期刊
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
卷 71, 期 5, 页码 525-530出版社
AMER SOC TROP MED & HYGIENE
DOI: 10.4269/ajtmh.2004.71.525
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Measuring baseline levels of adherence and identifying risk factors for non-adherence are important steps before the introduction of new antimalarials. In Mbarara in southwestern Uganda, we assessed adherence to artemether-lumefantrine (Coartem(R)) in its latest World Health Organization blister formulation. Patients with uncomplicated Plasmodium falciparum malaria were prescribed artemether-lumefantrine and received an explanation of how to take the following five doses at home. A tablet count was made and a questionnaire was completed during a home visit. Among 210 analyzable patients, 21 (10.0%) were definitely or probably non-adherent, whereas 189 (90.0%) were probably adherent. Age group was not associated with adherence. Lack of formal education was the only factor associated with non-adherence after controlling for confounders (odds ratio 3.1, 95% confidence interval [CI] = 1.1-9.7). Mean lumefantrine blood levels were-lower among non-adherent (n = 16) (2.76 mug/mL, 95% CI = 1.06-4.45) than among adherent (n = 171) (3.19 mug/mL, 95% CI = 2.84-3.54) patients, but this difference was not statistically significant. The high adherence to artemether-lumefantrine found in our study suggest that this drug is likely to be very effective in Mbarara provided that patients receive clear dosage explanations.
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