Browsing by Author "Tulli, Tuhuma S."

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    Comparative study to assess the new malaria chemotherapy policy at Temeke district Hospital
    (University of Dar es Salaam, 2002) Tulli, Tuhuma S.
    A retrospective study on the management and outcome of malaria before and after introduction of a new National Guidelines for Malaria Diagnosis and Treatment was done at Temeke hospital, comparing the month of March 2001 and 2002 admissions. In March 2001, there were 551(52.6%) records of malaria, while in March 2002; there were 619 (46.8%) records of hospitalised cases due to malaria. Blood smears done were 350 (56.5%) in March 2002 lower than March 2001, which were 333 (60.4%). Overall, in March 2001 about 367 (66.6%) out of 551 patients diagnosed to have malaria, were complicated or severe malaria, whereas in March 2002, severe or complicated malaria cases were 411(66.4%)out of 619 hospitalised cases due to malaria. Patients hospitalized due to malaria received antimalarial drugs on the basis of blood slides (60.4%) and on clinical grounds alone (39.6%) in March 2001, while in March 2002, were 56.5% and 43.5%, respectively. Again 32 (9.6%) of 333 hospitalised malaria cases with Blood slide done received antimalarial drugs despite negative blood smears in March 2001 while in March 2002, 23 (6.6%) out of 350 hospitalised malaria patients, received antimalarial drugs despite negative blood smears In March 2001, a total of 176(58.4) of the 301 hospitalised patients with blood smears positive were given quinine, and 71 (23.6%) were given CQ. While in March 2002 a total of 244 (74.6%) of the 327 hospitalised patients with blood smears positive were given quinine, and 28(8.6%) were given amodiaquine. This increase of Quinine was at the expense of lowering the rate of a first line drug (SP). Of the recorded cases due to malaria 472 (85.7%) were successfully managed (cured) and 26 (4.7%) patients died in March 2001.While in March 2002, 504 (81.4%) cases out of 619 hospitalised cases were successfully managed (cured) and 46 (7.4%)died. These differences were not significant. It is concluded that although the new policy has been adapted there is no improvement in management of malaria patients and outcome. These results emphasize the need to improve diagnosis by ensuring laboratory services available every day around the clock and operation research is done on training of health workers on malaria management.