Abstract
Primaquine is a drug widely used for Plasmodium vivax malaria treatment. It is known to be active on Plasmodium falciparum mature gametocytes which are responsible for the transmission of the parasite from humans to mosquitoes. In 2018, Senegal initiated the large-scale use of a single low dose of primaquine associated with artemisinin-based combination therapy for malaria elimination. This study aimed to assess the therapeutic adherence of the implementation of primaquine in the Saint-Louis region. To measure therapeutic adherence, questionnaires were developed and made it possible to collect information from treated malaria patients, health workers, the investigating team and health authorities. Out of 1087 malaria patients, 585 received primaquine. Children under the age of 5 could not receive it due to the lack of the pediatric formulation. The involvement of private health facilities has shown its effectiveness in the implementation of the strategy. However, efforts must be made to improve the documentation of cases in the national surveillance system and to acquire logistical means facilitating the supply of the drug in remote locations. The authorities must become more involved in finding a solution for the availability and sufficient supply of primaquine to formulations adapted to the population.
Highlights
The incidence of malaria has dropped significantly following the many advances made in the fight against this scourge in recent years [1]
This new situation of very low transmission has led the National Malaria Control Program (NMCP) to stratify the districts based on the incidence, leading to adapt control actions according to local epidemiological characteristics [3]
Primaquine is a molecule used for the treatment of Plasmodium vivax malaria which destroys mature gametocytes of Plasmodium falciparum [4, 5]
Summary
The incidence of malaria has dropped significantly following the many advances made in the fight against this scourge in recent years [1]. In Senegal, malaria is still endemic in certain regions, the northern part of the country has recorded low incidences for a few years [2] This new situation of very low transmission has led the National Malaria Control Program (NMCP) to stratify the districts based on the incidence, leading to adapt control actions according to local epidemiological characteristics [3]. Malaria is a real public health problem and its geographic spread is strongly caused by the transmission of the parasite to the vector. Its use as a single low dose of 0.25 mg / kg in combination with Artemisinin-based Combination Therapy (ACTs) is recommended by WHO in areas of low transmission This combination therapy offers possibilities to reduce the carriage of gametocytes and to interrupt the transmission of the parasite to vectors [6]
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