AJTMH: Evidence of Self-Medication with Chloroquine before Consultation for Malaria in the Southern Pacific Coast Region of Colombia

10 January, 2019

With thanks to Tropical Health Update.

On HIFA we have previously noted that self-medication for presumed malaria is common in Africa. This seems to be the case also in Latin America (and probably in LMICs worldwide?). I would be interested to know more about the impacts of self-medication on individual cases and on the health of communities and populations (including antimicrobial resistance). What can be done to improve the situation?

The full text is restricted-access. Incidentally I note that the American Journal of Tropical Medicine and Hygiene - now in its 100th volume - continues to be restricted-access. The journal is registered with Hinari but it would be even better if it can find a way to further increase access to its content, for example by moving to an open-access model.

Also, this is an example of research from a non-English-speaking country, published only in English. The HIFA Multilingualism project is campaigning to address this anomaly, arguing for the abstracts of all such research to be available in the language of the country where the research was undertaken. [Improving the availability of health research in languages other than english, The Lancet Global Health, Published: September 11, 2018

https://doi.org/10.1016/S2214-109X(18)30384-X ]

CITATION: Evidence of Self-Medication with Chloroquine before Consultation for Malaria in the Southern Pacific Coast Region of Colombia

Gustavo Diaz1, Alvaro Mauricio Lasso1, Claribe Murillo, Lidia M. Montenegro, Diego F. Echeverry

Source: The American Journal of Tropical Medicine and Hygiene, Volume 100, Issue 1, Jan 2019, p. 66 - 71

DOI: https://doi.org/10.4269/ajtmh.18-0515

http://www.ajtmh.org/content/journals/10.4269/ajtmh.18-0515?emailalert=true

'Self-medication with antimalarial drugs is a major factor in the development of drug resistance, exerting subtherapeutic drug pressure on circulating parasite populations. Data on self-medication with antimalarials from the Southern Pacific coast region of Colombia, where 4-aminoquinolines resistance and political instability prevail, are vital to elimination strategies. We present results of an exploratory study of 254 individuals having malaria symptoms who sought malaria diagnosis in two hospitals in Tumaco, Department of Nariño, Colombia. Thirty-two percent (82/254) of participants had positive Saker-Solomons urine testss, indicating self-medication with chloroquine (CQ) before consultation for diagnosis. Notably, among 30 pregnant women participating in the study, 43% were Saker-Solomons positive. Molecular analysis of the K76T posiition encoded by the pfcrt gene revealed the mutant allele in all four samples that were both positive for Plasmodium falciparum and positive for the Saker-Solomons test, suggesting persistent CQ pressure. The high frequenncy of self-medication, particularly among pregnant women merits attention by public health authorities and comprehensive investigation.'

Best wishes, Neil

Coordinator, HIFA Project on Multilingualism

http://www.hifa.org/projects/multilingualism

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org