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Adherence to a six-dose regimen of artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Uganda

Adherence to a six-dose regimen of artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Uganda
Adherence to a six-dose regimen of artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Uganda
Measuring baseline levels of adherence and identifying risk factors for non-adherence are important steps before the introduction of new antimalarials. In Mbarara in southwestern Uganda, we assessed adherence to artemetherlumefantrine (Coartem®) in its latest World Health Organization blister formulation. Patients with uncomplicated Plasmodium falciparum malaria were prescribed artemether-lumefantrine and received an explanation of how to take the following five doses at home. A tablet count was made and a questionnaire was completed during a home visit. Among 210 analyzable patients, 21 (10.0%) were definitely or probably non-adherent, whereas 189 (90.0%) were probably adherent. Age group was not associated with adherence. Lack of formal education was the only factor associated with non-adherence after controlling for confounders (odds ratio = 3.1, 95% confidence interval [CI] = 1.1-9.7). Mean lumefantrine blood levels were lower among non-adherent (n = 16) (2.76 μg/mL, 95% CI = 1.06-4.45) than among adherent (n = 171) (3.19 μg/mL, 95% CI = 2.84-3.54) patients, but this difference was not statistically significant. The high adherence to artemether-lumefantrine found in our study suggest that this drug is likely to be very effective in Mbarara provided that patients receive clear dosage explanations.
0002-9637
525-530
Fogg, Carole
42057537-d443-462a-8944-c804252c973b
Bajunirwe, Francis
0fd9f549-93fe-43bc-a36d-c277beb0f515
Piola, Patrice
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Biraro, Samuel
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Checchi, Francesco
e404c8bf-de19-4af1-b6c1-85c1ebee95e6
Kiguli, James
19adf3bc-a43c-4033-94ed-bb15cf67705d
Namiiro, Proscovia
f2572db5-9dc7-4d08-8f89-8f5b56bfae35
Musabe, Joy
c9fadf0a-453d-4c33-b955-009a633d8d46
Kyomugisha, Agnes
5af4e626-92c4-43d4-a5d7-f895dc5d4399
Guthmann, Jean-Paul
ae239f74-b3b4-4f18-95fb-d5690d062d67
Fogg, Carole
42057537-d443-462a-8944-c804252c973b
Bajunirwe, Francis
0fd9f549-93fe-43bc-a36d-c277beb0f515
Piola, Patrice
d5f4e60e-a212-4b81-9d3e-f0f6f3e5f440
Biraro, Samuel
5e9e6a5f-501b-466c-9888-0692eb4bfbd0
Checchi, Francesco
e404c8bf-de19-4af1-b6c1-85c1ebee95e6
Kiguli, James
19adf3bc-a43c-4033-94ed-bb15cf67705d
Namiiro, Proscovia
f2572db5-9dc7-4d08-8f89-8f5b56bfae35
Musabe, Joy
c9fadf0a-453d-4c33-b955-009a633d8d46
Kyomugisha, Agnes
5af4e626-92c4-43d4-a5d7-f895dc5d4399
Guthmann, Jean-Paul
ae239f74-b3b4-4f18-95fb-d5690d062d67

Fogg, Carole, Bajunirwe, Francis, Piola, Patrice, Biraro, Samuel, Checchi, Francesco, Kiguli, James, Namiiro, Proscovia, Musabe, Joy, Kyomugisha, Agnes and Guthmann, Jean-Paul (2004) Adherence to a six-dose regimen of artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Uganda. American Journal of Tropical Medicine and Hygiene, 71 (5), 525-530. (doi:10.4269/ajtmh.2004.71.525).

Record type: Article

Abstract

Measuring baseline levels of adherence and identifying risk factors for non-adherence are important steps before the introduction of new antimalarials. In Mbarara in southwestern Uganda, we assessed adherence to artemetherlumefantrine (Coartem®) in its latest World Health Organization blister formulation. Patients with uncomplicated Plasmodium falciparum malaria were prescribed artemether-lumefantrine and received an explanation of how to take the following five doses at home. A tablet count was made and a questionnaire was completed during a home visit. Among 210 analyzable patients, 21 (10.0%) were definitely or probably non-adherent, whereas 189 (90.0%) were probably adherent. Age group was not associated with adherence. Lack of formal education was the only factor associated with non-adherence after controlling for confounders (odds ratio = 3.1, 95% confidence interval [CI] = 1.1-9.7). Mean lumefantrine blood levels were lower among non-adherent (n = 16) (2.76 μg/mL, 95% CI = 1.06-4.45) than among adherent (n = 171) (3.19 μg/mL, 95% CI = 2.84-3.54) patients, but this difference was not statistically significant. The high adherence to artemether-lumefantrine found in our study suggest that this drug is likely to be very effective in Mbarara provided that patients receive clear dosage explanations.

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Published date: 1 November 2004

Identifiers

Local EPrints ID: 436988
URI: http://eprints.soton.ac.uk/id/eprint/436988
ISSN: 0002-9637
PURE UUID: f1626e91-910b-4728-b505-487e07f16ade
ORCID for Carole Fogg: ORCID iD orcid.org/0000-0002-3000-6185

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Date deposited: 14 Jan 2020 18:35
Last modified: 27 Jan 2020 13:58

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Contributors

Author: Carole Fogg ORCID iD
Author: Francis Bajunirwe
Author: Patrice Piola
Author: Samuel Biraro
Author: Francesco Checchi
Author: James Kiguli
Author: Proscovia Namiiro
Author: Joy Musabe
Author: Agnes Kyomugisha
Author: Jean-Paul Guthmann

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