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Treatment uptake by individuals infected with Plasmodium falciparum in rural Gambia, West Africa

von Seidlein, Lorenz, Clarke, Sian, Alexander, Neal, Manneh, Fandingding, Doherty, Tom, Pinder, Margaret, Walraven, Gijs and Greenwood, Brian (2002). Treatment uptake by individuals infected with Plasmodium falciparum in rural Gambia, West Africa. Bulletin of the World Health Organization,80(10):790-796.

Document type: Journal Article
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Title Treatment uptake by individuals infected with Plasmodium falciparum in rural Gambia, West Africa
Author von Seidlein, Lorenz
Clarke, Sian
Alexander, Neal
Manneh, Fandingding
Doherty, Tom
Pinder, Margaret
Walraven, Gijs
Greenwood, Brian
Journal Name Bulletin of the World Health Organization
Publication Date 2002
Volume Number 80
Issue Number 10
ISSN 00429686   (check CDU catalogue open catalogue search in new window)
Start Page 790
End Page 796
Total Pages 7
Place of Publication Switzerland
Publisher World Health Organization
Abstract Objective:
To find out what proportion of Plasmodium falciparum infections are treated in rural Gambia.


Subjects from four villages in the Gambia were followed over nine months through visits to village health workers. Monthly cross-sectional malaria surveys measured the prevalence of P. falciparum infection. Linked databases were searched for treatment requests. Treated cases were individuals with parasitaemia who requested treatment during narrow or extended periods (14 or 28 days, respectively) before or after a positive blood film was obtained.


Parasite prevalence peaked in November 1998, when 399/653 (61%) individuals had parasitaemia. Parasite prevalence was highest throughout the study in children aged 5–10 years. Although access to treatment was better than in most of sub-Saharan Africa, only 20% of infected individuals sought medical treatment up to 14 days before or after a positive blood film. Within two months of a positive blood film, 199/726 (27%) individuals with parasitaemia requested treatment. Despite easy access to health care, less than half (42%) of those with parasite densities consistent with malaria attacks (>5000/ml) requested treatment. High parasite density and
infection during October–November were associated with more frequent treatment requests. Self-treatment was infrequent in study villages: in 3/120 (2.5%) households antimalarial drugs had been used in the preceding malaria season.


Many P. falciparum infections may be untreated because of their subclinical nature. Intermittent presumptive treatment may reduce morbidity and mortality. It is likely that not all untreated infections were asymptomatic. Qualitative research should explore barriers to treatment uptake, to allow educational interventions to be planned.
Keywords Malaria
Falciparum/drug therapy/diagnosis
Plasmodium falciparum/pathogenicity
Antimalarials/ therapeutic use
Patient acceptance of health care
Self medication
Rural population
Cross-sectional studies
(source: MeSH, NLM )
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Created: Wed, 28 Nov 2012, 15:26:54 CST by Teresa Haendel