Access to artesunate-amodiaquine, quinine and other anti-malarials: policy and markets in Burundi

Malaria Journal

Research

Karly S Louie¹  Jean-René Kiechel²  Graciela Diap²  Isaac Boakye³  Samuel Blay-Nguah³  Patrick E Karikari³  John H Amuasi⁴  Jeanne Karenzo⁵  Lievin Nsabiyumva⁵  Baza Dismas⁵ 

[1] Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK;Drugs for Neglected Diseases initiative (DNDi), 1202, Geneva, Switzerland;Komfo Anokye Teaching Hospital (KATH), P.O. BOX KS 1934, Kumasi, Ghana;Komfo Anokye Teaching Hospital (KATH), P.O. BOX KS 1934, Kumasi, Ghana;Division of Health Policy and Management, Mayo Memorial Building, University of Minnesota School of Public Health, PhD Program, 420 Delaware Street S.E., 55455, Minneapolis, MN, USA;National Malaria Control Programme, Ministry of Health, Bujumbura, Burundi;

关键词: Malaria;    Private Sector;    Quinine;    Uncomplicated Malaria;    Artemisinin Combination Therapy;   

DOI  :  10.1186/1475-2875-10-34

 received in 2010-11-08, accepted in 2011-02-10,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMalaria is the leading cause of morbidity and mortality in post-conflict Burundi. To counter the increasing challenge of anti-malarial drug resistance and improve highly effective treatment Burundi adopted artesunate-amodiaquine (AS-AQ) as first-line treatment for uncomplicated Plasmodium falciparum malaria and oral quinine as second-line treatment in its national treatment policy in 2003. Uptake of this policy in the public, private and non-governmental (NGO) retail market sectors of Burundi is relatively unknown. This study was conducted to evaluate access to national policy recommended anti-malarials.MethodsAdapting a standardized methodology developed by Health Action International/World Health Organization (HAI/WHO), a cross-sectional survey of 70 (24 public, 36 private, and 10 NGO) medicine outlets was conducted in three regions of Burundi, representing different levels of transmission of malaria. The availability on day of the survey, the median prices, and affordability (in terms of number of days' wages to purchase treatment) of AS-AQ, quinine and other anti-malarials were calculated.ResultsAnti-malarials were stocked in all outlets surveyed. AS-AQ was available in 87.5%, 33.3%, and 90% of public, private, and NGO retail outlets, respectively. Quinine was the most common anti-malarial found in all outlet types. Non-policy recommended anti-malarials were mainly found in the private outlets (38.9%) compared to public (4.2%) and NGO (0%) outlets. The median price of a course of AS-AQ was US$0.16 (200 Burundi Francs, FBu) for the public and NGO markets, and 3.5-fold higher in the private sector (US$0.56 or 700 FBu). Quinine tablets were similarly priced in the public (US$1.53 or 1,892.50 FBu), private and NGO sectors (both US$1.61 or 2,000 FBu). Non-policy anti-malarials were priced 50-fold higher than the price of AS-AQ in the public sector. A course of AS-AQ was affordable at 0.4 of a day's wage in the public and NGO sectors, whereas, it was equivalent to 1.5 days worth of wages in the private sector.ConclusionsAS-AQ was widely available and affordable in the public and NGO markets of hard-to-reach post-conflict communities in Burundi. However greater accessibility and affordability of policy recommended anti-malarials in the private market sector is needed to improve country-wide policy uptake.

【 授权许可】

CC BY   
© Amuasi et al; licensee BioMed Central Ltd. 2011