utilization patterns of malaria chemoprophylaxis among Tanzanian children attending sickle cell clinic in Dar es Salaam tertiary hospitals |
title_full_unstemmed | Utilization patterns of malaria chemoprophylaxis among Tanzanian children attending sickle cell clinic in Dar es Salaam tertiary hospitals |
title_short | Utilization patterns of malaria chemoprophylaxis among Tanzanian children attending sickle cell clinic in Dar es Salaam tertiary hospitals |
title_sort | utilization patterns of malaria chemoprophylaxis among tanzanian children attending sickle cell clinic in dar es salaam tertiary hospitals |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888899/ https://www.ncbi.nlm.nih.gov/pubmed/31796035 http://dx.doi.org/10.1186/s12936-019-3029-y |
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