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The malaria testing and treatment landscape in the southern Lao People's Democratic Republic (PDR).
Malar J. 2017 04 25; 16(1):169.MJ

Abstract

BACKGROUND

In the context of national and regional goals to eliminate malaria by 2030, the Center for Malaria Parasitology and Entomology in the Lao PDR is implementing strategies to ensure all malaria cases are detected and appropriately treated with first-line artemisinin combination therapy, artemether-lumefantrine (AL). Timely and relevant evidence to inform policies and strategies is needed to ensure the most effective and efficient use of resources, and to accelerate progress towards elimination goals. A 2015 outlet survey conducted in five provinces of the southern Lao PDR was the first of its kind to study the total market for malaria treatments and diagnostics. The sub-national outlet survey was designed to describe the market and to assess public and private sector readiness and performance for malaria case management. Additionally, key indicators were estimated among private outlets within districts with and without a Public Private Mix (PPM) programme.

RESULTS

Over half of anti-malarial stockists were public sector (65.1%). In the private sector, pharmacies most commonly stocked anti-malarials, although anti-malarials were also found in private health facilities, drug stores, general retailers, and itinerant drug vendors. Nearly all anti-malarial stocking public health facilities had AL (99.5%) and 90.8% had confirmatory testing. Fewer than half of anti-malarial stocking private outlets stocked AL (40.8%) and malaria testing (43.5%). Chloroquine has not been a first-line treatment for Plasmodium falciparum malaria since 2005 and Plasmodium vivax since 2011 yet private sector availability was 77.6% and chloroquine accounted for 62.2% of the total anti-malarial market share. AL and confirmatory testing availability were higher in private outlets in PPM (68.1, 72.6%) versus non-PPM districts (2.5, 12.1%). Chloroquine was available in 63.6% of PPM and 96.7% of non-PPM-district outlets, and was the most commonly distributed anti-malarial among private outlets in both PPM (61.7%) and non-PPM districts (99.1%).

CONCLUSIONS

Public sector outlets in the southern Lao PDR are typically equipped to test and appropriately treat malaria. There is need to address widespread private sector availability and distribution of chloroquine. The PPM programme has improved private provider readiness to manage malaria according to national guidelines. However, supporting interventions to address provider and consumer behaviours are needed to further drive uptake.

Authors+Show Affiliations

No affiliation info availablePopulation Services International, PSI Lao PDR, T4 Road, Unit 61, Donkoi Village, Sisattanak District, Vientiane, Lao People's Democratic Republic. sphanalasy@psilaos.org.

Pub Type(s)

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

Language

eng

PubMed ID

28438155

Citation

ACTwatch Group, and Saysana Phanalasy. "The Malaria Testing and Treatment Landscape in the Southern Lao People's Democratic Republic (PDR)." Malaria Journal, vol. 16, no. 1, 2017, p. 169.
ACTwatch Group, Phanalasy S. The malaria testing and treatment landscape in the southern Lao People's Democratic Republic (PDR). Malar J. 2017;16(1):169.
Phanalasy, S. (2017). The malaria testing and treatment landscape in the southern Lao People's Democratic Republic (PDR). Malaria Journal, 16(1), 169. https://doi.org/10.1186/s12936-017-1769-0
ACTwatch Group, Phanalasy S. The Malaria Testing and Treatment Landscape in the Southern Lao People's Democratic Republic (PDR). Malar J. 2017 04 25;16(1):169. PubMed PMID: 28438155.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The malaria testing and treatment landscape in the southern Lao People's Democratic Republic (PDR). AU - ,, AU - Phanalasy,Saysana, Y1 - 2017/04/25/ PY - 2016/12/07/received PY - 2017/03/08/accepted PY - 2017/4/26/entrez PY - 2017/4/26/pubmed PY - 2018/1/20/medline KW - ACT KW - Anti-malarial KW - Case management KW - Chloroquine KW - Lao PDR KW - Private sector KW - Public private mix SP - 169 EP - 169 JF - Malaria journal JO - Malar J VL - 16 IS - 1 N2 - BACKGROUND: In the context of national and regional goals to eliminate malaria by 2030, the Center for Malaria Parasitology and Entomology in the Lao PDR is implementing strategies to ensure all malaria cases are detected and appropriately treated with first-line artemisinin combination therapy, artemether-lumefantrine (AL). Timely and relevant evidence to inform policies and strategies is needed to ensure the most effective and efficient use of resources, and to accelerate progress towards elimination goals. A 2015 outlet survey conducted in five provinces of the southern Lao PDR was the first of its kind to study the total market for malaria treatments and diagnostics. The sub-national outlet survey was designed to describe the market and to assess public and private sector readiness and performance for malaria case management. Additionally, key indicators were estimated among private outlets within districts with and without a Public Private Mix (PPM) programme. RESULTS: Over half of anti-malarial stockists were public sector (65.1%). In the private sector, pharmacies most commonly stocked anti-malarials, although anti-malarials were also found in private health facilities, drug stores, general retailers, and itinerant drug vendors. Nearly all anti-malarial stocking public health facilities had AL (99.5%) and 90.8% had confirmatory testing. Fewer than half of anti-malarial stocking private outlets stocked AL (40.8%) and malaria testing (43.5%). Chloroquine has not been a first-line treatment for Plasmodium falciparum malaria since 2005 and Plasmodium vivax since 2011 yet private sector availability was 77.6% and chloroquine accounted for 62.2% of the total anti-malarial market share. AL and confirmatory testing availability were higher in private outlets in PPM (68.1, 72.6%) versus non-PPM districts (2.5, 12.1%). Chloroquine was available in 63.6% of PPM and 96.7% of non-PPM-district outlets, and was the most commonly distributed anti-malarial among private outlets in both PPM (61.7%) and non-PPM districts (99.1%). CONCLUSIONS: Public sector outlets in the southern Lao PDR are typically equipped to test and appropriately treat malaria. There is need to address widespread private sector availability and distribution of chloroquine. The PPM programme has improved private provider readiness to manage malaria according to national guidelines. However, supporting interventions to address provider and consumer behaviours are needed to further drive uptake. SN - 1475-2875 UR - https://www.unboundmedicine.com/medline/citation/28438155/The_malaria_testing_and_treatment_landscape_in_the_southern_Lao_People's_Democratic_Republic__PDR__ L2 - https://malariajournal.biomedcentral.com/articles/10.1186/s12936-017-1769-0 DB - PRIME DP - Unbound Medicine ER -