Abstract
BackgroundEthiopia has set a goal to eliminate malaria by 2030; Artemether–lumefantrine (AL) is put as one of the cornerstone strategies for uncomplicated plasmodium falciparum malaria treatment. However, only focusing on prescribing of the treatment without assessing patients’ adherence could lead to the resistance of the drug. In Ethiopia, there is limited evidence about patients’ adherence to AL and its influencing factors. Therefore, this study aimed at addressing this information gap.MethodsA health facility based cross-sectional study was employed. Participants were selected using simple random sampling technique from registration books of the public health facilities in AsgedeTsimbla. Data were collected from March 24th to April 30th, 2018. We interviewed participants using a pre-tested structured questionnaire, and the blister pack was also inspected at their homes on day 4. Data were entered into Epi-Info and analyzed using SPSS 21. Odds ratios with 95% Confidence Intervals were estimated and the level of significance was declared at p-value ≤ 0.05.ResultsA total of 384 study participants were interviewed with a response rate of 95.5%. The overall AL adherence was 53.6% (95% CI 48.4–58.3%). Children aged < 5 years [AOR: 0.4, 95% CI (0.2–0.8)], and being treated in health post [AOR: 0.3, 95% CI (0.1–0.5)] were more likely to show AL adherence whereas illiteracy [AOR: 9.4, 95% CI (4.2–21.3)], didn’t know the consequence of discontinued AL [AOR: 4.0, 95% CI (2.1–7.6)], had concomitant drugs [AOR: 2.5, 95% CI (1.4–4.5)], and stopped/saved drug when improved before tablet got finished [AOR: 3.2, 95% CI (1.7–5.9)] were factors less likely to be associated with AL adherence.ConclusionAL adherence was low. Children aged < 5 years, and being treated in health post were determinants of AL adherence whereas illiteracy, didn’t know the consequence of discontinued the drug, had concomitant drugs, and stopped/saved drug when improved before tablet got finished were factors that hindered the AL adherence. Stakeholders should emphasize designing appropriate strategies including educational interventions to increase the AL adherence and prevent drug resistance. Further research should be conducted to evaluate AL resistance.
Highlights
In 2001, the World Health Organization (WHO) recommended artemisinin-based combination therapy (ACT) including Artemether–lumefantrine (AL) as a first-line treatment for uncomplicated Plasmodium falciparum (PF) for all countries that experienced resistance to mono-therapies, notably to chloroquine and sulfadoxine-pyrimethamine (SP) [1]
Adherence to Artemether–lumefantrine treatment (AL) Out of the 384 patients interviewed, 206 [53.6%] adhered to AL treatment
(80%) were adherent according to pill count and dose timing at the 2nd and 6th doses whereas the remaining 3rd, 4th and 5th AL doses were appropriately taken by majority of malaria patients (90%) who experienced pill count and dose timing adherence to AL treatment (Fig. 2)
Summary
In 2001, the World Health Organization (WHO) recommended artemisinin-based combination therapy (ACT) including Artemether–lumefantrine (AL) as a first-line treatment for uncomplicated Plasmodium falciparum (PF) for all countries that experienced resistance to mono-therapies, notably to chloroquine and sulfadoxine-pyrimethamine (SP) [1]. After three years (2004), Ethiopia adopted AL as a first line treatment following the widespread resistance of SP in the country. In 2017, AL plus single dose of primaquine was recommended as first-line drugs [2,3,4]. Ethiopia has set a goal to eliminate malaria by 2030; Artemether–lumefantrine (AL) is put as one of the cornerstone strategies for uncomplicated plasmodium falciparum malaria treatment. Only focusing on prescribing of the treatment without assessing patients’ adherence could lead to the resistance of the drug.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
