Determinants of Patients’ Adherence to Malaria Treatment in the Democratic Republic of the Congo

Abstract

(1) Background: Malaria heavily affects the Democratic Republic of the Congo (DRC) despite the use of effective drugs. Poor adherence to malaria treatment may contribute to this problem. (2) Methods: In one rural and one urban health area in each of the 11 former provinces of the DRC, all households with a case of malaria in the 15 days preceding the survey were selected and the patients or caregivers were interviewed. Adherence to malaria treatment was assessed by self-declaration about its completion. Logistic regression was used to assess predictors. (3) Results: 1732 households participated. Quinine was the most used drug; adherence to artesunate–amodiaquine was the lowest and the main reason for treatment discontinuation was adverse reactions. Predictors of adherence were residence in an urban area, university education, catholic religion, and adoption of recommended behaviour towards a malaria case. Adherence was significantly lower for responders who obtained information on antimalarials from Community Health Workers (CHW). (4) Conclusions: Usage of recommended drugs and adherence to malaria treatment need to be promoted, especially in rural areas, and CHW involvement needs to be improved. Awareness messages need to be made accessible and comprehensible to poorly educated populations and churches need to be involved.

Prescription patterns and compliance with World Health Organization recommendations for the management of uncomplicated and severe malaria: A prospective, real-world study in sub-Saharan Africa

“…Poor compliance to WHO treatment recommendations in patients with severe malaria has been observed previously in several studies [ 13 , 18 , 19 ]. A study conducted in Ghana and Uganda showed 30% compliance to WHO guidelines in patients with severe malaria [ 13 ].…”

“…The poor compliance was mainly due to sub-optimal healthcare facilities in Uganda [ 18 ]. A cross-sectional study in urban and rural areas in DRC showed that a higher proportion of patients living in urban areas (76.5%) adhered to treatment compared with those living in rural areas (66.8%) [ 19 ]. The level of education also played an important role in treatment compliance.…”

“…The level of education also played an important role in treatment compliance. Patients who were university graduates were more adherent than those who did not receive any education (78.3% vs. 68.2%) [ 19 ]. A recent retrospective study in Gambela town of Ethiopia showed that only one case of uncomplicated malaria was treated as per guideline recommendations, while 99.1% of cases did not receive treatment as per guidelines.…”

Exploring Novel Antimalarial Compounds Targeting Plasmodium falciparum Enoyl-ACP Reductase: Computational and Experimental Insights

“…5 However, the widespread adoption of these treatments is influenced by factors such as pharmaceutical availability and individual patient-specific requirements, limitations, or financial constraints. 6 Nevertheless, the emergence of drug resistance has severely compromised the effectiveness of current malaria therapies, including widely used drugs, such as chloroquine and artemisinin, leading to increased morbidity and mortality rates.…”

“…falciparum infections . However, the widespread adoption of these treatments is influenced by factors such as pharmaceutical availability and individual patient-specific requirements, limitations, or financial constraints …”