Evidence on anti-malarial and diagnostic markets in Cambodia to guide malaria elimination strategies and policies

Malaria Journal

Research

Sochea Phok¹  Dysoley Lek² 

[1] PSI Cambodia (PSK), No. 29, Street 334, Boeung Keng Kang I, Chamcar Mon, Phnom Penh, Kingdom of Cambodia;The National Centre for Parasitology, Entomology and Malaria Control, 477 Betong Street (Corner St. 92), Village Trapangsvay, Sanakat Phnom Penh Thmey, Khan Sen Sok, Phnom Penh, Kingdom of Cambodia;School of Public Health, National Institute of Public Health, Phnom Penh, Kingdom of Cambodia;

关键词: Malaria elimination;    Case management;    Anti-malarial;    ACT;    Private sector;    Cambodia;   

DOI  :  10.1186/s12936-017-1807-y

 received in 2016-12-05, accepted in 2017-04-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundUnderstanding Cambodia’s anti-malarial and diagnostic landscape in 2015 is critical for informing and monitoring strategies and policies as Cambodia moves forward with national efforts to eliminate malaria. The aim of this paper is to present timely and key findings on the public and private sector anti-malarial and diagnostic landscape in Cambodia. This evidence can serve as a baseline benchmark for guiding implementation of national strategies as well as other regional initiatives to address malaria elimination activities.MethodsFrom August 17th to October 1st, 2015, a cross sectional, nationally-representative malaria outlet survey was conducted in Cambodia. A census of all public and private outlets with potential to distribute malaria testing and/or treatment was conducted among 180 communes. An audit was completed for all anti-malarials, malaria rapid diagnostic tests (RDT) and microscopy.ResultsA total of 26,664 outlets were screened, and 1303 outlets were eligible and interviewed. Among all screened outlets in the public sector, 75.9% of public health facilities and 67.7% of community health workers stocked both malaria diagnostic testing and a first-line artemisinin-based combination therapy (ACT). Among anti-malarial-stocking private sector outlets, 64.7% had malaria blood testing available, and 70.9% were stocking a first-line ACT. Market share data illustrate that most of the anti-malarials were sold or distributed through the private sector (58.4%), including itinerant drug vendors (23.4%). First-line ACT accounted for the majority of the market share across the public and private sectors (90.3%). Among private sector outlets stocking any anti-malarial, the proportion of outlets with a first-line ACT or RDT was higher among outlets that had reportedly received one or more forms of ‘support’ (e.g. reportedly received training in the previous year on malaria diagnosis [RDT and/or microscopy] and/or the national treatment guidelines for malaria) compared to outlets that did not report receiving any support (ACT: 82.1 and 60.6%, respectively; RDT: 78.2 and 64.0%, respectively).ConclusionThe results point to high availability and distribution of first-line ACT and widespread availability of malaria diagnosis, especially in the public sector. This suggests that there is a strong foundation for achieving elimination goals in Cambodia. However, key gaps in terms of availability of malaria commodities for case management must be addressed, particularly in the private sector where most people seek treatment. Continued engagement with the private sector will be important to ensure accelerated progress towards malaria elimination.

【 授权许可】

CC BY   
© The Author(s) 2017