Decreased availability of antimalarials in the private sector following the policy change from chloroquine to sulphadoxine-pyrimethamine in the Kilombero Valley, Tanzania
2006

Impact of Changing Malaria Treatment Policy in Tanzania

Sample size: 758 publication 15 minutes Evidence: moderate

Author Information

Author(s): Hetzel Manuel W, Msechu June J, Goodman Catherine, Lengeler Christian, Obrist Brigit, Kachur S Patrick, Makemba Ahmed, Nathan Rose, Schulze Alexander, Mshinda Hassan

Primary Institution: Swiss Tropical Institute

Hypothesis

How did the policy change from chloroquine to sulphadoxine-pyrimethamine affect the availability of antimalarials in Tanzania?

Conclusion

The switch to sulphadoxine-pyrimethamine improved treatment efficacy but significantly reduced the availability of antimalarials in the study area.

Supporting Evidence

  • From 2001 to 2004, the number of general shops stocking drugs increased by 15%.
  • The proportion of general shops stocking antimalarials dropped markedly, resulting in an almost 50% decrease of antimalarial selling outlets.
  • In 2004, five out of 25 studied villages had neither a health facility nor a shop as a source of malaria treatment.
  • Despite the increase in drug stores, the overall access to antimalarials decreased significantly.

Takeaway

When Tanzania changed its main malaria medicine, it became harder for people to find the medicine they needed, even though the new medicine worked better.

Methodology

Surveys of drug-selling outlets were conducted in 2001 and 2004 to assess the availability of antimalarials.

Potential Biases

Potential bias in self-reported data from shopkeepers regarding stock levels and customer demand.

Limitations

The study only captures a snapshot of drug availability at specific times and does not account for seasonal variations.

Participant Demographics

The study involved commercial outlets in rural and semi-urban areas of Kilombero and Ulanga Districts, Tanzania.

Statistical Information

P-Value

<0.001

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1475-2875-5-109

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