Malaria case-management under artemether-lumefantrine treatment policy in Uganda

Zurovac, Dejan; Tibenderana, James; Nankabirwa, Joan; Ssekitooleko, James; Njogu, Julius; Rwakimari, John Bosco; Meek, Sylvia; Talisuna, Ambrose; Snow, Robert W.

doi:10.1186/1475-2875-7-181

Cited by 101 publications

(129 citation statements)

References 24 publications

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“…50 Malaria control efforts in Apac were not reliably monitored in the last decade and affected by political unrest in preceding years. The ACTs were officially available in Apac from the year 2006, but especially the smaller health facilities were affected by supply shortages that affected their implementation 51 ; recently, malaria initiatives in Apac have been intensified. Indoor residual spraying (IRS) with DDT was banned in Apac in 2008 by a court injunction launched by organic famers, 52 but IRS with pyrethroids (Fendona, BASF, Midrand, South Africa) started again in May 2010 (i.e., after the current survey was completed).…”

Section: Discussionmentioning

confidence: 99%

Continuing Intense Malaria Transmission in Northern Uganda

Proietti¹,

Pettinato²,

Kanoi³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. Recent reports of reductions in malaria transmission in several African countries have resulted in optimism that malaria can be eliminated in parts of Africa where it is currently endemic. It is not known whether these trends are global or whether they are also present in areas where political instability has hindered effective malaria control. We determined malaria parasite carriage and age-dependent antibody responses to Plasmodium falciparum antigens in cross-sectional surveys in Apac, northern Uganda that was affected by political unrest. Under-five parasite prevalence was 55.8% (115/206) by microscopy and 71.9% (41/57) by polymerase chain reaction. Plasmodium ovale alone, or as a co-infection, was detected in 8.6% (12/139) and Plasmodium malariae in 4.3% (6/139) of the infections. Age seroprevalence curves gave no indication of recent changes in malaria transmission intensity. Malaria control remains a tremendous challenge in areas that have not benefited from large-scale interventions, illustrated here by the district of Apac.

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Section: Discussionmentioning

confidence: 99%

Continuing Intense Malaria Transmission in Northern Uganda

Proietti¹,

Pettinato²,

Kanoi³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…These include inadequate supplies of the recommended drugs 25 and inadequate training of the prescribers. 26,27 An in-depth understanding of all these issues is essential for the generation of information to improve malaria case management in Swaziland.…”

Section: S6mentioning

confidence: 99%

Case management of malaria in Swaziland, 2011–2015: on track for elimination?

Dlamini

Kosgei

Mkhonta

et al. 2018

public health action

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“…Similar availability problems have been experienced elsewhere in sub-Saharan Africa. 9,10 The international community responded promptly to calls to replace failing medicines but now must turn its attention to failures in supply to fix problems of access and effectiveness of ACT policies in Africa. Lessons should be learned from the recent Kenyan experience.…”

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confidence: 99%

Malaria Drug Shortages in Kenya: A Major Failure to Provide Access to Effective Treatment

Kangwana¹,

Memusi²,

Snow³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

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Abstract. A key bench mark of successful therapeutic policy implementation, and thus effectiveness, is that the recommended drugs are available at the point of care. Two years after artemether-lumefathrine (AL) was introduced for the management of uncomplicated malaria in Kenya, we carried out a cross-sectional survey to investigate AL availability in government facilities in seven malaria-endemic districts. One of four of the surveyed facilities had none of the four AL weight-specific treatment packs in stock; three of four facilities were out of stock of at least one weight-specific AL pack, leading health workers to prescribe a range of inappropriate alternatives. The shortage was in large part caused by a delayed procurement process. National ministries of health and the international community must address the current shortcomings facing antimalarial drug supply to the public sector.The widespread failure of chloroquine and sulfadoxine pyrimethamine (SP) in the treatment of malaria in Africa during the late 1990s resulted in a turbulent public health debate, which led to universal acceptance that mono-therapies that failed to cure up to one in four patients should be replaced by highly efficacious artemisinin-based combination therapy (ACT). 1-3 More than 40 countries in Africa have now adopted ACT as their first line treatment recommendation for uncomplicated malaria. 4 Beyond the difficulties of changing national treatment policies, a key bench mark of successful policy implementation, and thus effectiveness, is that the recommended drugs are available at the point of care. [5][6][7] In most countries, ACTs are supplied only to the public, formal health sector managed by the government and its mission sector partners. In 2006, Kenya implemented a change in malaria treatment policy in all public facilities from SP to the ACT artemetherlumefantrine (AL), largely supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). 7 Two years after AL introduction, we carried out a crosssectional survey to investigate AL availability in government facilities. From August 18 through October 2, 2008, 164 facilities (115 dispensaries, 30 health centers, and 19 hospitals) were assessed in seven districts in Nyanza, Western, and Coast Provinces, Kenya, that were highly endemic for malaria. At each facility, information was collected on the availability of AL packs for the four patient weight groups either through direct review of stock cards or through phone interviews. Health workers were also asked what they prescribed in the absence of AL.One (25.6%) of four of the surveyed facilities had none of the four AL weight-specific treatment packs in stock, with such complete stockouts more common in dispensaries (30.4%) than in health centers (20.0%) and hospitals (5.3%). Furthermore, three (75.0%) of four facilities were out of stock of at least one weight-specific AL pack (Table 1 ). It was particularly worrying that packs for the youngest age group, the group most at risk of malaria mortality, were absent...

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Malaria case-management under artemether-lumefantrine treatment policy in Uganda

Cited by 101 publications

References 24 publications

Continuing Intense Malaria Transmission in Northern Uganda

Continuing Intense Malaria Transmission in Northern Uganda

Case management of malaria in Swaziland, 2011–2015: on track for elimination?

Malaria Drug Shortages in Kenya: A Major Failure to Provide Access to Effective Treatment

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