Factors associated with access and adherence to artemisinin‐based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone
Abstract Background Access and adherence to artemisinin-based combination therapy (ACT) are key challenges to effective malaria treatment. A secondary analysis of the Sierra Leone malaria Knowledge, Attitudes, and Practices (mKAP) survey was conducted to investigate access and adherence to ACT for t...
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ftdoajarticles:oai:doaj.org/article:243393f917734d5bb577436df99bb718 2023-05-15T15:18:54+02:00 Factors associated with access and adherence to artemisinin‐based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone Kristin Banek Emily L. Webb Emily Bostick Doogue Samuel Juana Smith Daniel Chandramohan Sarah G. Staedke 2021-01-01T00:00:00Z https://doi.org/10.1186/s12936-021-03590-9 https://doaj.org/article/243393f917734d5bb577436df99bb718 EN eng BMC https://doi.org/10.1186/s12936-021-03590-9 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03590-9 1475-2875 https://doaj.org/article/243393f917734d5bb577436df99bb718 Malaria Journal, Vol 20, Iss 1, Pp 1-13 (2021) Malaria Antimalarial Artemisinin-based combination therapy (ACT) Sierra Leone Prompt treatment Access Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1186/s12936-021-03590-9 2022-12-31T06:27:45Z Abstract Background Access and adherence to artemisinin-based combination therapy (ACT) are key challenges to effective malaria treatment. A secondary analysis of the Sierra Leone malaria Knowledge, Attitudes, and Practices (mKAP) survey was conducted to investigate access and adherence to ACT for the treatment of fever in children under-five. Methods The mKAP was a nationally representative, two-stage cluster-sample survey, conducted in 2012. Thirty primary sampling units per district were randomly selected using probability proportionate to size, based on national census estimates; 14 households were subsequently randomly selected and enrolled per sampling unit. The analysis was restricted to children under-five with fever in the past two weeks. Factors associated with access and adherence were assessed using multivariate logistic regression. Results Of 5169 enrolled households, 1456 reported at least one child under-five with fever in the past two weeks. Of the 1641 children from these households, 982 (59.8%) received any treatment for fever and were analysed for access to ACT; 469 (47.6%) received ACT and 466 were analysed for treatment adherence. Only 222 (47.4%) febrile children received ACT and completed 3-day treatment. In an adjusted analysis, factors associated with ACT access included knowledge of ACT (odds ratio [OR] 2.78, 95% CI 2.02–3.80; p < 0.001), knowledge of insecticide-treated nets (ITNs) (OR 1.84, 95% CI 1.29–2.63; p = 0.001), source of care (public health facility vs. other; OR 1.86, 95% CI 1.27–2.72, p = 0.001), geographic region (East vs. West; OR 2.30, 95% CI 1.20–4.44; p = 0.025), and age (24–59 vs. 0–23 months; OR 1.45, 95% CI 1.07–1.96; p = 0.016). The only factor associated with ACT adherence was time to treatment; children treated within 24 h were less likely to adhere (OR 0.55, 95% CI 0.34–0.89; p = 0.015). Conclusions In 2012, access and adherence to ACT remained low in Sierra Leone. Knowledge of ACT and ITNs, and seeking care in the public sector, were most strongly associated ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 20 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Malaria Antimalarial Artemisinin-based combination therapy (ACT) Sierra Leone Prompt treatment Access Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Malaria Antimalarial Artemisinin-based combination therapy (ACT) Sierra Leone Prompt treatment Access Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Kristin Banek Emily L. Webb Emily Bostick Doogue Samuel Juana Smith Daniel Chandramohan Sarah G. Staedke Factors associated with access and adherence to artemisinin‐based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone |
topic_facet |
Malaria Antimalarial Artemisinin-based combination therapy (ACT) Sierra Leone Prompt treatment Access Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Access and adherence to artemisinin-based combination therapy (ACT) are key challenges to effective malaria treatment. A secondary analysis of the Sierra Leone malaria Knowledge, Attitudes, and Practices (mKAP) survey was conducted to investigate access and adherence to ACT for the treatment of fever in children under-five. Methods The mKAP was a nationally representative, two-stage cluster-sample survey, conducted in 2012. Thirty primary sampling units per district were randomly selected using probability proportionate to size, based on national census estimates; 14 households were subsequently randomly selected and enrolled per sampling unit. The analysis was restricted to children under-five with fever in the past two weeks. Factors associated with access and adherence were assessed using multivariate logistic regression. Results Of 5169 enrolled households, 1456 reported at least one child under-five with fever in the past two weeks. Of the 1641 children from these households, 982 (59.8%) received any treatment for fever and were analysed for access to ACT; 469 (47.6%) received ACT and 466 were analysed for treatment adherence. Only 222 (47.4%) febrile children received ACT and completed 3-day treatment. In an adjusted analysis, factors associated with ACT access included knowledge of ACT (odds ratio [OR] 2.78, 95% CI 2.02–3.80; p < 0.001), knowledge of insecticide-treated nets (ITNs) (OR 1.84, 95% CI 1.29–2.63; p = 0.001), source of care (public health facility vs. other; OR 1.86, 95% CI 1.27–2.72, p = 0.001), geographic region (East vs. West; OR 2.30, 95% CI 1.20–4.44; p = 0.025), and age (24–59 vs. 0–23 months; OR 1.45, 95% CI 1.07–1.96; p = 0.016). The only factor associated with ACT adherence was time to treatment; children treated within 24 h were less likely to adhere (OR 0.55, 95% CI 0.34–0.89; p = 0.015). Conclusions In 2012, access and adherence to ACT remained low in Sierra Leone. Knowledge of ACT and ITNs, and seeking care in the public sector, were most strongly associated ... |
format |
Article in Journal/Newspaper |
author |
Kristin Banek Emily L. Webb Emily Bostick Doogue Samuel Juana Smith Daniel Chandramohan Sarah G. Staedke |
author_facet |
Kristin Banek Emily L. Webb Emily Bostick Doogue Samuel Juana Smith Daniel Chandramohan Sarah G. Staedke |
author_sort |
Kristin Banek |
title |
Factors associated with access and adherence to artemisinin‐based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone |
title_short |
Factors associated with access and adherence to artemisinin‐based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone |
title_full |
Factors associated with access and adherence to artemisinin‐based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone |
title_fullStr |
Factors associated with access and adherence to artemisinin‐based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone |
title_full_unstemmed |
Factors associated with access and adherence to artemisinin‐based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone |
title_sort |
factors associated with access and adherence to artemisinin‐based combination therapy (act) for children under five: a secondary analysis of a national survey in sierra leone |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12936-021-03590-9 https://doaj.org/article/243393f917734d5bb577436df99bb718 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 20, Iss 1, Pp 1-13 (2021) |
op_relation |
https://doi.org/10.1186/s12936-021-03590-9 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03590-9 1475-2875 https://doaj.org/article/243393f917734d5bb577436df99bb718 |
op_doi |
https://doi.org/10.1186/s12936-021-03590-9 |
container_title |
Malaria Journal |
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20 |
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1 |
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1766349066220863488 |