Medicines dispensers’ knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

Stanley Mwita, Mary Jande, Karol Marwa, Kayo Hamasaki, Deogratias Katabalo, Johanita Burger, Brian Godman, Alessandra Ferrario, Amos Massele, Deodatus Ruganuza

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: In 2005, Tanzania changed its policy for uncomplicated malaria treatment from sulphadoxine–pyrimethamine (SP) to artemisinin-based combination therapy (ACT), specifically artemether-lumefantrine (ALU). SP remains the medicine of choice for intermittent preventive treatment in pregnancy (IPTp). There is a need to assess dispensers’ knowledge regarding the treatment of uncomplicated malaria and IPTp in Tanzania given appreciable self-purchasing to improve future care. Methods: Descriptive cross-sectional design with structured questionnaires to capture quantitative data, with qualitative data captured using focus groups. The study was performed at 32 private pharmacies and 33 Accredited Drug Dispensing Outlets (ADDOs) in the Nyamagana and Sengerema Districts in Tanzania, with 20 dispensers included in the qualitative discussions. Key findings: The knowledge level of dispensers in the private medicine outlets was variable. Most dispensers knew ALU was first line treatment in uncomplicated malaria; however variable knowledge about taking ALU with fatty meals. Generally poor knowledge about dosing intervals for SP in IPTp and variable knowledge regarding treatments in the first trimester. Overall, 49% had good knowledge and 48% moderate knowledge of ACT in uncomplicated malaria. There was a significant relationship between dispenser type and knowledge of ACT but no statistical relationship between the level of knowledge on IPTp and the dispenser. Conclusion: Majority of dispensers in private medicines outlets have good knowledge on ACT policy in the treatment of uncomplicated malaria, however; few dispensers had good knowledge on IPTp, which may contribute to irrational dispensing of SP. This needs addressing given the extent of self-purchasing in Tanzania.
LanguageEnglish
JournalJournal of Pharmaceutical Health Services Research
Early online date17 Jul 2017
DOIs
Publication statusE-pub ahead of print - 17 Jul 2017

Fingerprint

Tanzania
Malaria
Medicine
Pregnancy
Therapeutics
Pharmacies
First Pregnancy Trimester
Focus Groups
Meals
artemisinine
Therapy
pyrimethamine drug combination fanasil
Pharmaceutical Preparations
lumefantrine
artemether

Keywords

  • artemisinin based combination therapy policy
  • private medicine outlets
  • sulphadoxine pyrimethamine
  • Tanzania

Cite this

Mwita, Stanley ; Jande, Mary ; Marwa, Karol ; Hamasaki, Kayo ; Katabalo, Deogratias ; Burger, Johanita ; Godman, Brian ; Ferrario, Alessandra ; Massele, Amos ; Ruganuza, Deodatus. / Medicines dispensers’ knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania. In: Journal of Pharmaceutical Health Services Research. 2017.
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abstract = "Objective: In 2005, Tanzania changed its policy for uncomplicated malaria treatment from sulphadoxine–pyrimethamine (SP) to artemisinin-based combination therapy (ACT), specifically artemether-lumefantrine (ALU). SP remains the medicine of choice for intermittent preventive treatment in pregnancy (IPTp). There is a need to assess dispensers’ knowledge regarding the treatment of uncomplicated malaria and IPTp in Tanzania given appreciable self-purchasing to improve future care. Methods: Descriptive cross-sectional design with structured questionnaires to capture quantitative data, with qualitative data captured using focus groups. The study was performed at 32 private pharmacies and 33 Accredited Drug Dispensing Outlets (ADDOs) in the Nyamagana and Sengerema Districts in Tanzania, with 20 dispensers included in the qualitative discussions. Key findings: The knowledge level of dispensers in the private medicine outlets was variable. Most dispensers knew ALU was first line treatment in uncomplicated malaria; however variable knowledge about taking ALU with fatty meals. Generally poor knowledge about dosing intervals for SP in IPTp and variable knowledge regarding treatments in the first trimester. Overall, 49{\%} had good knowledge and 48{\%} moderate knowledge of ACT in uncomplicated malaria. There was a significant relationship between dispenser type and knowledge of ACT but no statistical relationship between the level of knowledge on IPTp and the dispenser. Conclusion: Majority of dispensers in private medicines outlets have good knowledge on ACT policy in the treatment of uncomplicated malaria, however; few dispensers had good knowledge on IPTp, which may contribute to irrational dispensing of SP. This needs addressing given the extent of self-purchasing in Tanzania.",
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Medicines dispensers’ knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania. / Mwita, Stanley; Jande, Mary; Marwa, Karol ; Hamasaki, Kayo; Katabalo, Deogratias ; Burger, Johanita; Godman, Brian; Ferrario, Alessandra; Massele, Amos; Ruganuza, Deodatus.

