Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi

<p>Abstract</p> <p>Background</p> <p>Malaria is the leading cause of morbidity and mortality in post-conflict Burundi. To counter the increasing challenge of anti-malarial drug resistance and improve highly effective treatment Burundi adopted artesunate-amodiaquine (AS-...

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Main Authors: Dismas Baza, Karikari Patrick E, Boakye Isaac, Blay-Nguah Samuel, Diap Graciela, Amuasi John H, Karenzo Jeanne, Nsabiyumva Lievin, Louie Karly S, Kiechel Jean-René
Format: Article
Language:English
Published: BMC 2011-02-01
Series:Malaria Journal
Online Access:http://www.malariajournal.com/content/10/1/34
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author Dismas Baza
Karikari Patrick E
Boakye Isaac
Blay-Nguah Samuel
Diap Graciela
Amuasi John H
Karenzo Jeanne
Nsabiyumva Lievin
Louie Karly S
Kiechel Jean-René
author_facet Dismas Baza
Karikari Patrick E
Boakye Isaac
Blay-Nguah Samuel
Diap Graciela
Amuasi John H
Karenzo Jeanne
Nsabiyumva Lievin
Louie Karly S
Kiechel Jean-René
author_sort Dismas Baza
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Malaria is the leading cause of morbidity and mortality in post-conflict Burundi. To counter the increasing challenge of anti-malarial drug resistance and improve highly effective treatment Burundi adopted artesunate-amodiaquine (AS-AQ) as first-line treatment for uncomplicated <it>Plasmodium falciparum </it>malaria and oral quinine as second-line treatment in its national treatment policy in 2003. Uptake of this policy in the public, private and non-governmental (NGO) retail market sectors of Burundi is relatively unknown. This study was conducted to evaluate access to national policy recommended anti-malarials.</p> <p>Methods</p> <p>Adapting a standardized methodology developed by Health Action International/World Health Organization (HAI/WHO), a cross-sectional survey of 70 (24 public, 36 private, and 10 NGO) medicine outlets was conducted in three regions of Burundi, representing different levels of transmission of malaria. The availability on day of the survey, the median prices, and affordability (in terms of number of days' wages to purchase treatment) of AS-AQ, quinine and other anti-malarials were calculated.</p> <p>Results</p> <p>Anti-malarials were stocked in all outlets surveyed. AS-AQ was available in 87.5%, 33.3%, and 90% of public, private, and NGO retail outlets, respectively. Quinine was the most common anti-malarial found in all outlet types. Non-policy recommended anti-malarials were mainly found in the private outlets (38.9%) compared to public (4.2%) and NGO (0%) outlets. The median price of a course of AS-AQ was US$0.16 (200 Burundi Francs, FBu) for the public and NGO markets, and 3.5-fold higher in the private sector (US$0.56 or 700 FBu). Quinine tablets were similarly priced in the public (US$1.53 or 1,892.50 FBu), private and NGO sectors (both US$1.61 or 2,000 FBu). Non-policy anti-malarials were priced 50-fold higher than the price of AS-AQ in the public sector. A course of AS-AQ was affordable at 0.4 of a day's wage in the public and NGO sectors, whereas, it was equivalent to 1.5 days worth of wages in the private sector.</p> <p>Conclusions</p> <p>AS-AQ was widely available and affordable in the public and NGO markets of hard-to-reach post-conflict communities in Burundi. However greater accessibility and affordability of policy recommended anti-malarials in the private market sector is needed to improve country-wide policy uptake.</p>
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spelling doaj.art-76544d645920486abb5893a76288feca2022-12-21T21:05:12ZengBMCMalaria Journal1475-28752011-02-011013410.1186/1475-2875-10-34Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in BurundiDismas BazaKarikari Patrick EBoakye IsaacBlay-Nguah SamuelDiap GracielaAmuasi John HKarenzo JeanneNsabiyumva LievinLouie Karly SKiechel Jean-René<p>Abstract</p> <p>Background</p> <p>Malaria is the leading cause of morbidity and mortality in post-conflict Burundi. To counter the increasing challenge of anti-malarial drug resistance and improve highly effective treatment Burundi adopted artesunate-amodiaquine (AS-AQ) as first-line treatment for uncomplicated <it>Plasmodium falciparum </it>malaria and oral quinine as second-line treatment in its national treatment policy in 2003. Uptake of this policy in the public, private and non-governmental (NGO) retail market sectors of Burundi is relatively unknown. This study was conducted to evaluate access to national policy recommended anti-malarials.</p> <p>Methods</p> <p>Adapting a standardized methodology developed by Health Action International/World Health Organization (HAI/WHO), a cross-sectional survey of 70 (24 public, 36 private, and 10 NGO) medicine outlets was conducted in three regions of Burundi, representing different levels of transmission of malaria. The availability on day of the survey, the median prices, and affordability (in terms of number of days' wages to purchase treatment) of AS-AQ, quinine and other anti-malarials were calculated.</p> <p>Results</p> <p>Anti-malarials were stocked in all outlets surveyed. AS-AQ was available in 87.5%, 33.3%, and 90% of public, private, and NGO retail outlets, respectively. Quinine was the most common anti-malarial found in all outlet types. Non-policy recommended anti-malarials were mainly found in the private outlets (38.9%) compared to public (4.2%) and NGO (0%) outlets. The median price of a course of AS-AQ was US$0.16 (200 Burundi Francs, FBu) for the public and NGO markets, and 3.5-fold higher in the private sector (US$0.56 or 700 FBu). Quinine tablets were similarly priced in the public (US$1.53 or 1,892.50 FBu), private and NGO sectors (both US$1.61 or 2,000 FBu). Non-policy anti-malarials were priced 50-fold higher than the price of AS-AQ in the public sector. A course of AS-AQ was affordable at 0.4 of a day's wage in the public and NGO sectors, whereas, it was equivalent to 1.5 days worth of wages in the private sector.</p> <p>Conclusions</p> <p>AS-AQ was widely available and affordable in the public and NGO markets of hard-to-reach post-conflict communities in Burundi. However greater accessibility and affordability of policy recommended anti-malarials in the private market sector is needed to improve country-wide policy uptake.</p>http://www.malariajournal.com/content/10/1/34
spellingShingle Dismas Baza
Karikari Patrick E
Boakye Isaac
Blay-Nguah Samuel
Diap Graciela
Amuasi John H
Karenzo Jeanne
Nsabiyumva Lievin
Louie Karly S
Kiechel Jean-René
Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi
Malaria Journal
title Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi
title_full Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi
title_fullStr Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi
title_full_unstemmed Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi
title_short Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi
title_sort access to artesunate amodiaquine quinine and other anti malarials policy and markets in burundi
url http://www.malariajournal.com/content/10/1/34
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