Adherence To Artemisinin Based Combination Therapy In Malaria Patients Attended To In Public Health Facilities In Gembe Ward Mbita Subcounty, Kenya

ABSTRACT

World Health Organization (WHO) estimates that in 2017 there were 435 000 deaths from malaria globally with Sub-Saharan Africa region carrying a disproportionately high share of the global malaria burden. In 2017, the region had 92% of malaria cases and 93 % of malaria deaths. In Kenya, malaria is the second major cause of death with an estimated 6.7 million new clinical cases are reported each year. Malaria burden is not homogenous in Kenya since areas around Lake Victoria and coastal region exhibit the greatest risk of the disease with the prevalence ranging around 11% to 27% respectively.In Mbita sub County malaria is perennial with prevalence reported to be high at 30%, almost four times higher than the national prevalence at 8%. This could also be attributed to treatment failure due to lack of adherence to anti-malarial drugs among other factors like misuse of bednets and lack of vector control programe. Many studies have implicated improper use of anti-malarial as key cause of increased malaria prevalence in endemic settings. The main purpose of this study was to assess adherence to ACT in malaria patients attended to in public health facilities in Gembe Ward, Mbita Sub County.The specific objectives were to determine the socio-demographic factors that are associated with adherence to ACT medication, to determine the influence of patient/caregiver’s knowledge and medication taking practices on adherence to ACT and to establish the influence of health care practitioners dispensing practices to ACT adherence among patients/care givers. This was a descriptive cross-sectional survey done in three public health facilities.Fisher’s formula was used to obtain a samples size of 401 patients from the selected facilities. Questionnaire was used to gather information on socio-demographic characteristics, knowledge on ACT medication practices and healthcare practitioner dispensing practices. Key informant interviews were conducted among the health care practitioners in the selected facilities to gather information on ACT dispensing practices. The study found that 53.87% adhered to ACT and 46.13% were non adherent, majority of the females 56% constituted more than half of the participants (n=401). Factors associated with ACTs adherence was observed among respondents aged between 6-14 (OR = 7.0, 95% CI [2.737-17.906], p< = 0.001); 15-30 (OR=3.03, 95%CI [1.281-7.203],p=30 (OR=7.417 95%CI[3.190-17.246]p=