Impact of health education intervention on the patients' adherence to malaria artemisinin-based combination therapy...

Global malaria control programmes such as approaches to community engagements to deliver malaria control interventions have been successful in controlling malaria. Strategies aimed at accelerating patients' adherence to prescribed artemisinin-based combination therapy (ACT) are needed in the fight to control and eradicate malaria. Previous studies have shown the power of health education in improving patients' adherence to ACT. The objective of this study was to establish the impact of a community health education intervention on the patients' adherence to malaria ACT in Kamuli District, Uganda.

A pre-post-test intervention study without a control group was used to understand the impact of community health education training in improving patients' adherence to ACT. Quantitatively, equal number of 1266 patients were enrolled and assigned into any of the three arms equally (422)-no follow up, follow-up on day 2 and day 4 arm at pre-test and post-test phases. Qualitatively, 24 key informants were enrolled purposively. Mann-Whitney U test was used to establish the impact of the community health education on patients' adherence to ACT. Statistical significance was established at p < 0.05. Qualitative data was analysed using the thematic analysis technique.

A total of 1688 patients were analysed. At pre-test, the median age was 20 years with majority (64.3%) being females while patients' adherence was reported to be 588/844 (69.7%). At post-test, the median age was 21 years, majority (62.6%) females, and patients' adherence 700/844 (82.9%). A Mann-Whitney U test showed a statistically significant difference in the patients' adherence to ACT of pre-test and post-test after the intervention (U = 308,904, Z = - 6.409, p < 0.0001), with higher adherence at post-test (median = 900.5) than pre-test (median = 788.5) and small effect (0.156). Qualitatively, not all health workers explain clearly how to use the ACT medicines prescribed.

Community health education as an intervention was effective in improving patient's adherence to ACT. Therefore, there is need to avail medical supplies and patient education with adherence support to ensure adequate patients' adherence to ACT.