Feasibility of distributing rapid diagnostic tests for malaria in the retail sector: evidence from an implementation study in Uganda.
Feasibility of distributing rapid diagnostic tests for malaria in the retail sector: evidence from an implementation study in Uganda.
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DOI：
10.1371/journal.pone.0048296
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Dickens W
中科院分区：
文献类型：
--
作者：
Cohen J;Fink G;Berg K;Aber F;Jordan M;Maloney K;Dickens W
尽管疟疾诊断有好处，但大多数假定的疟疾发作从未进行过测试。一个主要原因是零售机构缺乏诊断测试，许多患者在那里寻求治疗。药店中的疟疾快速诊断测试(RDT)有望指导适当的治疗。然而，零售供应商普遍缺乏对RDTs的认识和管理培训。此外，没有补贴的RDTs可能对患者来说负担不起，对零售商也没有吸引力。本文报告了一项干预研究的结果，该研究测试了在乌干达药店分发RDT的可行性。58个村庄的92家药店在完成培训后被提供补贴的RDTs出售。收集有关RDT的购买、储存、管理和处置的数据，并将样品送去进行质量检测。进行了家庭调查，以了解治疗结果。估计每天RDT的销售额在不同商店之间差异很大，从零到8.46 RDT每天。对储存、处理和处置指南的总体遵守情况良好。所有从商店收集的RDTs(100%)都通过了质量检测。RDTs的价格中值为1000USH(0.40美元)，相当于100%的加价，与当地医疗诊所的血液玻片价格相同。RDT影响治疗决定。与RDT阴性患者相比，RDT阳性患者购买青蒿素联合疗法(ACTs)的可能性高23个百分点(p = .005)，购买其他抗疟疾药物(p<；.001)的可能性高33.1个百分点，购买其他抗疟疾药物(p<；.001)的可能性高5.6个百分点(p = .05)，购买其他抗疟疾药物(p<；.001)的可能性高31.4个百分点。尽管存在一些异质性，但商店表现出了储存RDTs并用它们来指导治疗建议的愿望。大多数商店适当地储存、管理和处置RDT，并收取与普通药品类似的加价。这项研究的结果表明，通过零售部门分发RDT是可行的，可以减少对疑似疟疾的不当治疗。
Despite the benefits of malaria diagnosis, most presumed malaria episodes are never tested. A primary reason is the absence of diagnostic tests in retail establishments, where many patients seek care. Malaria rapid diagnostic tests (RDTs) in drug shops hold promise for guiding appropriate treatment. However, retail providers generally lack awareness of RDTs and training to administer them. Further, unsubsidized RDTs may be unaffordable to patients and unattractive to retailers. This paper reports results from an intervention study testing the feasibility of RDT distribution in Ugandan drug shops. 92 drug shops in 58 villages were offered subsidized RDTs for sale after completing training. Data on RDT purchases, storage, administration and disposal were collected, and samples were sent for quality testing. Household surveys were conducted to capture treatment outcomes. Estimated daily RDT sales varied substantially across shops, from zero to 8.46 RDTs per days. Overall compliance with storage, treatment and disposal guidelines was excellent. All RDTs (100%) collected from shops passed quality testing. The median price charged for RDTs was 1000USH ($0.40), corresponding to a 100% markup, and the same price as blood slides in local health clinics. RDTs affected treatment decisions. RDT-positive patients were 23 percentage points more likely to buy Artemisinin Combination Therapies (ACTs) (p = .005) and 33.1 percentage points more likely to buy other antimalarials (p<.001) than RDT-negative patients, and were 5.6 percentage points more likely to buy ACTs (p = .05) and 31.4 percentage points more likely to buy other antimalarials (p<.001) than those not tested at all. Despite some heterogeneity, shops demonstrated a desire to stock RDTs and use them to guide treatment recommendations. Most shops stored, administered and disposed of RDTs properly and charged mark-ups similar to those charged on common medicines. Results from this study suggest that distributing RDTs through the retail sector is feasible and can reduce inappropriate treatment for suspected malaria.
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DOI：
10.1136/bmj.c930
发表时间：
2010-03-05
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Ansah EK;Narh-Bana S;Epokor M;Akanpigbiam S;Quartey AA;Gyapong J;Whitty CJ
通讯作者：
Whitty CJ
影响因子：
3
作者：
Hawkes M;Katsuva JP;Masumbuko CK
通讯作者：
Masumbuko CK
影响因子：
3
作者：
Chanda, Pascalina;Hamainza, Busiku;Pagnoni, Franco
通讯作者：
Pagnoni, Franco
影响因子：
3.7
作者：
Endeshaw T;Graves PM;Ayele B;Mosher AW;Gebre T;Ayalew F;Genet A;Mesfin A;Shargie EB;Tadesse Z;Teferi T;Melak B;Richards FO;Emerson PM
通讯作者：
Emerson PM
影响因子：
3
作者：
Batwala V;Magnussen P;Nuwaha F
通讯作者：
Nuwaha F