Table of Contents Author Guidelines Submit a Manuscript
Journal of Tropical Medicine
Volume 2015, Article ID 189232, 11 pages
http://dx.doi.org/10.1155/2015/189232
Review Article

Adherence to Artemisinin-Based Combination Therapy for the Treatment of Uncomplicated Malaria: A Systematic Review and Meta-Analysis

1Infectious and Tropical Diseases Unit, Public Health and Diagnostic Institute, College of Medical Sciences, Northwest University, PMB 3220, Kano, Nigeria
2Infectious and Tropical Diseases Unit, Department of Medicine, Aminu Kano Teaching Hospital, Bayero University, PMB 3452, Kano, Nigeria
3Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, PMB 3452, Kano, Nigeria
4Department of Pharmacy, Aminu Kano Teaching Hospital, PMB 3452, Kano, Nigeria
5Department of Medicine, Aminu Kano Teaching Hospital, Bayero University, PMB 3452, Kano, Nigeria
6Infectious and Tropical Diseases Unit, Department of Paediatrics, Aminu Kano Teaching Hospital, Bayero University, PMB 3452, Kano, Nigeria

Received 16 December 2014; Revised 3 May 2015; Accepted 4 May 2015

Academic Editor: Aditya Prasad Dash

Copyright © 2015 Ahmad M. Yakasai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Adherence to artemisinin-based combination therapy (ACT) is not clearly defined. This meta-analysis determines the prevalence and predictors of adherence to ACT. Twenty-five studies and six substudies met the inclusion criteria. The prevalence of ACT adherence in the public sector was significantly higher compared to retail sector (76% and 45%, resp., ). However, ACT adherence was similar across different ACT dosing regimens and formulations. In metaregression analysis prevalence estimates of adherence significantly decrease with increasing year of study publication . Factors found to be significant predictors of ACT adherence were years of education ≥ 7 odds ratio (OR) (95% CI) = 1.63 (1.05–2.53), higher income 2.0 (1.35–2.98), fatty food 4.6 (2.49–8.50), exact number of pills dispensed 4.09 (1.60–10.7), and belief in traditional medication for malaria 0.09 (0.01–0.78). The accuracy of pooled estimates could be limited by publication bias, and differing methods and thresholds of assessing adherence. To improve ACT adherence, educational programs to increase awareness and understanding of ACT dosing regimen are interventions urgently needed. Patients and caregivers should be provided with an adequate explanation at the time of prescribing and/or dispensing ACT.