A1256655568wbyOl

1
Household adoption of the new antimalarial drug
policy in Tanzania implications for future
policy changes

• Combination therapy possible A dramatic shift in
  care- seeking behaviour from self-treatment to
  seeking care at health facilities (HF) in
  Tanzania was seen less than 1 year after the
  policy change.
• This indicates possibilities for future policy
  change to Artemisinin-based Combination Therapy
  (ACT)

Objectives To assess the adoption of the new
malaria treatment policy in a rural district of
Tanzania. Study population 779 members of 730
households and health staff in Kibaha district,
Tanzania. Methods A triangulation of household
interviews (n779), blood samples from underfives
(n336) and focus group discussions (FGD)(n12).

Only 5 of mothers had given antimalarials at
home and only 10 stocked them. The majority of
mothers sought care for their sick underfives as
public HF where they were treated with SP.
Eriksen J1,2, Nsimba SED3, Minzi OS3,4, Sanga
AJ5, Gustafsson LL1, Warsame M2 and Tomson G2,6

1. Division of Clinical Pharmacology, Karolinska
   University Hospital Huddinge, Sweden
2. Division of International Health (IHCAR),
   Karolinska Institute, Sweden
3. Department of Clinical Pharmacology, Muhimbili
   University College of Health Sciences (MUCHS),
   Tanzania
4. Department of Medicinal Chemistry, Faculty of
   Pharmacy, MUCHS, Tanzania
5. Department of Sociology, University of Dar es
   Salaam, Tanzania
6. Medical Management Centre (MMC), Karolinska
   Institute, Sweden

Malaria Treatment Policy Chloroquine (CQ) was
effective against malaria for decades, but due to
spreading resistance many African countries have
been forced to change treatment policies. The
WHO recommends a policy change when the
resistance levels surpass 25. In 1999, CQ
resistance in Tanzania averaged 42. As in most
South- and East African countries, Tanzania
changed its 1st line treatment to
Sulfadoxine/Pyrimethamine (SP).
SP was given under direct observation at HF
because of fear of side effects due to horror
stories published in mass media.
Conclusions Tanzanian policy shift strategy
successful in terms of changes in actual
practice. Although this indicates possibilities
for implementing ACT in the country, the health
effects of the behavioural change are unclear.
Results 41 of the mothers knew that SP was the
new 1st line treatment against malaria.