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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/46077
Title: Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia
Authors: Angela Devine
Enny Kenangalem
Faustina Helena Burdam
Nicholas M. Anstey
Jeanne Rini Poespoprodjo
Ric N. Price
Shunmay Yeung
Universitas Gadjah Mada
London School of Hygiene & Tropical Medicine
Menzies School of Health Research
Mahidol University
Nuffield Department of Clinical Medicine
Papuan Health and Community Development Foundation
Mimika District Health Authority
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-2018
Citation: American Journal of Tropical Medicine and Hygiene. Vol.98, No.2 (2018), 543-550
Abstract: Copyright © 2018 by The American Society of Tropical Medicine and Hygiene. Artemisinin combination therapy is recommended for the treatment of multidrug resistant Plasmodium falciparum and Plasmodium vivax. In March 2006, antimalarial policy in Indonesia was changed to a unified treatment with dihydroartemisinin-piperaquine for all species of malaria because of the low efficacy of previous drug treatments. In 2013, a randomized cross-sectional household survey in Papua was used to collect data on demographics, parasite positivity, treatment-seeking behavior, diagnosis and treatment of malaria, and household costs. Results were compared with a similar survey undertaken in 2005. A total of 800 households with 4,010 individuals were included in the 2013 survey. The prevalence of malaria parasitemia was 12% (348/2,795). Of the individuals who sought treatment of fever, 67% (66/98) reported attending a public provider at least once compared with 46% (349/764) before policy change (P < 0.001). During the 100 visits to healthcare providers, 95% (95) included a blood test for malaria and 74% (64/86) resulted in the recommended antimalarial for the diagnosed species, the corresponding figures before policy change were 48% (433/ 894) and 23% (78/336). The proportion of individuals seeking treatment more than once fell from 14% (107/764) before policy change to 2% (2/98) after policy change (P = 0.005). The mean indirect cost per fever episode requiring treatment seeking decreased from US$44.2 in 2005 to US$33.8 in 2013 (P = 0.006). The implementation of a highly effective antimalarial treatment was associated with better adherence of healthcare providers in both the public and private sectors and a reduction in clinical malaria and household costs.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85041492236&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/46077
ISSN: 00029637
Appears in Collections:Scopus 2018

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