OBJECTIVE: To assess the degree to which policy changes to artemisinin-based combination therapies (ACTs) as first-line treatment for uncomplicated malaria translate into effective ACT delivery. METHODS: Prospective observational study of drug dispensing practices at baseline and during the 3 years following introduction of ACT with sulfadoxine-pyrimethamine (SP) plus artesunate (AS) in Rufiji District, compared with two neighbouring districts where SP monotherapy remained the first-line treatment, was carried out. Demographic and dispensing data were collected from all patients at the dispensing units of selected facilities for 1 month per quarter, documenting a total of 271, 953 patient encounters in the three districts. RESULTS: In Rufiji, the proportion of patients who received a clinical diagnosis of malaria increased from 47.6% to 57.0%. A majority (75.9%) of these received SP + AS during the intervention period. Of patients who received SP + AS, 94.6% received the correct dose of both. Among patients in Rufiji who received SP, 14.2% received SP monotherapy, and among patients who received AS, 0.3% received AS monotherapy. CONCLUSIONS: The uptake of SP + AS in Rufiji was rapid and sustained. Although some SP monotherapy occurred, AS monotherapy was rare, and most received the correct dose of both drugs. These results suggest that implementation of an artemisinin combination therapy, accompanied by training, job aids and assistance in stock management, can rapidly increase access to effective antimalarial treatment.
OBJECTIVE: To assess the degree to which policy changes to artemisinin-based combination therapies (ACTs) as first-line treatment for uncomplicated malaria translate into effective ACT delivery. METHODS: Prospective observational study of drug dispensing practices at baseline and during the 3 years following introduction of ACT with sulfadoxine-pyrimethamine (SP) plus artesunate (AS) in Rufiji District, compared with two neighbouring districts where SP monotherapy remained the first-line treatment, was carried out. Demographic and dispensing data were collected from all patients at the dispensing units of selected facilities for 1 month per quarter, documenting a total of 271, 953 patient encounters in the three districts. RESULTS: In Rufiji, the proportion of patients who received a clinical diagnosis of malaria increased from 47.6% to 57.0%. A majority (75.9%) of these received SP + AS during the intervention period. Of patients who received SP + AS, 94.6% received the correct dose of both. Among patients in Rufiji who received SP, 14.2% received SP monotherapy, and among patients who received AS, 0.3% received AS monotherapy. CONCLUSIONS: The uptake of SP + AS in Rufiji was rapid and sustained. Although some SP monotherapy occurred, AS monotherapy was rare, and most received the correct dose of both drugs. These results suggest that implementation of an artemisinin combination therapy, accompanied by training, job aids and assistance in stock management, can rapidly increase access to effective antimalarial treatment.
Authors: Rashid A Khatib; Jacek Skarbinski; Joseph D Njau; Catherine A Goodman; Berty F Elling; Elizeus Kahigwa; Jacquelin M Roberts; John R MacArthur; Julie R Gutman; Abdunoor M Kabanywanyi; Ernest E Smith; Masha F Somi; Thomas Lyimo; Alex Mwita; Blaise Genton; Marcel Tanner; Anne Mills; Hassan Mshinda; Peter B Bloland; Salim M Abdulla; S Patrick Kachur Journal: Malar J Date: 2012-04-30 Impact factor: 2.979
Authors: Andrew Nyandigisi; Dorothy Memusi; Agneta Mbithi; Newton Ang'wa; Mildred Shieshia; Alex Muturi; Raymond Sudoi; Sophie Githinji; Elizabeth Juma; Dejan Zurovac Journal: PLoS One Date: 2011-09-14 Impact factor: 3.240
Authors: David Sears; Ruth Kigozi; Arthur Mpimbaza; Stella Kakeeto; Asadu Sserwanga; Sarah G Staedke; Michelle Chang; Bryan K Kapella; Denis Rubahika; Moses R Kamya; Grant Dorsey Journal: Malar J Date: 2013-07-19 Impact factor: 2.979