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Prevalence of Malaria Parasitemia and Purchase of Artemisinin-Based Combination Therapies (ACTs) among Drug Shop Clients in Two Regions in Tanzania with ACT Subsidies

Author

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  • Melissa A Briggs
  • Admirabilis Kalolella
  • Katia Bruxvoort
  • Ryan Wiegand
  • Gerard Lopez
  • Charles Festo
  • Pierre Lyaruu
  • Mitya Kenani
  • Salim Abdulla
  • Catherine Goodman
  • S Patrick Kachur

Abstract

Background: Throughout Africa, many people seek care for malaria in private-sector drug shops where diagnostic testing is often unavailable. Recently, subsidized artemisinin-based combination therapies (ACTs), a first-line medication for uncomplicated malaria, were made available in these drug shops in Tanzania. This study assessed the prevalence of malaria among and purchase of ACTs by drug shop clients in the setting of a national ACT subsidy program and sub-national drug shop accreditation program. Method and Findings: A cross-sectional survey of drug shop clients was performed in two regions in Tanzania, one with a government drug shop accreditation program and one without, from March-May, 2012. Drug shops were randomly sampled from non-urban districts. Shop attendants were interviewed about their education, training, and accreditation status. Clients were interviewed about their symptoms and medication purchases, then underwent a limited physical examination and laboratory testing for malaria. Malaria prevalence and predictors of ACT purchase were assessed using univariate analysis and multiple logistic regression. Amongst 777 clients from 73 drug shops, the prevalence of laboratory-confirmed malaria was 12% (95% CI: 6–18%). Less than a third of clients with malaria had purchased ACTs, and less than a quarter of clients who purchased ACTs tested positive for malaria. Clients were more likely to have purchased ACTs if the participant was 5 years, experience (aOR: 2.8; 95% CI: 1.2–6.3). Having malaria was only a predictor of ACT purchase in the region with a drug shop accreditation program (aOR: 3.4; 95% CI: 1.5–7.4). Conclusion: Malaria is common amongst persons presenting to drug shops with a complaint of fever. The low proportion of persons with malaria purchasing ACTs, and the high proportion of ACTs going to persons without malaria demonstrates a need to better target who receives ACTs in these drug shops.

Suggested Citation

  • Melissa A Briggs & Admirabilis Kalolella & Katia Bruxvoort & Ryan Wiegand & Gerard Lopez & Charles Festo & Pierre Lyaruu & Mitya Kenani & Salim Abdulla & Catherine Goodman & S Patrick Kachur, 2014. "Prevalence of Malaria Parasitemia and Purchase of Artemisinin-Based Combination Therapies (ACTs) among Drug Shop Clients in Two Regions in Tanzania with ACT Subsidies," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-11, April.
    • Handle: RePEc:plo:pone00:0094074
    DOI: 10.1371/journal.pone.0094074
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    References listed on IDEAS

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    1. Chandler, Clare I.R. & Hall-Clifford, Rachel & Asaph, Turinde & Pascal, Magnussen & Clarke, Siân & Mbonye, Anthony K., 2011. "Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: Limitations of diagnostic testing in the reality of diagnosis," Social Science & Medicine, Elsevier, vol. 72(6), pages 937-944, March.
    2. Williams, Holly Ann & Jones, Caroline O. H., 2004. "A critical review of behavioral issues related to malaria control in sub-Saharan Africa:: what contributions have social scientists made?," Social Science & Medicine, Elsevier, vol. 59(3), pages 501-523, August.
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    1. Elisa Maria Maffioli & Wendy Prudhomme O’Meara & Elizabeth L. Turner & Manoj Mohanan, 2021. "Can individuals’ beliefs help us understand nonadherence to malaria test results? Evidence from rural Kenya," Review of Development Economics, Wiley Blackwell, vol. 25(1), pages 163-182, February.

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