Background: The introduction of new anti-malarial treatment that is effective, but more expensive, raises questions about whether the high level of effectiveness observed in clinical trials can be found in a context of family use. The objective of this study was to determine the factors related to adherence, when using the amodiaquine/sulphadoxine-pyrimethamine (AQ/SP) association, a transitory strategy before ACT implementation in Senegal.

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The emergence of increasing plasmodium falciparum resistance to chloroquine in Africa has prompted national malaria programmes to develop new policies regarding appropriate and essential treatment, moving from the use of chloroquine to a new set of bi-therapy methods. In Senegal, the malaria treatment policy has shifted from chloroquine to amodiaquine/sulfadoxine-pyrimethamine. The authors studied the availability of these new drugs and their use by the care providers in 10 rural health district dispensaries. Patient records were examined and nurses were interviewed on their knowledge about and implementation of the new policy. It was noted that the nurses have not yet mastered the proper use of these new medications, and the prescriptions given were not always in line with regulations and practice corresponding to the required or necessary doses. The families which were interviewed stated that they were not aware of the changes in treatment which had been recommended. The conclusion of this study was that it brought to the forefront the need to put specific emphasis on population information and awareness campaigns as well as that of ensuring that caregivers receive thorough training to secure the successful and sustainable implementation and maintenance of the new policy.

The daunting challenge of obtaining sufficient labor for their colonial enterprise in Senegal led the French to implement a system of travail forc� or forced labor. Its violence and the sustained resistance of the colonized populations plagued the system from the very beginning, and ended by affecting it very deeply by the late 1920s. What followed was a vast reorganization of the Senegalese prisons in 1927, aiming at a better use of penal labor. The outcome would be the institution of itinerant penal camps in 1936. They were established in the cercles (provinces) of Louga, Thi�s, Diourbel, and eventually in Bignona. They were used until 1940 to supply much of the work force for road building and maintenance along the main transportation routes of the colony. Lacking any deterrent or rehabilitative objective, the penal camps epitomized the political and economic functions of colonial imprisonment.

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