Healthcare professionals’ perspective can guide post-marketing surveillance of artemisinin-based combination therapy in Uganda
Abstract Background Efficient testing to identify poor quality artemisinin-based combination therapy (ACT) is important to optimize efforts to control and eliminate malaria. Healthcare professionals interact with both ACT and malaria patients they treat and hence could observe, first-hand, suspect p...
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| Format: | Article |
| Language: | English |
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BMC
2020-02-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12936-020-3148-5 |
| _version_ | 1818676940607848448 |
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| author | Helen Byomire Ndagije Ronald Kiguba Leonard Manirakiza Elijah Kirabira Allan Sserwanga Leah Nabirye Jackson Mukonzo Sten Olsson Anne Spinewine William D’Hoore Niko Speybroeck |
| author_facet | Helen Byomire Ndagije Ronald Kiguba Leonard Manirakiza Elijah Kirabira Allan Sserwanga Leah Nabirye Jackson Mukonzo Sten Olsson Anne Spinewine William D’Hoore Niko Speybroeck |
| author_sort | Helen Byomire Ndagije |
| collection | DOAJ |
| description | Abstract Background Efficient testing to identify poor quality artemisinin-based combination therapy (ACT) is important to optimize efforts to control and eliminate malaria. Healthcare professionals interact with both ACT and malaria patients they treat and hence could observe, first-hand, suspect poor quality artemisinin-based combinations linked to poor malaria treatment outcomes and the factors associated with inappropriate use or treatment failure. Methods A cross-sectional study of 685 HCP perspectives about the efficacy of ACT between June and July 2018 at selected health facilities in Uganda. Medicine samples were obtained from the seven regions of Uganda and tested for quality using the Germany Pharma Health Fund™ minilabs. Results The average age of the 685 respondents was 30 (SD = 7.4) years. There was an almost equal distribution between male and female respondents (51:49), respectively. Seventy percent (n = 480) were diploma holders and the nurses contributed to half (49%, n = 334) of the study population. Sixty-one percent of the HCPs reported having ever encountered ACT failures while treating uncomplicated malaria. Nineteen percent of HCPs thought that dihydroartemisinin/piperaquine gave the most satisfactory patient treatment outcomes, while 80% HCPs thought that artemether/lumefantrine gave the least satisfactory patient treatment outcomes, possibly due to dosing schedule and pill burden. Healthcare professionals from the Central region (OR = 3.0, CI 0.3–1.0; P = 0.0001), Eastern region (OR = 5.4, CI 2.9–9.8; P = 0.0001) and Northern region (OR = 5.3, CI 2.9–9.9; P = 0.0001) had a higher chance of encountering ACT failure in 4 weeks prior to the survey as compared to those from the western region. Healthcare professionals from private health facilities also had higher chances of encountering ACT failures in past 4 weeks as compared to those from public health facilities (OR = 2.7, CI 1.7–3.9; P = 0.0001). All 192 samples passed the quality screening tests. The random sample of 10% of all samples randomly obtained by the laboratory staff also passed the chemical content analysis and dissolution tests. Conclusion ACT medicines are widely available over-the-counter to the public and it is very difficult to report and monitor a decrease in efficacy or treatment failure. The perspectives of HCPs on treatment failure or lack of efficacy may potentially guide optimization efforts of sampling methodologies for the quality survey of ACT medicines. |
| first_indexed | 2024-12-17T08:51:28Z |
| format | Article |
| id | doaj.art-1c894c9cffdd46f486605362fa1a8b06 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-17T08:51:28Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-1c894c9cffdd46f486605362fa1a8b062022-12-21T21:56:03ZengBMCMalaria Journal1475-28752020-02-0119111210.1186/s12936-020-3148-5Healthcare professionals’ perspective can guide post-marketing surveillance of artemisinin-based combination therapy in UgandaHelen Byomire Ndagije0Ronald Kiguba1Leonard Manirakiza2Elijah Kirabira3Allan Sserwanga4Leah Nabirye5Jackson Mukonzo6Sten Olsson7Anne Spinewine8William D’Hoore9Niko Speybroeck10National Pharmacovigilance Centre, National Drug AuthorityDepartment of Pharmacology and Therapeutics, Makerere UniversityNational Pharmacovigilance Centre, National Drug AuthorityNational Pharmacovigilance Centre, National Drug