A cross-sectional study of the availability and price of anti-malarial medicines and malaria rapid diagnostic tests in private sector retail drug outlets in rural Western Kenya, 2013

Malaria Journal

Research

Christina Riley¹  Simon Kariuki²  Vincent Were²  Peter Ouma²  Stephanie Dellicour³  Meghna Desai⁴  Julie Gutman⁴  Ann M. Buff⁵  Ahmeddin Omar⁶  Urbanus Kioko⁷ 

[1] Emory Rollins School of Public Health, 1518 Clifton Road NE, 30322, Atlanta, GA, USA;KEMRI, Centre for Global Health Research, Box 1578, 40100, Kisumu, Kenya;Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, Merseyside, UK;Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, CDC, 1600 Clifton Rd NE, Mailstop A-06, 30333, Atlanta, GA, USA;Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, CDC, 1600 Clifton Rd NE, Mailstop A-06, 30333, Atlanta, GA, USA;U.S. President’s Malaria Initiative, PO Box 606, United Nations Avenue, Village Market, 00621, Nairobi, Kenya;Malaria Control Unit, Ministry of Health, PO Box 30016, Afya House, Cathedral Road, 00100, Nairobi, Kenya;Malaria Control Unit, Ministry of Health, PO Box 30016, Afya House, Cathedral Road, 00100, Nairobi, Kenya;Field Epidemiology and Laboratory Training Programme, Ministry of Health, PO Box 30016, Afya House, Cathedral Road, 00100, Nairobi, Kenya;

关键词: Malaria;    Anti-malarials;    Diagnostic tests;    Private sector;    Kenya;   

DOI  :  10.1186/s12936-016-1404-5

 received in 2016-02-02, accepted in 2016-06-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAlthough anti-malarial medicines are free in Kenyan public health facilities, patients often seek treatment from private sector retail drug outlets. In mid-2010, the Affordable Medicines Facility-malaria (AMFm) was introduced to make quality-assured artemisinin-based combination therapy (ACT) accessible and affordable in private and public sectors.MethodsPrivate sector retail drug outlets stocking anti-malarial medications within a surveillance area of approximately 220,000 people in a malaria perennial high-transmission area in rural western Kenya were identified via a census in September 2013. A cross-sectional study was conducted in September–October 2013 to determine availability and price of anti-malarial medicines and malaria rapid diagnostic tests (RDTs) in drug outlets. A standardized questionnaire was administered to collect drug outlet and personnel characteristics and availability and price of anti-malarials and RDTs.ResultsOf 181 drug outlets identified, 179 (99 %) participated in the survey. Thirteen percent were registered pharmacies, 25 % informal drug shops, 46 % general shops, 13 % homesteads and 2 % other. One hundred sixty-five (92 %) had at least one ACT type: 162 (91 %) had recommended first-line artemether-lumefantrine (AL), 22 (12 %) had recommended second-line dihydroartemisinin-piperaquine (DHA-PPQ), 85 (48 %) had sulfadoxine-pyrimethamine (SP), 60 (34 %) had any quinine (QN) formulation, and 14 (8 %) had amodiaquine (AQ) monotherapy. The mean price (range) of an adult treatment course for AL was $1.01 ($0.35–4.71); DHA-PPQ was $4.39 ($0.71–7.06); QN tablets were $2.24 ($0.12–4.71); SP was $0.62 ($0.24–2.35); AQ monotherapy was $0.42 ($0.24–1.06). The mean AL price with or without the AMFm logo did not differ significantly ($1.01 and 1.07, respectively; p = 0.45). Only 17 (10 %) drug outlets had RDTs; 149 (84 %) never stocked RDTs. The mean RDT price was $0.92 ($0.24–2.35).ConclusionsMost outlets never stocked RDTs; therefore, testing prior to treatment was unlikely for customers seeking treatment in the private retail sector. The recommended first-line treatment, AL, was widely available. Although SP and AQ monotherapy are not recommended for treatment, both were less expensive than AL, which might have caused preferential use by customers. Interventions that create community demand for malaria diagnostic testing prior to treatment and that increase RDT availability should be encouraged.

【 授权许可】

CC BY   
© The Author(s) 2016