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MIND
LINES
AGAINST
GUIDELINES
IN
TREATMENT
OF
MALARIA
…

and
dispensaries),
secondary
level
health
care
facilities
(tehsil
headquarter

hospitals
and
district
head
quarter
hospitals)
and
tertiary
level
health
care

facilities
(tertiary
hospitals,
post
graduate
medical
institutes,
teaching
hospitals).

All
the
tertiary
healthcare
facilities
have
a
primary
section
for
treating
common

disease
including
malaria.

Cases
are
referred
from
lower
to
higher
level
depending
on
severity
of

problem
and
available
infrastructure
(8).
The
study
population
included
all
the

public
and
private
tertiary
health
care
facilities
treating
malaria
in
Islamabad
and

Rawalpindi.
A
list
of
all
the
public
and
private
tertiary
healthcare
facilities
was

obtained
from
respective
District
Health
Offices.
All
the
20
public
and
private

tertiary
healthcare
facilities
were
selected
for
the
study
and
the
sample
size
was

Islamabad
(n
=10,
5
each
public
and
private
healthcare
facilities)
and
Rawalpindi

(n
=10,
5
each
public
and
private
healthcare
facilities).

For
assessing
the
prescribing
practices
in
each
facility,
thirty
patients

treated
for
malaria
by
the
prescribers
over
the
last
one
year
were
reviewed
(7).

A
total
of
600
patient
encounters
i.e.
300
from
each
sector
(public
and

private)
healthcare
facilities
situated
in
both
cities
were
collected
randomly
from

daily
registers,
medical
records,
prescriptions,
patient-­-held
records.
At
least
two

patients
encounter
per
month
during
the
low
season
(October
till
April)
and
four

patients
encounter
per
month
during
the
high
season
(May
till
September)
for

malaria
were
selected.

As
there
is
no
trend
of
laboratory
confirmation
of
malaria
in
Pakistan
all
the

prescriptions
with
diagnosis
of
malaria,
anti-­-malarial
drugs
and
tests
of
malaria

parasite
results
were
included
in
the
sample.
Plasmodium
vivax
is
common
in

Rawalpindi
and
Islamabad
so
the
adherence
of
prescribers
with
standard

treatment
regimen
for
P.vivax
was
assessed.

Interview
of
the
head
of
the
outpatient
department
on
recommended

current
prescribing
practices
in
the
healthcare
facilities
were
recorded
and
applied

to
all
encounters
where
records
were
missing
(9).
Prescriptions
without
the
name

of
the
prescriber
and
folder
without
patient’s
information
were
excluded.
The

prescribers
were
identified
from
patient’s
prescriptions
and
information
regarding

their
designation
and
experience
was
recorded.

Data
collection
and
analysis

Data
was
collected
by
the
principal
investigator
along
with
two
teams

comprised
of
five
trained
data
collectors
in
each
team
trained
by
the
group
of

experts
including
principal
investigator
(9).

The
data
collectors
were
trained
students
of
the
final
year
Doctor
of

Pharmacy
program
who
tallied
data
with
standard
treatment
regimen.
Data
were

503