Malariabehandeling niet overal beschikbaar

Objective

To investigate the cause of the delays observed in clinical practice concerning treatment of patients with severe malaria in hospitals in the Netherlands.

Design

Descriptive study

Method

During the last months of 2017, the on-call pharmacists of all 74 Dutch hospitals with an emergency department were surveyed by telephone about the availability of antimalarial drugs.

Results

In 50 of the 74 Dutch hospitals (68%), artesunate was available as standard and in 7 of the 74 hospitals (9%) there was a pre-existing arrangement with a neighbouring hospital or pharmaceutical wholesaler for direct supply. In 11 of the 74 hospitals (15%) oral antimalarial drugs were available, but artesunate was not. The remaining 6 hospitals (8%) had no antimalarial drugs in stock.

Conclusion

Treatment of severe malaria with artesunate is possible in only 77% of the Dutch hospitals with an emergency department. This limited availability, in combination with logistical problems regarding the dispensing of artesunate, contributes to delays in initiation of antimalarial treatment. Every hospital should, therefore, have a clear protocol that guarantees timely administration of adequate antimalarial treatment or have an agreement in place for immediate referral to a centre in which patients with malaria can be treated.

Conflict of interest and financial support: none declared.