{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T10:08:42Z","timestamp":1789812522104,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2008,4,6]],"date-time":"2008-04-06T00:00:00Z","timestamp":1207440000000},"content-version":"vor","delay-in-days":36,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2008,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Objective\u2002<\/jats:bold> To assess the quality of healthcare workers\u2019 performance with regard to malaria diagnosis and treatment and to assess patients\u2019 self\u2010medication with chloroquine (CQ) before and after presentation at a health centre.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> In the rainy season 2004, in five rural dispensaries in Burkina Faso, we observed 1101 general outpatient consultations and re\u2010examined all these patients. CQ whole blood concentrations of confirmed malaria cases were measured before and after treatment.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> The clinical diagnosis based on fever and\/or a history of fever had a sensitivity of 75% and a specificity of 41% when compared to confirmed malaria (defined as an axillary temperature of \u226537.5\u2003\u00b0C and\/or a history of fever and parasites of any density in the blood smear). Few febrile children under 5\u2003years of age were assessed for other diseases than malaria such as pneumonia. No antimalarial was prescribed for 1.3% of patients with the clinical diagnosis malaria and for 24% of confirmed cases, while 2% received an antimalarial drug prescription without the corresponding clinical diagnosis. CQ was overdosed in 22% of the prescriptions. Before and 2\u2003weeks after consultation, 25% and 46% respectively of the patients with confirmed malaria had potentially toxic CQ concentrations.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> As long as artemisinin\u2010based combination therapy remains unavailable or unaffordable for most people in rural areas of Burkina Faso, self\u2010medication with and prescription of CQ are likely to continue despite increasing resistance. Apart from considering more pragmatic first\u2010line regimens for malaria treatment such as the combination of sulfadoxine\u2010pyrimethamine with amodiaquine, more and better training on careful clinical management of febrile children including an appropriate consideration of other illnesses than malaria should be made available in the frame of the IMCI initiative in sub\u2010Saharan Africa.<\/jats:p>","DOI":"10.1111\/j.1365-3156.2008.02017.x","type":"journal-article","created":{"date-parts":[[2010,8,11]],"date-time":"2010-08-11T22:14:58Z","timestamp":1281564898000},"page":"418-426","source":"Crossref","is-referenced-by-count":23,"title":["Clinical diagnosis of malaria and the risk of chloroquine self\u2010medication in rural health centres in Burkina Faso"],"prefix":"10.1111","volume":"13","author":[{"given":"K.","family":"Pfeiffer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Some","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Sie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Kouyat\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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