Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and Nigeria
<h4>Background</h4> Artemisinin-based combination therapies (ACTs) are the recommended treatment for uncomplicated Plasmodium falciparum malaria in all malaria endemic countries. Artemisinin resistance, partner drug resistance, and subsequent ACT failure are widespread in Southeast Asia....
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462557/?tool=EBI |
| _version_ | 1818063765114978304 |
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| author | Paulina Tindana Rosemonde Guissou Oladimeji Akeem Bolarinwa Fatoumata Tou Freek de Haan Mehul Dhorda Arjen M. Dondorp Chanaki Amaratunga Olugbenga Ayodeji Mokuolu Jean Bosco Ouedraogo Phaik Yeong Cheah |
| author_facet | Paulina Tindana Rosemonde Guissou Oladimeji Akeem Bolarinwa Fatoumata Tou Freek de Haan Mehul Dhorda Arjen M. Dondorp Chanaki Amaratunga Olugbenga Ayodeji Mokuolu Jean Bosco Ouedraogo Phaik Yeong Cheah |
| author_sort | Paulina Tindana |
| collection | DOAJ |
| description | <h4>Background</h4> Artemisinin-based combination therapies (ACTs) are the recommended treatment for uncomplicated Plasmodium falciparum malaria in all malaria endemic countries. Artemisinin resistance, partner drug resistance, and subsequent ACT failure are widespread in Southeast Asia. The more recent independent emergence of artemisinin resistance in Africa is alarming. In response, triple artemisinin-based combination therapies (TACTs) are being developed to mitigate the risks associated with increasing drug resistance. Since ACTs are still effective in Africa, where malaria is mainly a paediatric disease, the potential deployment of TACTs raises important ethical questions. This paper presents an analysis of stakeholders’ perspectives regarding key ethical considerations to be considered in the deployment of TACTs in Africa provided they are found to be safe, well-tolerated and effective for the treatment of uncomplicated malaria. <h4>Methods</h4> We conducted a qualitative study in Burkina Faso and Nigeria assessing stakeholders’ (policy makers, suppliers and end-users) perspectives on ethical issues regarding the potential future deployment of TACTs through 68 in-depth interviews and 11 focus group discussions. <h4>Findings</h4> Some respondents suggested that there should be evidence of local artemisinin resistance before they consider deploying TACTs, while others suggested that TACTs should be deployed to protect the efficacy of current ACTs. Respondents suggested that additional side effects of TACTs compared to ACTs should be minimal and the cost of TACTs to end-users should not be higher than the cost of current ACTs. There was some disagreement among respondents regarding whether patients should have a choice of treatment options between ACTs and TACTs or only have TACTs available, while ACTs are still effective. The study also suggests that community, public and stakeholder engagement activities are essential to support the introduction and effective uptake of TACTs. <h4>Conclusion</h4> Addressing ethical issues regarding TACTs and engaging early with stakeholders will be important for their potential deployment in Africa. |
| first_indexed | 2024-12-10T14:25:18Z |
| format | Article |
| id | doaj.art-f46ad0b847244173a28f2f8849e69bc2 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T14:25:18Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f46ad0b847244173a28f2f8849e69bc22022-12-22T01:45:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01179Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and NigeriaPaulina TindanaRosemonde GuissouOladimeji Akeem BolarinwaFatoumata TouFreek de HaanMehul DhordaArjen M. DondorpChanaki AmaratungaOlugbenga Ayodeji MokuoluJean Bosco OuedraogoPhaik Yeong Cheah<h4>Background</h4> Artemisinin-based combination therapies (ACTs) are the recommended treatment for uncomplicated Plasmodium falciparum malaria in all malaria endemic countries. Artemisinin resistance, partner drug resistance, and subsequent ACT failure are widespread in Southeast Asia. The more recent independent emergence of artemisinin resistance in Africa is alarming. In response, triple artemisinin-based combination therapies (TACTs) are being developed to mitigate the risks associated with increasing drug resistance. Since ACTs are still effective in Africa, where malaria is mainly a paediatric disease, the potential deployment of TACTs raises important ethical questions. This paper presents an analysis of stakeholders’ perspectives regarding key ethical considerations to be considered in the deployment of TACTs in Africa provided they are found to be safe, well-tolerated and effective for the treatment of uncomplicated malaria. <h4>Methods</h4> We conducted a qualitative study in Burkina Faso and Nigeria assessing stakeholders’ (policy makers, suppliers and end-users) perspectives on ethical issues regarding the potential future deployment of TACTs through 68 in-depth interviews and 11 focus group discussions. <h4>Findings</h4> Some respondents suggested that there should be evidence of local artemisinin resistance before they consider deploying TACTs, while others suggested that TACTs should be deployed to protect the efficacy of current ACTs. Respondents suggested that additional side effects of TACTs compared to ACTs should be minimal and the cost of TACTs to end-users should not be higher than the cost of current ACTs. There was some disagreement among respondents regarding whether patients should have a choice of treatment options between ACTs and TACTs or only have TACTs available, while ACTs are still effective. The study also suggests that community, public and stakeholder engagement activities are essential to support the introduction and effective uptake of TACTs. <h4>Conclusion</h4> Addressing ethical issues regarding TACTs and engaging early with stakeholders will be important for their potential deployment in Africa.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462557/?tool=EBI |
| spellingShingle | Paulina Tindana Rosemonde Guissou Oladimeji Akeem Bolarinwa Fatoumata Tou Freek de Haan Mehul Dhorda Arjen M. Dondorp Chanaki Amaratunga Olugbenga Ayodeji Mokuolu Jean Bosco Ouedraogo Phaik Yeong Cheah Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and Nigeria PLoS ONE |
| title | Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and Nigeria |
| title_full | Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and Nigeria |
| title_fullStr | Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and Nigeria |
| title_full_unstemmed | Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and Nigeria |
| title_short | Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and Nigeria |
| title_sort | ethical considerations in deploying triple artemisinin based combination therapies for malaria an analysis of stakeholders perspectives in burkina faso and nigeria |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462557/?tool=EBI |
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