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- - - Reductions in Artemisinin-Based Combination Therapy Consumption after Scale-up of RDT in Zambia

Sunday, 24th of March 2013

REDUCTIONS IN ARTEMISININ-BASED COMBINATION THERAPY CONSUMPTION AFTER THE NATIONWIDE SCALE UP OF ROUTINE MALARIA RAPID DIAGNOSTIC TESTING IN ZAMBIA
 

Am J Trop Med Hyg 2012 vol. 87 no. 3 437-446

 

1. 1.   Joshua O. Yukich*,
2. 2.   Adam Bennett,
3. 3.   Audrey Albertini,
4. 4.   Sandra Incardona,
5. 5.   Hawela Moonga,
6. 6.   Zunda Chisha,
7. 7.   Busiku Hamainza,
8. 8.   John M. Miller,
9. 9.   Joseph Keating,

10. Thomas P. Eisele and

11. David Bell 

+ Author Affiliations

1. 1.    Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland; Ministry of Health, National Malaria Control Centre, Lusaka, Zambia; Akros Research, Lusaka, Zambia; PATH Malaria Control and Evaluation Partnership in Africa (MACEPA), National Malaria Control Centre, Lusaka, Zambia

+ Author Notes

       Authors' addresses: Joshua O. Yukich, Adam Bennett, Joseph Keating, and Thomas P. Eisele, Tulane University School of Public Health and Tropical Medicine, Department of Global Health Systems and Development, New Orleans, LA, E-mails: jyukich@tulane.edu, abennett@tulane.edu, jkeating@tulane.edu, and teisele@tulane.edu. Audrey Albertini, Sandra Incardona, and David Bell, Foundation for Innovative New Diagnostics, Geneva, Switzerland, E-mails: Audrey.Albertini@finddiagnostics.org, Sandra.Incardona@finddiagnostics.org, and David.Bell@finddiagnostics.org. Hawela Moonga and Busiku Hamainza, National Malaria Control Centre, Ministry of Health, Lusaka, Zambia, E-mails: mhawela@yahoo.co.uk, and bossbusk@gmail.com. Zunda Chisha, Akros Research, Lusaka, Zambia, E-mail: zchisha@akrosresearch.com. John M. Miller, Malaria Control and Evaluation Partnership in Africa/PATH, National Malaria Control Centre, Ministry of Health, Lusaka, Zambia, E-mail: jmiller@path.org.

1. ↵* Address correspondence to Joshua O. Yukich, Tulane University School of Public Health and Tropical Medicine, Department of Global Health Systems and Development, 1440 Canal Street, New Orleans, LA 70112. E-mail: jyukich@tulane.edu

 

Abstract below; full text is at

 http://www.ajtmh.org/content/87/3/437.full?sid=608d7073-ef94-45ba-abc2-5afce8ce2761

 

The National Malaria Control Center of Zambia introduced rapid diagnostic tests (RDTs) to detect Plasmodium falciparum as a pilot in some districts in 2005 and 2006; scale up at a national level was achieved in 2009. Data on RDT use, drug consumption, and diagnostic results were collected in three Zambian health districts to determine the impact RDTs had on malaria case management over the period 2004–2009. Reductions were seen in malaria diagnosis and antimalarial drug prescription (66.1 treatments per facility-month (95% confidence interval [CI] = 44.7–87.4) versus 26.6 treatments per facility-month (95% CI = 11.8–41.4)) pre- and post-RDT introduction. Results varied between districts, with significant reductions in low transmission areas but none in high areas. Rapid diagnostic tests may contribute to rationalization of treatment of febrile illness and reduce antimalarial drug consumption in Africa; however, their impact may be greater in lower transmission areas. National scale data will be necessary to confirm these findings.