AuthorityNational Pharmacovigilance Centre, National Drug AuthorityDepartment of Pharmacology and Therapeutics, Makerere UniversityDepartment of Pharmacology and Therapeutics, Makerere UniversityPharmacovigilance ConsultingInstitute of Health and Society (IRSS), Université catholique de LouvainInstitute of Health and Society (IRSS), Université catholique de LouvainInstitute of Health and Society (IRSS), Université catholique de LouvainAbstract Background Efficient testing to identify poor quality artemisinin-based combination therapy (ACT) is important to optimize efforts to control and eliminate malaria. Healthcare professionals interact with both ACT and malaria patients they treat and hence could observe, first-hand, suspect poor quality artemisinin-based combinations linked to poor malaria treatment outcomes and the factors associated with inappropriate use or treatment failure. Methods A cross-sectional study of 685 HCP perspectives about the efficacy of ACT between June and July 2018 at selected health facilities in Uganda. Medicine samples were obtained from the seven regions of Uganda and tested for quality using the Germany Pharma Health Fund™ minilabs. Results The average age of the 685 respondents was 30 (SD = 7.4) years. There was an almost equal distribution between male and female respondents (51:49), respectively. Seventy percent (n = 480) were diploma holders and the nurses contributed to half (49%, n = 334) of the study population. Sixty-one percent of the HCPs reported having ever encountered ACT failures while treating uncomplicated malaria. Nineteen percent of HCPs thought that dihydroartemisinin/piperaquine gave the most satisfactory patient treatment outcomes, while 80% HCPs thought that artemether/lumefantrine gave the least satisfactory patient treatment outcomes, possibly due to dosing schedule and pill burden. Healthcare professionals from the Central region (OR = 3.0, CI 0.3–1.0; P = 0.0001), Eastern region (OR = 5.4, CI 2.9–9.8; P = 0.0001) and Northern region (OR = 5.3, CI 2.9–9.9; P = 0.0001) had a higher chance of encountering ACT failure in 4 weeks prior to the survey as compared to those from the western region. Healthcare professionals from private health facilities also had higher chances of encountering ACT failures in past 4 weeks as compared to those from public health facilities (OR = 2.7, CI 1.7–3.9; P = 0.0001). All 192 samples passed the quality screening tests. The random sample of 10% of all samples randomly obtained by the laboratory staff also passed the chemical content analysis and dissolution tests. Conclusion ACT medicines are widely available over-the-counter to the public and it is very difficult to report and monitor a decrease in efficacy or treatment failure. The perspectives of HCPs on treatment failure or lack of efficacy may potentially guide optimization efforts of sampling methodologies for the quality survey of ACT medicines.https://doi.org/10.1186/s12936-020-3148-5Healthcare professional perspectivesArtemisinin-based combination therapyPerceived treatment failure |
| spellingShingle | Helen Byomire Ndagije Ronald Kiguba Leonard Manirakiza Elijah Kirabira Allan Sserwanga Leah Nabirye Jackson Mukonzo Sten Olsson Anne Spinewine William D’Hoore Niko Speybroeck Healthcare professionals’ perspective can guide post-marketing surveillance of artemisinin-based combination therapy in Uganda Malaria Journal Healthcare professional perspectives Artemisinin-based combination therapy Perceived treatment failure |
| title | Healthcare professionals’ perspective can guide post-marketing surveillance of artemisinin-based combination therapy in Uganda |
| title_full | Healthcare professionals’ perspective can guide post-marketing surveillance of artemisinin-based combination therapy in Uganda |
| title_fullStr | Healthcare professionals’ perspective can guide post-marketing surveillance of artemisinin-based combination therapy in Uganda |
| title_full_unstemmed | Healthcare professionals’ perspective can guide post-marketing surveillance of artemisinin-based combination therapy in Uganda |
| title_short | Healthcare professionals’ perspective can guide post-marketing surveillance of artemisinin-based combination therapy in Uganda |
| title_sort | healthcare professionals perspective can guide post marketing surveillance of artemisinin based combination therapy in uganda |
| topic | Healthcare professional perspectives Artemisinin-based combination therapy Perceived treatment failure |
| url | https://doi.org/10.1186/s12936-020-3148-5 |
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