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

Kangwana, Beth; Kedenge, Sarah V.; Noor, Abdisalan M.; Alegana, Victor A.; Nyandigisi, Andrew; Pandit, Jayesh; Fegan, Greg; Todd, Jim; Brooker, Simon; Snow, Robert W.; Goodman, Catherine

doi:10.1371/journal.pmed.1000437

Cited by 64 publications

(115 citation statements)

References 35 publications

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“…Out of the 1,813 potential articles, 16 fulfilled the inclusion criteria ( Figure 1) [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] and comprised a total of 9,247 patients. Of these, two studies included two different interventions.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies (62.5%) were undertaken in Africa [20][21][22][23][24][25][26]29,31,32 and the remainder were set in Asia. [17][18][19]27,28,30 All the studies were based in the public healthcare sectors (12 in a hospital 17,19 -22,24 -31 and 4 in a community setting) 18,23,25,32 but one study also included a group from the private sector. 32 Eight studies (50.0%) investigated the impact of adherence promoting intervention on children or their mothers/ caregivers.…”

Section: Resultsmentioning

confidence: 99%

“…[17][18][19]27,28,30 All the studies were based in the public healthcare sectors (12 in a hospital 17,19 -22,24 -31 and 4 in a community setting) 18,23,25,32 but one study also included a group from the private sector. 32 Eight studies (50.0%) investigated the impact of adherence promoting intervention on children or their mothers/ caregivers. 20,22,23,25,26,29,31,32 The other studies enrolled adults or patients at all ages.…”

Section: Resultsmentioning

confidence: 99%

“…20,22,23,25,26,29,31,32 The other studies enrolled adults or patients at all ages. [17][18][19]21,24,27,28,30 In 14 studies (87.5%), the patients were infected with falciparum malaria [18][19][20][21][22][23][24][25][26][27][28][29]31,32 and the remaining studies used patients with vivax malaria. 17,30 Six studies (37.5%) used chloroquine, [20][21][22][23][24][25] five studies (31.2%) used artemisinin-based combination therapy (ACT).…”

Section: Resultsmentioning

confidence: 99%

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Intervention to Promote Patients' Adherence to Antimalarial Medication: A Systematic Review

Fuangchan

Dhippayom

Kongkaew³

2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Non-adherence as a major contributor to poor treatment outcomes. This study aimed to explore the effectiveness of existing interventions promoting adherence to antimalarial drugs by systematic review. The following databases were used to identify potential articles: MEDLINE, EMBASE, the Cochrane CENTRAL, and CINAHL (through March 2013). From 1,813 potential papers identified, 16 studies met the selection criteria comprising 9,247 patients. Interventions were classified as packaging aids, visual media, combined visual media and verbal information, community education, medication supervision, and convenient regimen. These interventions were shown to increase adherence to antimalarial drugs (median relative risk = 1.4, interquartile range 1.2-2.0). Although a most effective intervention did not emerge, community education and visual media/verbal information combinations may well have most potential to improve adherence to antimalarial medication. These interventions should be implemented in combination to optimize their beneficial effects. The current understanding on improved adherence would facilitate to contain outbreaks of malaria cost effectively.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Intervention to Promote Patients' Adherence to Antimalarial Medication: A Systematic Review

Fuangchan

Dhippayom

Kongkaew³

2014

The American Society of Tropical Medicine and Hygiene

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“…Strategies of engagement with the private sector in Kenya and Tanzania have shown to be effective at increasing child take-up of malaria medication. 36,37 Similar strategies should be pursued for ORT.…”

Section: Discussionmentioning

confidence: 99%

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

Sood

Wagner²

2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13-17) than public providers and 12% points more likely to provide other treatments (95% CI 10-15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored.

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Adding rapid diagnostic tests to community-based programmes for treating malaria

Allen

Wiyeh

McCaul

2022

Cochrane Database of Systematic Reviews

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Background The World Health Organization (WHO) recommends parasitological testing of all suspected malaria cases using malaria rapid diagnostic tests (mRDTs) or microscopy prior to treatment. Some governments have extended this responsibility to community health workers (CHWs) to reduce malaria morbidity and mortality through prompt and appropriate treatment. This is an update of a Cochrane Review first published in 2013. Objectives To evaluate community‐based management strategies for treating malaria or fever that incorporate both a definitive diagnosis with an mRDT and appropriate antimalarial treatment. Search methods We searched CENTRAL, MEDLINE, Embase, five other databases, and three trials registers up to 14 September 2021. Selection criteria We included individually randomized trials and cluster‐randomized controlled trials (cRCTs), controlled before‐after studies, and controlled interrupted time series studies in people living in malaria‐endemic areas, comparing programmes that train CHWs and drug shop vendors to perform mRDTs and provide appropriate treatment versus similar programmes that do not use mRDTs, and versus routine health facility care. Data collection and analysis We used standard Cochrane methods. For each dichotomous outcome, we extracted the number of participants with the event and the total number of participants in each group, unless studies presented results at a population level only. Primary outcomes were all‐cause mortality, hospitalizations, and number of people receiving an antimalarial within 24 hours. Secondary outcomes were malaria‐specific mortality, severe malaria, outcomes related to antimalarial treatments, antibiotic prescribing to people with a negative microscopy or polymerase chain reaction (PCR) result, parasitaemia, anaemia, and all adverse events. Main results We included eight studies from several African countries, Afghanistan, and Myanmar. Staff included CHWs and drug shop vendors. Community use of malaria rapid diagnostic tests compared to clinical diagnosis Compared to clinical diagnosis, mRDT diagnosis results in reduced prescribing of antimalarials to people who are found to be malaria parasite‐negative by microscopy or PCR testing (71 fewer per 100 people, 95% confidence interval (CI) 79 to 51 fewer; risk ratio (RR) 0.17, 95% CI 0.07 to 0.40; 3 cRCTs, 7877 participants; moderate‐certainty evidence). This reduction may be greater among CHWs compared to drug shop vendors. People diagnosed by mRDT are more likely to receive appropriate treatment; that is, an antimalarial if they are microscopy‐ or PCR‐positive and no antimalarial if they are microscopy‐ or PCR‐negative (RR 3.04, 95% CI 2.46 to 3.74, 3 cRCTs, 9332 participants; high‐certainty evidence). Three studies found that a small percentage of people with a negative mRDT result (as read by the CHW ...

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

Abstract: In a cluster randomized trial, Beth Kangwana and colleagues find that provision of subsidized packs of the malaria therapy artemether-lumefantrine to shops more than doubled the proportion of children with fever who received drugs promptly.

Cited by 64 publications

References 35 publications

Intervention to Promote Patients' Adherence to Antimalarial Medication: A Systematic Review

Intervention to Promote Patients' Adherence to Antimalarial Medication: A Systematic Review

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

Adding rapid diagnostic tests to community-based programmes for treating malaria

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