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    Jan 16, 2021
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    Adherence to the combination of sulphadoxine-pyrimethamine and artesunate in the Maheba refugee settlement, Zambia.

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    Authors
    Depoortere, E
    Guthmann, J P
    Sipilanyambe, N
    Nkandu, E
    Fermon, F
    Balkan, S
    Legros, D
    Affiliation
    Epicentre, Paris, France. evelyn.depoortere@msf.be
    Issue Date
    2004-01
    
    Metadata
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    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.
    Publisher
    Wiley-Blackwell
    URI
    http://hdl.handle.net/10144/16796
    PubMed ID
    14728608
    Additional Links
    http://www.blackwell-synergy.com/loi/tmi
    Language
    en
    ISSN
    1360-2276
    Collections
    Malaria

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