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Adherence to artemether/lumefantrine treatment in children under real-life situations in rural Tanzania.
Trans R Soc Trop Med Hyg. 2012 Jan; 106(1):3-9.TR

Abstract

A follow-up study was conducted to determine the magnitude of and factors related to adherence to artemether/lumefantrine (ALu) treatment in rural settings in Tanzania. Children in five villages of Kilosa District treated at health facilities were followed-up at their homes on Day 7 after the first dose of ALu. For those found to be positive using a rapid diagnostic test for malaria and treated with ALu, their caretakers were interviewed on drug administration habits. In addition, capillary blood samples were collected on Day 7 to determine lumefantrine concentrations. The majority of children (392/444; 88.3%) were reported to have received all doses, in time. Non-adherence was due to untimeliness rather than missing doses and was highest for the last two doses. No significant difference was found between blood lumefantrine concentrations among adherent (median 286 nmol/l) and non-adherent [median 261 nmol/l; range 25 nmol/l (limit of quantification) to 9318 nmol/l]. Children from less poor households were more likely to adhere to therapy than the poor [odds ratio (OR)=2.45, 95% CI 1.35-4.45; adjusted OR=2.23, 95% CI 1.20-4.13]. The high reported rate of adherence to ALu in rural areas is encouraging and needs to be preserved to reduce the risk of emergence of resistant strains. The age-based dosage schedule and lack of adherence to ALu treatment guidelines by health facility staff may explain both the huge variability in observed lumefantrine concentrations and the lack of difference in concentrations between the two groups.

Authors+Show Affiliations

Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. dsimba@muhas.ac.tzNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22099005

Citation

Simba, Daudi O., et al. "Adherence to Artemether/lumefantrine Treatment in Children Under Real-life Situations in Rural Tanzania." Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 106, no. 1, 2012, pp. 3-9.
Simba DO, Kakoko D, Tomson G, et al. Adherence to artemether/lumefantrine treatment in children under real-life situations in rural Tanzania. Trans R Soc Trop Med Hyg. 2012;106(1):3-9.
Simba, D. O., Kakoko, D., Tomson, G., Premji, Z., Petzold, M., Mahindi, M., & Gustafsson, L. L. (2012). Adherence to artemether/lumefantrine treatment in children under real-life situations in rural Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene, 106(1), 3-9. https://doi.org/10.1016/j.trstmh.2011.09.006
Simba DO, et al. Adherence to Artemether/lumefantrine Treatment in Children Under Real-life Situations in Rural Tanzania. Trans R Soc Trop Med Hyg. 2012;106(1):3-9. PubMed PMID: 22099005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adherence to artemether/lumefantrine treatment in children under real-life situations in rural Tanzania. AU - Simba,Daudi O, AU - Kakoko,Deodatus, AU - Tomson,Goran, AU - Premji,Zul, AU - Petzold,Max, AU - Mahindi,Margarita, AU - Gustafsson,Lars L, Y1 - 2011/11/17/ PY - 2010/11/15/received PY - 2011/09/12/revised PY - 2011/09/12/accepted PY - 2011/11/22/entrez PY - 2011/11/22/pubmed PY - 2012/2/7/medline SP - 3 EP - 9 JF - Transactions of the Royal Society of Tropical Medicine and Hygiene JO - Trans R Soc Trop Med Hyg VL - 106 IS - 1 N2 - A follow-up study was conducted to determine the magnitude of and factors related to adherence to artemether/lumefantrine (ALu) treatment in rural settings in Tanzania. Children in five villages of Kilosa District treated at health facilities were followed-up at their homes on Day 7 after the first dose of ALu. For those found to be positive using a rapid diagnostic test for malaria and treated with ALu, their caretakers were interviewed on drug administration habits. In addition, capillary blood samples were collected on Day 7 to determine lumefantrine concentrations. The majority of children (392/444; 88.3%) were reported to have received all doses, in time. Non-adherence was due to untimeliness rather than missing doses and was highest for the last two doses. No significant difference was found between blood lumefantrine concentrations among adherent (median 286 nmol/l) and non-adherent [median 261 nmol/l; range 25 nmol/l (limit of quantification) to 9318 nmol/l]. Children from less poor households were more likely to adhere to therapy than the poor [odds ratio (OR)=2.45, 95% CI 1.35-4.45; adjusted OR=2.23, 95% CI 1.20-4.13]. The high reported rate of adherence to ALu in rural areas is encouraging and needs to be preserved to reduce the risk of emergence of resistant strains. The age-based dosage schedule and lack of adherence to ALu treatment guidelines by health facility staff may explain both the huge variability in observed lumefantrine concentrations and the lack of difference in concentrations between the two groups. SN - 1878-3503 UR - https://www.unboundmedicine.com/medline/citation/22099005/Adherence_to_artemether/lumefantrine_treatment_in_children_under_real_life_situations_in_rural_Tanzania_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0035-9203(11)00191-X DB - PRIME DP - Unbound Medicine ER -