The Impact of Retail-Sector Delivery of Artemether–Lumefantrine on Malaria Treatment of Children under Five in Kenya: A Cluster Randomized Controlled Trial
2011

Impact of Retail-Sector Delivery of Artemether–Lumefantrine on Malaria Treatment in Kenya

Sample size: 2749 publication 10 minutes Evidence: high

Author Information

Author(s): Kangwana Beth P., Kedenge Sarah V., Noor Abdisalan M., Alegana Victor A., Nyandigisi Andrew J., Pandit Jayesh, Fegan Greg W., Todd James E., Brooker Simon, Snow Robert W., Goodman Catherine A.

Primary Institution: Kenya Medical Research Institute - Wellcome Trust Research Programme

Hypothesis

Does providing subsidized artemether-lumefantrine through retail providers improve malaria treatment coverage for children under five in Kenya?

Conclusion

Subsidizing ACT in the retail sector can significantly increase ACT coverage for reported fevers in rural areas.

Supporting Evidence

  • 29% of children experienced fever within 2 weeks before the interview.
  • At follow-up, the percentage of children receiving AL on the day of fever or the following day had risen by 40.2% points in the intervention arm.
  • The intervention more than doubled the proportion of children with fever who received AL promptly.
  • Subsidized AL was stocked by 37.6% of outlets in the intervention arm at follow-up.

Takeaway

This study shows that giving cheaper malaria medicine in shops helps more kids get treated quickly when they have a fever.

Methodology

A cluster-randomized controlled trial with cross-sectional household surveys conducted before and after the intervention.

Potential Biases

Potential bias due to contamination between intervention and control groups.

Limitations

The study's findings may not be generalizable to other settings and the intervention only achieved prompt ACT uptake in 44.9% of children with fever.

Participant Demographics

Children aged 3–59 months in rural Kenya.

Statistical Information

P-Value

0.0001

Confidence Interval

95% CI: 14.1%, 35.9%

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pmed.1000437

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