Exploring provider and community responses to the new malaria diagnostic and treatment regime in Solomon Islands

Wijesinghe, Rushika S., Atkinson, Jo-An M., Bobogare, Albino, Wini, Lyndes and Whittaker, Maxine (2011) Exploring provider and community responses to the new malaria diagnostic and treatment regime in Solomon Islands. Malaria Journal, 10 3.1-3.12. doi:10.1186/1475-2875-10-3

Author Wijesinghe, Rushika S.
Atkinson, Jo-An M.
Bobogare, Albino
Wini, Lyndes
Whittaker, Maxine
Title Exploring provider and community responses to the new malaria diagnostic and treatment regime in Solomon Islands
Journal name Malaria Journal   Check publisher's open access policy
ISSN 1475-2875
Publication date 2011-01
Sub-type Article (original research)
DOI 10.1186/1475-2875-10-3
Open Access Status DOI
Volume 10
Start page 3.1
End page 3.12
Total pages 12
Place of publication London, England, U.K.
Publisher BioMed Central
Collection year 2012
Language eng
Formatted abstract
Improvements in availability and accessibility of artemisinin-based combination therapy (ACT) for malaria treatment and the emergence of multi-drug-resistant parasites have prompted many countries to adopt ACT as the first-line drug. In 2009, Solomon Islands (SI) likewise implemented new national treatment guidelines for malaria. The ACT, Coartem® (artemether-lumefantrine) is now the primary pharmacotherapy in SI for Plasmodium falciparum malaria, Plasmodium vivax malaria or mixed infections. Targeted treatment is also recommended in the new treatment regime through maintenance of quality microscopy services and the introduction of Rapid Diagnostic Tests (RDTs). Ascertaining the factors that influence community and provider acceptance of and adherence to the new treatment regime will be vital to improving the effectiveness of this intervention and reducing the risk of development of drug resistance.
In order to understand community and prescriber perceptions and acceptability of the new diagnostic and treatment interventions, 12 focus group discussions (FGDs) and 12 key informant interviews (KII) were carried out in rural and urban villages of Malaita Province, Solomon Islands four months subsequent to roll out of these interventions.
Lack of access to microscopy or distrust in the accuracy of diagnostic tools were reported by some participants as reasons for the ongoing practice of presumptive treatment of malaria. Lack of confidence in RDT accuracy has negatively impacted its acceptability. Coartem® had good acceptability among most participants, however, some rural participants questioned its effectiveness due to lack of side effects and the larger quantity of tablets required to be taken. Storing of left over medication for subsequent fever episodes was reported as common.
To address these issues, further training and supportive supervision of healthcare workers will be essential, as will the engagement of influential community members in health promotion activities to improve acceptability of RDTs and adherence to the new treatment regime. Exploring the extent of these issues beyond the study population must be a priority for malaria programme managers. Practices such as presumptive treatment and the taking of sub-curative doses are of considerable concern for both the health of individuals and the increased risk it poses to the development of parasite resistance to this important first-line treatment against malaria.
Keyword Falciparum
Acceptance of Health Care
Rural Population
Urban Population
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 8 times in Scopus Article | Citations
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Created: Wed, 14 Mar 2012, 10:54:50 EST by Geraldine Fitzgerald on behalf of School of Public Health