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Table 1 Studies that measure adherence to AL

From: Adherence to artemisinin-based combination therapy for the treatment of malaria: a systematic review of the evidence

Study design

Study author

Country

Study year

Population

Sample size

Measurement method

Adherence

Cross-sectional

Barnes [49]

South Africa

2002

All ages

239

Self-report

96.0%

 

Simba [46]

Tanzania

2008

3-59mo

467

Bioassay (blood levels) plus self-report

88.3%

Prospective observational

Depoortere [58]

South Sudan

2002

6-59mo

107

Pill counts & self -report (questionnaire)

59.1%

Fogg [31]

Uganda

2002

<5 yrs 5-14 yrs 15 + yrs

210

Pill counts & self-report (questionnaire) & bioassay

90.0%

Ngasala [68]

Tanzania

2007

3-59mo

177

Bioassay (D7 lumefantrine levels)

37%

Kabanywanyi [36]

Tanzania

2008

<13 yrs 13 + yrs

552

Pill counts & self -report (questionnaire)

89.2%

Lemma [43]

Ethiopia

2008

>2mo

180

Pill counts & self -report (questionnaire)

38.7%

Mace [38]

Malawi

2009

6-59mo 5-17 yrs 18 + yrs

868

Pill counts & self -report (questionnaire)

65.0%

Ogolla [44]

Kenya

2009

12-59mo

73

Pill counts & self -report (questionnaire)

75.8%

Lawford [37]

Kenya

2009

<15 yrs 15 + yrs

918

Pill counts & self -report (questionnaire)

64.1%

Kalyango [63]

Uganda

2011

4-59mo

1256

Pill counts & self -report (questionnaire)

99.2% (I)iii

98.5% (C)

 

Zaw Win [47]

Myanmar

2012iv

All ages

248

Pill counts & self -report (questionnaire)

89.5%

Pre- post intervention study

Chinbuah [42]

Ghana

2004/ 2005

6-59mo

363

Pill counts & self -report (questionnaire)

92.5%v

 

Kangwana [51]

Kenya

2008/ 2009

3-59mo

3,288b; 3,182a

Self-report

53.1% Before 67.0% Aftervi

RCT

Mubi [64]

Tanzania

2006

All ages

2156

Pill counts & self -report (questionnaire)

99.3% CDvii

97.4% RDT

Rahman [45]

Bangladesh

2006/ 2007

>2 yrs

320

Pill counts & self -report (questionnaire) & bioassay

93.1%viii

 

Cohen [57]

Uganda

2009

All ages

395

Pill count or Self-report

65.8%

  1. iSelf-report only. The lumefantrine levels were not found to be significantly different between those that adhered vs. those that did not adhere.
  2. iiBased on a cut-off of 280 ng/ml. Only 37% had > 280 ng/ml.
  3. iii(I) = intervention and (C) = combination.
  4. ivYear published.
  5. vAlthough described as a pre-post intervention study, adherence data was only provided for the post-intervention phase.
  6. viNumbers presented are for the Intervention group. The control group was 40.5% before/49.4% after. There was no significant difference found between the two groups during the post survey.
  7. viiCD = Clinical Diagnosis Group; RDT = Rapid Diagnostic Test Group.
  8. viiiNon-Directly Observed Treatment.