Effectiveness of Artemisinin-based Combination Therapy for Home Management of Malaria
Author Information
Author(s): Ajayi Ikeoluwapo O, Browne Edmund N, Bateganya Fred, Yar Denis, Happi Christian, Falade Catherine O, Gbotosho Grace O, Yusuf Bidemi, Boateng Samuel, Mugittu Kefas, Cousens Simon, Nanyunja Miriam, Pagnoni Franco
Primary Institution: Malaria Research Laboratories, Institute of Medical Research and Training, College of Medicine, University of Ibadan, Nigeria
Hypothesis
The study evaluates the parasitological effectiveness of artemisinin-based combination therapy (ACT) when dispensed by community medicine distributors and used unsupervised by caregivers at home.
Conclusion
The study provides encouraging data on the parasitological outcomes of children treated with ACT in the context of home management of malaria.
Supporting Evidence
- The crude parasitological failure rate varied from 3.7% in Uganda to 41.8% in Nigeria.
- The PCR adjusted parasitological cure rate was greater than 90% in all sites.
- Reported adherence to correct treatment varied from 81% in Uganda to 97% in Ghana.
Takeaway
This study shows that giving malaria treatment at home can work well, especially when caregivers follow the instructions correctly.
Methodology
The study involved a multi-centre evaluation of children aged 6 to 59 months with fever, assessing the effectiveness of ACT administered by community medicine distributors.
Potential Biases
Potential recall bias in caregiver reports of adherence and selection bias in follow-up reporting.
Limitations
Follow-up rates were low, and adherence was based on caregiver recall, which may introduce bias.
Participant Demographics
Children aged 6 to 59 months presenting with fever in rural areas of Ghana, Nigeria, and Uganda.
Statistical Information
P-Value
p<0.001
Confidence Interval
C.I. 1.2%–6.2% for Uganda; C.I. 35%–49% for Nigeria; C.I. 86%–95% for PCR adjusted cure rate in Nigeria.
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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