Background: The development and spread of drug-resistant strains of
malaria parasites has been identified as a key factor in malaria resurgence
and is one of the greatest challenges to malaria control today. It is important
to prevent or delay significantly the spread of artemisinin resistant parasites within the
country and beyond its borders. Efforts to prevent deterioration of this problem are,
therefore, at present directed towards finding novel ways of intervening to improve
adherence and prevent the irrational use of currently available multi-dose anti-malarial
drugs. The primary objective of this study was to access the level of patient adherence
to artemether-lumefantrine under routine conditions of prescription.
Method and Technique: Patients who consulted the fixed clinic or mobile clinic were
routinely examined and screened for eligibility of inclusion in the study. The malaria
positive P. falciparum malaria cases were treated with six doses of artemetherlumefantrine.
Patient adherence was conducted by questionnaire and counting
remaining pills on day 3 of anti-malaria treatment at their home. The adherence level
was classified into three categories: definitely non-adherent, probably non-adherent
and probably adherent. Reasons for being definitely non-adherent were also assessed.
Results: Out of the total initially enrolled 175 patients, 161 (92%) patients completed
the follow-up. Out of these, 138 (85.7%) were classified as probably adherent, 8 (5%)
as probably non-adherent, and 15(9.3%) were definitely non-adherent. 40% of patients
among definitely non-adherent group were age more than 15 years of age while 2-4
years of age compromised 70% of probably non-adherent group.