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Self-reported data: a major tool to assess compliance with anti-malarial combination therapy among children in
Aurélia Souares1, Patricia Moulin, Sophie Sarrassat
1Institut de Recherche pour le Développement, UR10, Faculté de pharmacie, 4 av de l'Observatoire, 75006 Paris, France. souares@uni-heidelberg.De
Insights
Self-reported data and drug level testing showed varying adherence to antimalarial treatment in Senegalese children. Self-reporting offers a practical method for assessing compliance in resource-limited settings.
Area of Science:
- Pharmacology
- Public Health
- Clinical Trials
Background:
- Measuring medication compliance is challenging due to the absence of a formal gold standard.
- This study evaluated different compliance measurement techniques for amodiaquine/sulphadoxine-pyrimethamine (AQ/SP) in Senegalese children.
Purpose of the Study:
- To compare the effectiveness of various methods for measuring drug compliance.
- To assess adherence to antimalarial treatment in children in Senegal.
Main Methods:
- A study was conducted in five health centers in Senegal's Thies region.
- Children prescribed AQ/SP were recruited, with blood and urine samples collected for drug dosage analysis.
- Caregivers and children were interviewed to gather self-reported data on drug intake.
Main Results:
- 64.7% of children adhered to at least 80% of the prescribed antimalarial dose; only 37.7% were fully compliant.
- Self-reported data showed 72.7% agreement with blood drug levels for amodiaquine.
- Blood drug levels for SP were 91.4% concordant with urine tests and 90% with self-reported data.
Conclusions:
- Self-reported data can provide valuable quantitative insights into drug intake and administration, especially in resource-poor settings.
- This method is practical for assessing patient behavior and the use of new antimalarial treatments.
- Blood and urine drug assays offer qualitative confirmation of drug intake, with urine assays useful for public health surveillance.
Background:
Although there are many methods available for measuring compliance, there is no formal gold standard. Different techniques used to measure compliance were compared among children treated by the anti-malarial amodiaquine/sulphadoxine-pyrimethamine (AQ/SP) combination therapy, in use in Senegal between 2004 and 2006.
Methods:
The study was carried out in 2004, in five health centres located in the Thies region (Senegal). Children who had AQ/SP prescribed for three and one day respectively at the health centre were recruited. The day following the theoretical last intake of AQ, venous blood, and urine samples were collected for anti-malarial drugs dosage. Caregivers and children above five years were interviewed concerning children's drug intake.
Results:
Among the children, 64.7% adhered to 80% of the prescribed dose and only 37.7% were strict full adherent to the prescription. There was 72.7% agreement between self-reported data and blood drug dosage for amodiaquine treatment. Concerning SP, results found that blood dosages were 91.4% concordant with urine tests and 90% with self-reported data based on questionnaires.
Conclusion:
Self-reported data could provide useful quantitative information on drug intake and administration. Under strict methodological conditions this method, easy to implement, can be used to describe patients' behaviors and their use of new anti-malarial treatment. Self-reported data is a major tool for assessing compliance in resource poor countries. Blood and urine drug dosages provide qualitative results that confirm any drug intake. Urine assays for SP could be useful to obtain public health data, for example on chemoprophylaxis among pregnant women.
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