Project Title: Respond to efficacy decay analysis of Artemisinin based combination Therapy, (ACTS) in rural Tanzania. Intervening on provider compliance and patient adherence to correct malaria treatment
Project Description: Malaria predominates in Tanzania’s disease burden[1]. There is significant progress for malaria control in the country as is evident in several regions that malaria transmission was endemic [2-9]. However, in many areas of the country transmission is still very high even though the National Malaria Control Programme’s (NMCP) objectives are aligned with Global Malaria Eradication Plans. Case management with Artemisinin based Combination Therapy (ACT) for malaria is the main disease’s control strategy. It is evident... Malaria predominates in Tanzania’s disease burden[1]. There is significant progress for malaria control in the country as is evident in several regions that malaria transmission was endemic [2-9]. However, in many areas of the country transmission is still very high even though the National Malaria Control Programme’s (NMCP) objectives are aligned with Global Malaria Eradication Plans. Case management with Artemisinin based Combination Therapy (ACT) for malaria is the main disease’s control strategy. It is evident that in combination with other efficacious control interventions, ACTs can help Tanzania move towards sustained control and subsequent malaria elimination. As part of an initial observational phase IV platform (INESS), we assessed systems effectiveness (efficacy decay) of ACTs, through the staircase approach[10] in two neighboring Health and Demographic Surveillance System sites (HDSS) in rural Tanzania. The overall effectiveness of ACT was shown to be below 20 percent in both sites (see Figure 1, unpublished results from INESS studies). These results are disturbing because while the country and its development partners have substantially invested in drugs that would save lives for thousands of patients with malaria, weaknesses in the health systems can compromise these efforts. The INESS study was designed to investigate conditions in each stage of the health care delivery staircase (i) patients’ access (ii) targeting accuracy and provider compliance and (iii) patient adherence. It was found out that none of them were optimally performing. Hence, it is obvious that there are urgent needs to implement interventions addressing all bottlenecks identified in the staircases to improve overall systems effectiveness of ACT. This is essential for delivering the maximum benefits of these expensive drugs to the target population. Continued investments in ACTs in these areas will be justified if they prevent malaria morbidity and mortality as suggested by current efficacy levels of the ACTs in use.
Principal Investigator : Irene Masanja
Department Name : HSIEP
Time frame: (2014-04-25) - (2016-03-31)
Swiss Tropical and Public Health Institute (Normal)
External Collaborating Partners
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