Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia.
<h4>Background</h4>Adherence to effective malaria medication is extremely important in the context of Cambodia's elimination targets and drug resistance containment. Although the public sector health facilities are accessible to the local ethnic minorities of Ratanakiri province (No...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2013
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/91d00910da5e46858466fc0ebeb49165 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:91d00910da5e46858466fc0ebeb49165 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:91d00910da5e46858466fc0ebeb491652021-11-18T08:47:18ZInjections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia.1932-620310.1371/journal.pone.0080343https://doaj.org/article/91d00910da5e46858466fc0ebeb491652013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24244678/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Adherence to effective malaria medication is extremely important in the context of Cambodia's elimination targets and drug resistance containment. Although the public sector health facilities are accessible to the local ethnic minorities of Ratanakiri province (Northeast Cambodia), their illness itineraries often lead them to private pharmacies selling "cocktails" and artemether injections, or to local diviners prescribing animal sacrifices to appease the spirits.<h4>Methods</h4>The research design consisted of a mixed methods study, combining qualitative (in-depth interviews and participant observation) and quantitative methods (household and cross-sectional survey).<h4>Results</h4>Three broad options for malaria treatment were identified: i) the public sector; ii) the private sector; iii) traditional treatment based on divination and ceremonial sacrifice. Treatment choice was influenced by the availability of treatment and provider, perceived side effects and efficacy of treatments, perceived etiology of symptoms, and patient-health provider encounters. Moreover, treatment paths proved to be highly flexible, changing mostly in relation to the perceived efficacy of a chosen treatment.<h4>Conclusions</h4>Despite good availability of anti-malarial treatment in the public health sector, attendance remained low due to both structural and human behavioral factors. The common use and under-dosage of anti-malaria monotherapy in the private sector (single-dose injections, single-day drug cocktails) represents a threat not only for individual case management, but also for the regional plan of drug resistance containment and malaria elimination.Charlotte GryseelsSambunny UkAnnette ErhartRené GerretsVincent SluydtsLies DurnezJoan Muela RiberaSusanna Hausmann MuelaDidier MenardSomony HengTho SochanthaUmberto D'AlessandroMarc CoosemansKoen Peeters GrietensPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e80343 (2013) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Charlotte Gryseels Sambunny Uk Annette Erhart René Gerrets Vincent Sluydts Lies Durnez Joan Muela Ribera Susanna Hausmann Muela Didier Menard Somony Heng Tho Sochantha Umberto D'Alessandro Marc Coosemans Koen Peeters Grietens Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia. |
| description |
<h4>Background</h4>Adherence to effective malaria medication is extremely important in the context of Cambodia's elimination targets and drug resistance containment. Although the public sector health facilities are accessible to the local ethnic minorities of Ratanakiri province (Northeast Cambodia), their illness itineraries often lead them to private pharmacies selling "cocktails" and artemether injections, or to local diviners prescribing animal sacrifices to appease the spirits.<h4>Methods</h4>The research design consisted of a mixed methods study, combining qualitative (in-depth interviews and participant observation) and quantitative methods (household and cross-sectional survey).<h4>Results</h4>Three broad options for malaria treatment were identified: i) the public sector; ii) the private sector; iii) traditional treatment based on divination and ceremonial sacrifice. Treatment choice was influenced by the availability of treatment and provider, perceived side effects and efficacy of treatments, perceived etiology of symptoms, and patient-health provider encounters. Moreover, treatment paths proved to be highly flexible, changing mostly in relation to the perceived efficacy of a chosen treatment.<h4>Conclusions</h4>Despite good availability of anti-malarial treatment in the public health sector, attendance remained low due to both structural and human behavioral factors. The common use and under-dosage of anti-malaria monotherapy in the private sector (single-dose injections, single-day drug cocktails) represents a threat not only for individual case management, but also for the regional plan of drug resistance containment and malaria elimination. |
| format |
article |
| author |
Charlotte Gryseels Sambunny Uk Annette Erhart René Gerrets Vincent Sluydts Lies Durnez Joan Muela Ribera Susanna Hausmann Muela Didier Menard Somony Heng Tho Sochantha Umberto D'Alessandro Marc Coosemans Koen Peeters Grietens |
| author_facet |
Charlotte Gryseels Sambunny Uk Annette Erhart René Gerrets Vincent Sluydts Lies Durnez Joan Muela Ribera Susanna Hausmann Muela Didier Menard Somony Heng Tho Sochantha Umberto D'Alessandro Marc Coosemans Koen Peeters Grietens |
| author_sort |
Charlotte Gryseels |
| title |
Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia. |
| title_short |
Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia. |
| title_full |
Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia. |
| title_fullStr |
Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia. |
| title_full_unstemmed |
Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia. |
| title_sort |
injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in northeast cambodia. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2013 |
| url |
https://doaj.org/article/91d00910da5e46858466fc0ebeb49165 |
| work_keys_str_mv |
AT charlottegryseels injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT sambunnyuk injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT annetteerhart injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT renegerrets injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT vincentsluydts injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT liesdurnez injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT joanmuelaribera injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT susannahausmannmuela injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT didiermenard injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT somonyheng injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT thosochantha injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT umbertodalessandro injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT marccoosemans injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia AT koenpeetersgrietens injectionscocktailsanddivinerstherapeuticflexibilityinthecontextofmalariaeliminationanddrugresistanceinnortheastcambodia |
| _version_ |
1718421335704600576 |