Trong tiến trình Phòng chống và Loại trừ sốt rét không thể tách rời kiểm soát Plasmodium falciparum và Plasmodium vivax riêng biệt mà phải song hành vì hầu hết các vùng còn sốt rét lưu hành (SRLH) hiện nay.

             Đặc biệt hiện nay, tại các vùng SRLH ở châu Phi, Nam Mỹ và châu Á Thái Bình Dương qua các khảo sát cho thấy hầu như bệnh nhân nhiễm P. vivax tuân thủ phác đồ đầy đủ gồm [chloroquin phosphate 3 ngày + primaquine phosphate 14 ngày] có tỷ lệ rất thấp, điều này dẫn đến sự tồn tại giao bào (cả Plasmodium falciparum và Plasmodium vivax) và thể ẩn trong các tế bào gan và đưa đến tái phát xa nhiều lần trên bệnh nhân và nhiễm trùng mạn tính (đối với Plasmodium vivax và Plasmodium ovale) là khó tránh khỏi.

Điều này dẫn đến trở ngại trong việc loại trừ tiệt để sốt rét tại các vùng đó. Lý do tại sao bệnh nhân không tuân thủ liệu trình dài ngày có thể do khách quan lẫn chủ quan:

-Hoặc có thể trong nhiều bệnh án bệnh nhân tại cơ ở điều trị và thầy thuốc lâm sàng quên không kê đơn trong hoặc sau khi bệnh nhân ra viện đầy đủ primaquin phosphate 14 ngày;

-Hoặc bác sỹ lâm sàng có kê trong hồ sơ nội trú hoặc kê đơn ngoại trú đủ 14 ngày primaquin phosphate nhưng bệnh nhân không uống đầy đủ 14 ngày;

-Hoặc bệnh nhân nhận đủ thuốc nhưng về không nhớ uống, không muốn uống nữa vì đã hết sốt và khỏe hơn thì không chịu dùng thêm thuốc, bệnh nhân cũng óc uống thêm mấy ngày đầu nhưng sau đó lại không dùng đủ ngày, …

Dưới đây là một số nghiên cứu thử nghiệm có sự tham gia của hệ thống y tế tư nhân và y tế công để làm thế nào khắc phục và nâng cao sự tuân thủ của bệnh nhân với các liệu trình và phác đồ thuốc sốt rét trong điều trị cho bệnh nhân tại một số vùng SRLH trên thế giới, nhất là tại châu Á-Thái Bình Dương để tham khảo, đồng thời có những khuyến cáo sao cho quản lý ca bệnh tốt hơn.

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Select item 2828874694.

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