Understanding Malaria Treatment Adherence in Rwanda: Implications for Artemisinin Resistance

Area of Science:

• Global Health
• Infectious Diseases
• Public Health

Background:

• Prompt malaria diagnosis and effective treatment are crucial interventions.
• Emerging artemisinin resistance in Rwanda necessitates optimal community treatment practices.
• Community knowledge and adherence significantly impact malaria treatment outcomes.

Purpose of the Study:

• To examine malaria knowledge, attitudes, and practices among febrile patients in Rwandan government clinics.
• To identify factors influencing malaria treatment practices and adherence.
• To inform interventions for improving antimalarial adherence in Rwanda.

Main Methods:

• A cross-sectional study was conducted in six health facilities in moderate- to high-malaria-transmission areas of Rwanda.
• Semistructured questionnaires were used to interview 406 patients or caregivers of children with fevers.
• Data collection occurred from December 2023 to February 2024.

Main Results:

• High malaria knowledge was observed: 81% knew symptoms, 72% understood transmission, and 74.6% were aware of control measures.
• Despite high knowledge, only 46% of patients who received malaria treatment completed the full 3-day course.
• Poor adherence was noted, with 37% stopping medication within 2 days and 11% exceeding 3 days.

Conclusions:

• High malaria knowledge in Rwanda contrasts with poor treatment adherence among febrile patients.
• Suboptimal adherence to antimalarial medication poses a significant risk for the development and spread of drug resistance.
• Urgent interventions are needed to improve antimalarial adherence, especially in regions with documented resistance.