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Published in: Malaria Journal 1/2011

Open Access 01-12-2011 | Research

Knowledge and malaria treatment practices using artemisinin combination therapy (ACT) in Malawi: survey of health professionals

Authors: Linda V Kalilani-Phiri, Douglas Lungu, Renia Coghlan

Published in: Malaria Journal | Issue 1/2011

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Abstract

Background

Malaria still remains a life-threatening disease worldwide causing between 190 and 311 million cases of malaria in 2008. Due to increased resistance to sulphadoxine-pyrimethamine (SP), the Ministry of Health in Malawi, as in many sub-Saharan African countries, changed the malaria treatment policy to use artemisinin-based combination therapy (ACT). In order to optimize the correct use of this drug, and protect against the development of the parasite's resistance, it is important to assess the knowledge and practices of medical practitioners on the use of ACT and its impact on adherence to new treatment policy guidelines.

Methods

A cross-sectional survey was conducted to assess the knowledge and perceptions of Malawian medical doctors and pharmacists on the use of ACT and the drivers of treatment choice and clinical treatment decisions. Medical doctors and pharmacists who are involved in managing malaria patients in Malawi were recruited and a self-administered questionnaire was used to obtain information on socio-demographic characteristics of the study participants, knowledge on ACT, source of information on ACT and methods used to decide on the treatment of patients with malaria.

Results

Most of the participants (95.7%) know at least one form of ACT, 67.4% reported that different forms of ACT have different characteristics, 77.3% reported that there are special formulations for children. The most commonly mentioned ACT was artemether-lumefantrine (AL), by 94.6% of the participants and 75.0% of the participants indicated that they prefer to prescribe AL. 73.9% of participants had ever received information on ACT. However, only 31.5% had received training on management of malaria using ACT. There were 71.7% respondents who had heard of ACT causing side effects. Only 25.0% of the participants had received training on how to report SAEs.