In: Journal of Pharmaceutical Health Services Research, 17.07.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Medicines dispensers’ knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

AU - Mwita, Stanley

AU - Jande, Mary

AU - Marwa, Karol

AU - Hamasaki, Kayo

AU - Katabalo, Deogratias

AU - Burger, Johanita

AU - Godman, Brian

AU - Ferrario, Alessandra

AU - Massele, Amos

AU - Ruganuza, Deodatus

PY - 2017/7/17

Y1 - 2017/7/17

N2 - Objective: In 2005, Tanzania changed its policy for uncomplicated malaria treatment from sulphadoxine–pyrimethamine (SP) to artemisinin-based combination therapy (ACT), specifically artemether-lumefantrine (ALU). SP remains the medicine of choice for intermittent preventive treatment in pregnancy (IPTp). There is a need to assess dispensers’ knowledge regarding the treatment of uncomplicated malaria and IPTp in Tanzania given appreciable self-purchasing to improve future care. Methods: Descriptive cross-sectional design with structured questionnaires to capture quantitative data, with qualitative data captured using focus groups. The study was performed at 32 private pharmacies and 33 Accredited Drug Dispensing Outlets (ADDOs) in the Nyamagana and Sengerema Districts in Tanzania, with 20 dispensers included in the qualitative discussions. Key findings: The knowledge level of dispensers in the private medicine outlets was variable. Most dispensers knew ALU was first line treatment in uncomplicated malaria; however variable knowledge about taking ALU with fatty meals. Generally poor knowledge about dosing intervals for SP in IPTp and variable knowledge regarding treatments in the first trimester. Overall, 49% had good knowledge and 48% moderate knowledge of ACT in uncomplicated malaria. There was a significant relationship between dispenser type and knowledge of ACT but no statistical relationship between the level of knowledge on IPTp and the dispenser. Conclusion: Majority of dispensers in private medicines outlets have good knowledge on ACT policy in the treatment of uncomplicated malaria, however; few dispensers had good knowledge on IPTp, which may contribute to irrational dispensing of SP. This needs addressing given the extent of self-purchasing in Tanzania.

AB - Objective: In 2005, Tanzania changed its policy for uncomplicated malaria treatment from sulphadoxine–pyrimethamine (SP) to artemisinin-based combination therapy (ACT), specifically artemether-lumefantrine (ALU). SP remains the medicine of choice for intermittent preventive treatment in pregnancy (IPTp). There is a need to assess dispensers’ knowledge regarding the treatment of uncomplicated malaria and IPTp in Tanzania given appreciable self-purchasing to improve future care. Methods: Descriptive cross-sectional design with structured questionnaires to capture quantitative data, with qualitative data captured using focus groups. The study was performed at 32 private pharmacies and 33 Accredited Drug Dispensing Outlets (ADDOs) in the Nyamagana and Sengerema Districts in Tanzania, with 20 dispensers included in the qualitative discussions. Key findings: The knowledge level of dispensers in the private medicine outlets was variable. Most dispensers knew ALU was first line treatment in uncomplicated malaria; however variable knowledge about taking ALU with fatty meals. Generally poor knowledge about dosing intervals for SP in IPTp and variable knowledge regarding treatments in the first trimester. Overall, 49% had good knowledge and 48% moderate knowledge of ACT in uncomplicated malaria. There was a significant relationship between dispenser type and knowledge of ACT but no statistical relationship between the level of knowledge on IPTp and the dispenser. Conclusion: Majority of dispensers in private medicines outlets have good knowledge on ACT policy in the treatment of uncomplicated malaria, however; few dispensers had good knowledge on IPTp, which may contribute to irrational dispensing of SP. This needs addressing given the extent of self-purchasing in Tanzania.

KW - artemisinin based combination therapy policy

KW - private medicine outlets

KW - sulphadoxine pyrimethamine

KW - Tanzania

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