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Adherence to national malaria treatment guidelines in private drug outlets: a cross-sectional survey in the malaria-endemic Kisumu County, Kenya.

Publication ,  Journal Article
Odhiambo, FO; O'Meara, WP; Abade, A; Owiny, M; Odhiambo, F; Oyugi, EO
Published in: Malar J
October 11, 2023

BACKGROUND: Malaria prevalence in Kenya is 6%, with a three-fold higher prevalence in western Kenya. Adherence to malaria treatment guidelines improves care for suspected malaria cases and can reduce unnecessary anti-malarial use. Data on adherence to guidelines in retail drug outlets (DOs) is limited, yet approximately 50% of people with fever access treatment first in these outlets. This study assessed adherence to the national malaria treatment guidelines among DOs in a high transmission area of Western Kenya. METHODS: In a cross-sectional survey of DOs in Kisumu Central and Seme sub-counties in 2021, DO staff were interviewed using structured questionnaires to assess outlet characteristics (location, testing services), staff demographics (age, sex, training), and health system context (supervision, inspection). Mystery shoppers (research assistants disguised as clients) observed malaria management practices and recorded observations on a standardized tool. Adherence was defined as dispensing artemether-lumefantrine (AL) to patients with a confirmed positive test, accompanied by appropriate medication counseling. Logistic regression was used to test for association between adherence to guidelines and DO-related factors. RESULTS: None of the 70 DOs assessed had a copy of the guidelines, and 60 (85.7%) were in an urban setting. Staff adhered to the guidelines in 14 (20%) outlets. The odds of adherence were higher among staff who had a bachelor's degree {odds ratio (OR) 6.0, 95% confidence interval (95% CI) 1.66-21.74}, those trained on malaria rapid diagnostic test (RDT) {OR 4.4, 95% CI 1.29-15.04}, and those who asked about patient's symptoms {OR 3.6, 95% CI 1.08-12.25}. DOs that had higher odds of adherence included those with functional thermometers {OR 5.3, 95% CI 1.46-19.14}, those recently inspected (within three months) by Pharmacy and Poisons Board (PPB) {OR 9.4, 95% CI 2.55-34.67}, and those with all basic infrastructure {OR 3.9, 95% CI 1.01-15.00}. On logistic regression analysis, recent PPB inspection {adjusted OR (AOR) 4.6, 95% CI 1.03-20.77} and malaria RDT-trained staff (aOR 4.5, 95% CI 1.02-19.84) were independently associated with adherence. CONCLUSION: Most outlets didn't adhere to malaria guidelines. Regular interaction with regulatory bodies could improve adherence. Ministry of Health should enhance private sector engagement and train DOs on RDT use.

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Published In

Malar J

DOI

EISSN

1475-2875

Publication Date

October 11, 2023

Volume

22

Issue

1

Start / End Page

307

Location

England

Related Subject Headings

  • Tropical Medicine
  • Surveys and Questionnaires
  • Malaria
  • Kenya
  • Humans
  • Fever
  • Cross-Sectional Studies
  • Artemether, Lumefantrine Drug Combination
  • Artemether
  • Antimalarials
 

Citation

APA
Chicago
ICMJE
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Odhiambo, F. O., O’Meara, W. P., Abade, A., Owiny, M., Odhiambo, F., & Oyugi, E. O. (2023). Adherence to national malaria treatment guidelines in private drug outlets: a cross-sectional survey in the malaria-endemic Kisumu County, Kenya. Malar J, 22(1), 307. https://doi.org/10.1186/s12936-023-04744-7
Odhiambo, Fredrick Ouma, Wendy P. O’Meara, Ahmed Abade, Maurice Owiny, Fredrick Odhiambo, and Elvis O. Oyugi. “Adherence to national malaria treatment guidelines in private drug outlets: a cross-sectional survey in the malaria-endemic Kisumu County, Kenya.Malar J 22, no. 1 (October 11, 2023): 307. https://doi.org/10.1186/s12936-023-04744-7.
Odhiambo FO, O’Meara WP, Abade A, Owiny M, Odhiambo F, Oyugi EO. Adherence to national malaria treatment guidelines in private drug outlets: a cross-sectional survey in the malaria-endemic Kisumu County, Kenya. Malar J. 2023 Oct 11;22(1):307.
Odhiambo, Fredrick Ouma, et al. “Adherence to national malaria treatment guidelines in private drug outlets: a cross-sectional survey in the malaria-endemic Kisumu County, Kenya.Malar J, vol. 22, no. 1, Oct. 2023, p. 307. Pubmed, doi:10.1186/s12936-023-04744-7.
Odhiambo FO, O’Meara WP, Abade A, Owiny M, Odhiambo F, Oyugi EO. Adherence to national malaria treatment guidelines in private drug outlets: a cross-sectional survey in the malaria-endemic Kisumu County, Kenya. Malar J. 2023 Oct 11;22(1):307.
Journal cover image

Published In

Malar J

DOI

EISSN

1475-2875

Publication Date

October 11, 2023

Volume

22

Issue

1

Start / End Page

307

Location

England

Related Subject Headings

  • Tropical Medicine
  • Surveys and Questionnaires
  • Malaria
  • Kenya
  • Humans
  • Fever
  • Cross-Sectional Studies
  • Artemether, Lumefantrine Drug Combination
  • Artemether
  • Antimalarials