Conclusion

It was found that most of the participants know about ACT and treatment guidelines for malaria. However, most of the participants have not received any training on how to use ACT and how to report adverse effects arising from the use of ACT. There is need for more training of health care professionals to ensure correct and effective use of ACT.
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Literature
2.
go back to reference Lengeler C: Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004, 2: CD000363-PubMed Lengeler C: Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004, 2: CD000363-PubMed
3.
go back to reference Whitty CJ, Chandler C, Ansah E, Leslie T, Staedke SG: Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities. Malar J. 2008, 11 (7 Suppl 1): S7-CrossRef Whitty CJ, Chandler C, Ansah E, Leslie T, Staedke SG: Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities. Malar J. 2008, 11 (7 Suppl 1): S7-CrossRef
4.
go back to reference Plowe CV, Cortese JF, Djimde A, Nwanyanwu OC, Watkins WM, Winstanley PA, Estrade-Franco JG, Mollinedo RE, Avila JC, Cespedes JL, Carter D, Doumbo OK: Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase and epidemiologic patterns of pyrimethamine-sulfadoxine use and resistance. J Infect Dis. 1997, 176: 1590-1596. 10.1086/514159.CrossRefPubMed Plowe CV, Cortese JF, Djimde A, Nwanyanwu OC, Watkins WM, Winstanley PA, Estrade-Franco JG, Mollinedo RE, Avila JC, Cespedes JL, Carter D, Doumbo OK: Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase and epidemiologic patterns of pyrimethamine-sulfadoxine use and resistance. J Infect Dis. 1997, 176: 1590-1596. 10.1086/514159.CrossRefPubMed
5.
go back to reference Mutabingwa TK: Artemisinin-based combination therapies (ACTs): Best hope for malaria treatment but inaccessible to the needy!. Acta Tropica. 2005, 95: 305-315. 10.1016/j.actatropica.2005.06.009.CrossRefPubMed Mutabingwa TK: Artemisinin-based combination therapies (ACTs): Best hope for malaria treatment but inaccessible to the needy!. Acta Tropica. 2005, 95: 305-315. 10.1016/j.actatropica.2005.06.009.CrossRefPubMed
6.
go back to reference Bloland PB, Ettling M, Meek S: Combination therapy formalaria in Africa: hype or hope?. Bull World Health Org. 2000, 78: 1378-1388.PubMedCentralPubMed Bloland PB, Ettling M, Meek S: Combination therapy formalaria in Africa: hype or hope?. Bull World Health Org. 2000, 78: 1378-1388.PubMedCentralPubMed
7.
go back to reference Mubyazi GM, Gonzalez-Block MA: Research influence on antimalarial drug policy change in Tanzania: case study of replacing chloroquine with sulfadoxine-pyrimethamine as the first-line drug. Malar J. 2005, 20: 51-CrossRef Mubyazi GM, Gonzalez-Block MA: Research influence on antimalarial drug policy change in Tanzania: case study of replacing chloroquine with sulfadoxine-pyrimethamine as the first-line drug. Malar J. 2005, 20: 51-CrossRef
8.
go back to reference Tarimo DS, Malekela DA: Health workers perceptions on chloroquine and sulfadoxine/sulfalene pyrimethamine monotherapies: implications for the change to combination therapy of artemether/lumefantrine in Tanzania. East Afr J Public Health. 2007, 4: 43-6.PubMed Tarimo DS, Malekela DA: Health workers perceptions on chloroquine and sulfadoxine/sulfalene pyrimethamine monotherapies: implications for the change to combination therapy of artemether/lumefantrine in Tanzania. East Afr J Public Health. 2007, 4: 43-6.PubMed
9.
go back to reference Minzi OM, Haule AF: Poor knowledge on new malaria treatment guidelines among drug dispensers in private pharmacies in Tanzania: the need for involving the private sector in policy preparations and implementation. East Afr J Public Health. 2008, 5: 117-21.PubMed Minzi OM, Haule AF: Poor knowledge on new malaria treatment guidelines among drug dispensers in private pharmacies in Tanzania: the need for involving the private sector in policy preparations and implementation. East Afr J Public Health. 2008, 5: 117-21.PubMed
10.
go back to reference Kurth F, Bélard S, Adegnika AA, Gaye O, Kremsner PG, Ramharter M: Do paediatric drug formulations of artemisinin combination therapies improve the treatment of children with malaria? A systematic review and meta-analysis. Lancet Infect Dis. 2010, 10: 125-32. 10.1016/S1473-3099(09)70327-5.CrossRefPubMed Kurth F, Bélard S, Adegnika AA, Gaye O, Kremsner PG, Ramharter M: Do paediatric drug formulations of artemisinin combination therapies improve the treatment of children with malaria? A systematic review and meta-analysis. Lancet Infect Dis. 2010, 10: 125-32. 10.1016/S1473-3099(09)70327-5.CrossRefPubMed
11.
go back to reference Ahmed ME, Youssif MA: Impact of the national protocol for malaria treatment on prescribing patterns in Gezira state, Sudan. East Mediterr Health J. 2004, 10: 566-572.PubMed Ahmed ME, Youssif MA: Impact of the national protocol for malaria treatment on prescribing patterns in Gezira state, Sudan. East Mediterr Health J. 2004, 10: 566-572.PubMed
12.
go back to reference Phillips-Howard PA, Wannemuehler KA, Ter Kuile FO, Hawley WA, Kolczak MS, Odhacha A, Vulule JM, Nahlen BL: Diagnosis and prescribing practices in peripheral health facilities in rural western Kenya. Am J Trop Med Hyg. 2003, 68: 44-49.PubMed Phillips-Howard PA, Wannemuehler KA, Ter Kuile FO, Hawley WA, Kolczak MS, Odhacha A, Vulule JM, Nahlen BL: Diagnosis and prescribing practices in peripheral health facilities in rural western Kenya. Am J Trop Med Hyg. 2003, 68: 44-49.PubMed
13.
go back to reference Sayang C, Gausseres M, Vernazza-Licht N, Malvy D, Bley D, Millet P: Treat-ment of malaria from monotherapy to artemisinin-based combination therapy by health professionals in urban health facilities in Yaoundé, central province, Cameroon. Malar J. 2009, 29: 176-CrossRef Sayang C, Gausseres M, Vernazza-Licht N, Malvy D, Bley D, Millet P: Treat-ment of malaria from monotherapy to artemisinin-based combination therapy by health professionals in urban health facilities in Yaoundé, central province, Cameroon. Malar J. 2009, 29: 176-CrossRef
14.
go back to reference Sayang C, Gausseres M, Vernazza-Licht N, Malvy D, Bley D, Millet P: Treat-ment of malaria from monotherapy to artemisinin-based combination therapy by health professionals in rural health facilities in southern Cameroon. Malar J. 2009, 29: 174-CrossRef Sayang C, Gausseres M, Vernazza-Licht N, Malvy D, Bley D, Millet P: Treat-ment of malaria from monotherapy to artemisinin-based combination therapy by health professionals in rural health facilities in southern Cameroon. Malar J. 2009, 29: 174-CrossRef
15.
go back to reference Brabin BJ, Romagosa C, Abdelgalil S, Menéndez C, Verhoeff FH, McGready R, Fletcher KA, Owens S, D'Alessandro U, Nosten F, Fischer PR, Ordi J: The sick placenta-the role of malaria. Placenta. 2004, 25: 359-78. 10.1016/j.placenta.2003.10.019.CrossRefPubMed Brabin BJ, Romagosa C, Abdelgalil S, Menéndez C, Verhoeff FH, McGready R, Fletcher KA, Owens S, D'Alessandro U, Nosten F, Fischer PR, Ordi J: The sick placenta-the role of malaria. Placenta. 2004, 25: 359-78. 10.1016/j.placenta.2003.10.019.CrossRefPubMed
16.
go back to reference Kalilani L, Mofolo I, Chaponda M, Rogerson SJ, Alker AP, Kwiek JJ, Meshnick SR: A randomized controlled pilot trial of azithromycin or artesunate added to sulfadoxine-pyrimethamine as treatment for malaria in pregnant women. PLoS One. 2007, 2 (11): e1166.-PubMedCentralCrossRefPubMed Kalilani L, Mofolo I, Chaponda M, Rogerson SJ, Alker AP, Kwiek JJ, Meshnick SR: A randomized controlled pilot trial of azithromycin or artesunate added to sulfadoxine-pyrimethamine as treatment for malaria in pregnant women. PLoS One. 2007, 2 (11): e1166.-PubMedCentralCrossRefPubMed
17.
go back to reference Amexo M, Tolhurst R, Barnish G, Bates I: Malaria misdiagnosis: effects on the poor and vulnerable. The Lancet. 2004, 364: 1896-1898. 10.1016/S0140-6736(04)17446-1.CrossRef Amexo M, Tolhurst R, Barnish G, Bates I: Malaria misdiagnosis: effects on the poor and vulnerable. The Lancet. 2004, 364: 1896-1898. 10.1016/S0140-6736(04)17446-1.CrossRef
Metadata
Title
Knowledge and malaria treatment practices using artemisinin combination therapy (ACT) in Malawi: survey of health professionals
Authors
Linda V Kalilani-Phiri
Douglas Lungu
Renia Coghlan
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2011
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-10-279

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