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