40

RésuméL’apparition de résistances à la chloroquine a conduit de nombreux états africains à modifier leur politique de traitement passant de la chloroquine à des bi-thérapies ; au Sénégal, il s’agit de l’association amodiaquine/sulfadoxine-pyriméthamine. Nous avons étudié la disponibilité des médicaments et leur utilisation dans 10 postes de santé en zone rurale. Les registres de consultations ont été analysés et les infirmiers interrogés sur leurs connaissances et leur utilisation du nouveau traitement. Les infirmiers ne maîtrisaient pas parfaitement ces nouveaux médicaments, et les prescriptions n’étaient pas toujours en adéquation avec le schéma établi. Les familles interrogées n’avaient pas entendu parler du changement de thérapeutique. Au terme de cette étude, il apparaît donc nécessaire de mettre l’accent sur l’information des populations et la formation des acteurs de santé pour une mise en place réussie de ces nouvelles politiques.

The emergence of increasing plasmodium falciparum resistance to chloroquine in Africa has prompted national malaria programmes to develop new policies regarding appropriate and essential treatment, moving from the use of chloroquine to a new set of bi-therapy methods. In Senegal, the malaria treatment policy has shifted from chloroquine to amodiaquine/sulfadoxine-pyrimethamine. The authors studied the availability of these new drugs and their use by the care providers in 10 rural health district dispensaries. Patient records were examined and nurses were interviewed on their knowledge about and implementation of the new policy. It was noted that the nurses have not yet mastered the proper use of these new medications, and the prescriptions given were not always in line with regulations and practice corresponding to the required or necessary doses. The families which were interviewed stated that they were not aware of the changes in treatment which had been recommended. The conclusion of this study was that it brought to the forefront the need to put specific emphasis on population information and awareness campaigns as well as that of ensuring that caregivers receive thorough training to secure the successful and sustainable implementation and maintenance of the new policy.