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

Table 3 Studies that measure adherence as comparative studies

Study design	Study author	Country	Study year	Population	Sample size	Measurement method	Drugs	Adherence
RCT	Bell [67]	Malawi	2004-2006	>6 mo	841	Bioassay; self-report	AL	100% SR 92.0% MEMS
						(questionnaire); MEMS*	CPD	99.2% SR 90.6% MEMS
						(questionnaire); MEMS*	SP	100% DOT
	Dunyo [59]	Gambia	2004	6mo - 10 yrs	1238	Pill Counts & self-report (questionnaire)	AL	67.0%
	Dunyo [59]	Gambia	2004	6mo - 10 yrs	1238	Pill Counts & self-report (questionnaire)	CPD	94.0%
	Faucher [60]	Benin	2007	<5 yrs	240	Recovery of drug blisters	AL	83.0%
						Recovery of drug blisters	AQAS	91.0%
						(pill-count)	AQAS	91.0%
						(pill-count)	SP	100%*
	Achan [55]	Uganda	2007/2008	6-59 mo	175	Pill Counts & care giver	AL QNN	94.5% 85.4%
						self-report (questionnaire)
Cross-sectional	Ajayi [39]	Ghana Uganda Nigeria	2008**	6-59 mo	244	Self-report:	AL	Composite 94%
	Ajayi [39]	Ghana Uganda Nigeria	2008**	6-59 mo	244	(timing, # doses, # of days)	AQ + AS	Composite 94%
	Ajayi [40]	Ghana Uganda Nigeria	2008**	6-59 mo	1096	Self-report:	AL	Composite 85%
	Ajayi [40]	Ghana Uganda Nigeria	2008**	6-59 mo	1096	(timing, # doses, # of days)	AQ + AS	Composite 85%
	Alba [41]	Tanzania	2004-2008	All ages	32***	Self-report:	AL	69.0%
						(timing, # doses, # of days)	SP	84.0%
						(timing, # doses, # of days)	QNN	0%
							Composite	51.0%

*SR = Self-report; MEMS = Medical Event Monitoring System.
**In Ghana and Nigeria treatments were given at home unsupervised. In Uganda the first dose was administered as DOT.
***Information for AL was only available in the third survey conducted in 2008, so results presented are only from that survey.

ISSN: 1475-2875