Malaria treatment in Queensland, 1992. The use of malaria treatment guidelines.

Abstract

To investigate treatment patterns for malaria and the use of Australian guidelines which were then current for the treatment of malaria in Queensland in 1992. A review of patient treatment and demographic details, obtained from the treating doctor by questionnaire, for all cases of malaria in Queensland in 1992 which were reported to Queensland Health (316 people treated for 341 episodes of malaria). Plasmodium falciparum infections were treated according to the recommendations in the guidelines in 20% of cases. Thirty-five per cent of infections were treated with chloroquine, even though most of these were acquired in countries where chloroquine or chloroquine/antifolate-resistant P. falciparum malaria existed. Plasmodium vivax infections were treated with the recommended course of chloroquine in 58% of cases. Fifty per cent of patients with P. vivax infection were treated with primaquine, but only 57% of these received the dose recommended in the guidelines for the eradication of hypnozoites. Patterns of malaria treatment were basically similar in the malaria-receptive zone and elsewhere in Queensland, although P. falciparum infections in the receptive zone were treated according to the guidelines at a higher rate (32%) than in the rest of Queensland (13%). In 1992, many cases of malaria in Queensland were not treated according to the recommendations in the Australian malaria treatment guidelines. We suggest that improved distribution of simple but comprehensive guidelines for malaria treatment may assist medical practitioners in the provision of prompt, effective treatment, and help prevent the reestablishment of endemic malaria in Australia.