Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia
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 dihyd...
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th-mahidol.460772019-08-28T13:40:09Z Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia 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 Immunology and Microbiology Medicine 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. 2019-08-23T11:24:58Z 2019-08-23T11:24:58Z 2018-01-01 Article American Journal of Tropical Medicine and Hygiene. Vol.98, No.2 (2018), 543-550 10.4269/ajtmh.17-0680 00029637 2-s2.0-85041492236 https://repository.li.mahidol.ac.th/handle/123456789/46077 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85041492236&origin=inward |
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Immunology and Microbiology Medicine Angela Devine Enny Kenangalem Faustina Helena Burdam Nicholas M. Anstey Jeanne Rini Poespoprodjo Ric N. Price Shunmay Yeung Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia |
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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. |
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Universitas Gadjah Mada |
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Universitas Gadjah Mada Angela Devine Enny Kenangalem Faustina Helena Burdam Nicholas M. Anstey Jeanne Rini Poespoprodjo Ric N. Price Shunmay Yeung |
format |
Article |
author |
Angela Devine Enny Kenangalem Faustina Helena Burdam Nicholas M. Anstey Jeanne Rini Poespoprodjo Ric N. Price Shunmay Yeung |
author_sort |
Angela Devine |
title |
Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia |
title_short |
Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia |
title_full |
Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia |
title_fullStr |
Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia |
title_full_unstemmed |
Treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in Papua, Indonesia |
title_sort |
treatment-seeking behavior after the implementation of a unified policy of dihydroartemisinin- piperaquine for the treatment of uncomplicated malaria in papua, indonesia |
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2019 |
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https://repository.li.mahidol.ac.th/handle/123456789/46077 |
_version_ |
1763497330687868928 |