Tags

Type your tag names separated by a space and hit enter

Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dar es Salaam, Tanzania.
Malar J. 2010 Feb 26; 9:61.MJ

Abstract

BACKGROUND

New malaria treatment guidelines in Tanzania have led to the large-scale deployment of artemether-lumefantrine (Coartem), popularly known as ALu or dawa mseto. Very little is known about how people in malaria endemic areas interpret policy makers' decision to replace existing anti-malarials, such as sulphadoxine-pyrimethamine (SP) with "new" treatment regimens, such as ALu or other formulations of ACT. This study was conducted to examine community level understandings and interpretations of ALu's efficacy and side-effects. The paper specifically examines the perceived efficacy of ALu as articulated by the mothers of young children diagnosed with malaria and prescribed ALu.

METHODS

Participant observation, six focus group discussions in two large villages, followed by interviews with a random sample of 110 mothers of children less than five years of age, who were diagnosed with malaria and prescribed ALu. Additionally, observations were conducted in two village dispensaries involving interactions between mothers/caretakers and health care providers.

RESULTS

While more than two-thirds of the mothers had an overall negative disposition toward SP, 97.5% of them spoke favourably about ALu, emphasizing it's ability to help their children to rapidly recover from malaria, without undesirable side-effects. 62.5% of the mothers reported that they were spending less money dealing with malaria than previously when their child was treated with SP. 88% of the mothers had waited for 48 hours or more after the onset of fever before taking their child to the dispensary. Mothers' knowledge and reporting of ALu's dosage was, in many cases, inconsistent with the recommended dosage schedule for children.

CONCLUSION

Deployment of ALu has significantly changed community level perceptions of anti-malarial treatment. However, mothers continue to delay seeking care before accessing ALu, limiting the impact of highly subsidized rollout of the drug. Implementation of ACT-based treatment guidelines must be complemented with educational campaigns to insure that mothers seek prompt help for their children within 24 hours of the onset of fever. Improved communication between health care providers and mothers of sick children can facilitate better adherence to ALu's recommended dosage. Community level interpretations of anti-malarials are multifaceted; integrating knowledge of local beliefs and practices surrounding consumption of anti-malarials into programmatic goals can help to significantly improve malaria control interventions.

Authors+Show Affiliations

Department of Anthropology, University of British Columbia, Vancouver, Canada. kamatvin@interchange.ubc.caNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20187949

Citation

Kamat, Vinay R., and Daniel J. Nyato. "Community Response to Artemisinin-based Combination Therapy for Childhood Malaria: a Case Study From Dar Es Salaam, Tanzania." Malaria Journal, vol. 9, 2010, p. 61.
Kamat VR, Nyato DJ. Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dar es Salaam, Tanzania. Malar J. 2010;9:61.
Kamat, V. R., & Nyato, D. J. (2010). Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dar es Salaam, Tanzania. Malaria Journal, 9, 61. https://doi.org/10.1186/1475-2875-9-61
Kamat VR, Nyato DJ. Community Response to Artemisinin-based Combination Therapy for Childhood Malaria: a Case Study From Dar Es Salaam, Tanzania. Malar J. 2010 Feb 26;9:61. PubMed PMID: 20187949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dar es Salaam, Tanzania. AU - Kamat,Vinay R, AU - Nyato,Daniel J, Y1 - 2010/02/26/ PY - 2009/11/13/received PY - 2010/02/26/accepted PY - 2010/3/2/entrez PY - 2010/3/2/pubmed PY - 2010/4/14/medline SP - 61 EP - 61 JF - Malaria journal JO - Malar J VL - 9 N2 - BACKGROUND: New malaria treatment guidelines in Tanzania have led to the large-scale deployment of artemether-lumefantrine (Coartem), popularly known as ALu or dawa mseto. Very little is known about how people in malaria endemic areas interpret policy makers' decision to replace existing anti-malarials, such as sulphadoxine-pyrimethamine (SP) with "new" treatment regimens, such as ALu or other formulations of ACT. This study was conducted to examine community level understandings and interpretations of ALu's efficacy and side-effects. The paper specifically examines the perceived efficacy of ALu as articulated by the mothers of young children diagnosed with malaria and prescribed ALu. METHODS: Participant observation, six focus group discussions in two large villages, followed by interviews with a random sample of 110 mothers of children less than five years of age, who were diagnosed with malaria and prescribed ALu. Additionally, observations were conducted in two village dispensaries involving interactions between mothers/caretakers and health care providers. RESULTS: While more than two-thirds of the mothers had an overall negative disposition toward SP, 97.5% of them spoke favourably about ALu, emphasizing it's ability to help their children to rapidly recover from malaria, without undesirable side-effects. 62.5% of the mothers reported that they were spending less money dealing with malaria than previously when their child was treated with SP. 88% of the mothers had waited for 48 hours or more after the onset of fever before taking their child to the dispensary. Mothers' knowledge and reporting of ALu's dosage was, in many cases, inconsistent with the recommended dosage schedule for children. CONCLUSION: Deployment of ALu has significantly changed community level perceptions of anti-malarial treatment. However, mothers continue to delay seeking care before accessing ALu, limiting the impact of highly subsidized rollout of the drug. Implementation of ACT-based treatment guidelines must be complemented with educational campaigns to insure that mothers seek prompt help for their children within 24 hours of the onset of fever. Improved communication between health care providers and mothers of sick children can facilitate better adherence to ALu's recommended dosage. Community level interpretations of anti-malarials are multifaceted; integrating knowledge of local beliefs and practices surrounding consumption of anti-malarials into programmatic goals can help to significantly improve malaria control interventions. SN - 1475-2875 UR - https://www.unboundmedicine.com/medline/citation/20187949/Community_response_to_artemisinin_based_combination_therapy_for_childhood_malaria:_a_case_study_from_Dar_es_Salaam_Tanzania_ L2 - https://malariajournal.biomedcentral.com/articles/10.1186/1475-2875-9-61 DB - PRIME DP - Unbound Medicine ER -