Adherence to the combination of sulphadoxine-pyrimethamine and artesunate in the Maheba refugee settlement, Zambia.

Hdl Handle:
http://hdl.handle.net/10144/16796
Title:
Adherence to the combination of sulphadoxine-pyrimethamine and artesunate in the Maheba refugee settlement, Zambia.
Authors:
Depoortere, E; Guthmann, J P; Sipilanyambe, N; Nkandu, E; Fermon, F; Balkan, S; Legros, D
Journal:
Tropical Medicine & International Health
Abstract:
Artemisinin-based combination therapy (ACT) is one strategy recommended to increase cure rates in malaria and to contain resistance to Plasmodium falciparum. In the Maheba refugee settlement, children aged 5 years or younger with a confirmed diagnosis of uncomplicated falciparum malaria are treated with the combination of sulphadoxine-pyrimethamine (1 day) and artesunate (3 days). To measure treatment adherence, home visits were carried out the day after the last treatment dose. Patients who had any treatment dose left were considered certainly non-adherent. Other patients' classification was based on the answers to the questionnaire: patients whose caretakers stated the child had received the treatment regimen exactly as prescribed were considered probably adherent; all other patients were considered probably non-adherent. Reasons for non-adherence were assessed. We found 21.2% (95% CI [15.0-28.4]) of the patients to be certainly non-adherent, 39.4% (95% CI [31.6-47.6]) probably non-adherent, and 39.4% (95% CI [31.6-47.6]) probably adherent. Insufficient explanation by the dispenser was identified as an important reason for non-adherence. When considering the use of ACT, the issue of patient adherence remains challenging. However, it should not be used as an argument against the introduction of ACT. For these treatment regimens to remain efficacious on a long-term basis, specific and locally adapted strategies need to be implemented to ensure completion of the treatment.
Affiliation:
Epicentre, Paris, France. evelyn.depoortere@msf.be
Publisher:
Wiley-Blackwell
Issue Date:
Jan-2004
URI:
http://hdl.handle.net/10144/16796
PubMed ID:
14728608
Additional Links:
http://www.blackwell-synergy.com/loi/tmi
Language:
en
ISSN:
1360-2276
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorDepoortere, E-
dc.contributor.authorGuthmann, J P-
dc.contributor.authorSipilanyambe, N-
dc.contributor.authorNkandu, E-
dc.contributor.authorFermon, F-
dc.contributor.authorBalkan, S-
dc.contributor.authorLegros, D-
dc.date.accessioned2008-01-24T15:24:48Z-
dc.date.available2008-01-24T15:24:48Z-
dc.date.issued2004-01-
dc.identifier.citationAdherence to the combination of sulphadoxine-pyrimethamine and artesunate in the Maheba refugee settlement, Zambia. 2004, 9 (1):62-7 Trop. Med. Int. Healthen
dc.identifier.issn1360-2276-
dc.identifier.pmid14728608-
dc.identifier.urihttp://hdl.handle.net/10144/16796-
dc.description.abstractArtemisinin-based combination therapy (ACT) is one strategy recommended to increase cure rates in malaria and to contain resistance to Plasmodium falciparum. In the Maheba refugee settlement, children aged 5 years or younger with a confirmed diagnosis of uncomplicated falciparum malaria are treated with the combination of sulphadoxine-pyrimethamine (1 day) and artesunate (3 days). To measure treatment adherence, home visits were carried out the day after the last treatment dose. Patients who had any treatment dose left were considered certainly non-adherent. Other patients' classification was based on the answers to the questionnaire: patients whose caretakers stated the child had received the treatment regimen exactly as prescribed were considered probably adherent; all other patients were considered probably non-adherent. Reasons for non-adherence were assessed. We found 21.2% (95% CI [15.0-28.4]) of the patients to be certainly non-adherent, 39.4% (95% CI [31.6-47.6]) probably non-adherent, and 39.4% (95% CI [31.6-47.6]) probably adherent. Insufficient explanation by the dispenser was identified as an important reason for non-adherence. When considering the use of ACT, the issue of patient adherence remains challenging. However, it should not be used as an argument against the introduction of ACT. For these treatment regimens to remain efficacious on a long-term basis, specific and locally adapted strategies need to be implemented to ensure completion of the treatment.en
dc.language.isoenen
dc.publisherWiley-Blackwell-
dc.relation.urlhttp://www.blackwell-synergy.com/loi/tmi-
dc.rightsArchived on this site with the kind permission of Wiley-Blackwellen
dc.subject.meshAntimalarialsen
dc.subject.meshArtemisininsen
dc.subject.meshChild, Preschoolen
dc.subject.meshDrug Combinationsen
dc.subject.meshDrug Therapy, Combinationen
dc.subject.meshFamilyen
dc.subject.meshFemaleen
dc.subject.meshHealth Educationen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMalaria, Falciparumen
dc.subject.meshMaleen
dc.subject.meshPatient Complianceen
dc.subject.meshPyrimethamineen
dc.subject.meshQuestionnairesen
dc.subject.meshRefugeesen
dc.subject.meshSesquiterpenesen
dc.subject.meshSulfadoxineen
dc.subject.meshTreatment Refusalen
dc.subject.meshZambiaen
dc.titleAdherence to the combination of sulphadoxine-pyrimethamine and artesunate in the Maheba refugee settlement, Zambia.en
dc.contributor.departmentEpicentre, Paris, France. evelyn.depoortere@msf.been
dc.identifier.journalTropical Medicine & International Healthen

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