Decreased Availability of Antimalarials in the Private Sector Following the Policy Change from Chloroquine to Sulphadoxine-Pyrimethamine in the Kilombero Valley, Tanzania
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Date
2006
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BioMed Central
Abstract
Background: Malaria control strategies emphasize the need for prompt and effective treatment
of malaria episodes. To increase treatment efficacy, Tanzania changed its first-line treatment from
chloroquine to sulphadoxine-pyrimethamine (SP) in 2001. The effect of this policy change on the
availability of antimalarials was studied in rural south-eastern Tanzania.
Methods: In 2001 and 2004, the study area was searched for commercial outlets selling drugs and
their stocks were recorded. Household information was obtained from the local Demographic
Surveillance System.
Results: From 2001 to 2004, the number of general shops stocking drugs increased by 15% and
the number of drug stores nearly doubled. However, the proportion of general shops stocking
antimalarials dropped markedly, resulting in an almost 50% decrease of antimalarial selling outlets.
This led to more households being located farther from a treatment source. In 2004, five out of 25
studied villages with a total population of 13,506 (18%) had neither a health facility, nor a shop as
source of malaria treatment.
Conclusion: While the change to SP resulted in a higher treatment efficacy, it also led to a
decreased antimalarial availability in the study area. Although there was no apparent impact on
overall antimalarial use, the decline in access may have disproportionately affected the poorest and
most remote groups. In view of the imminent policy change to artemisinin-based combination
therapy these issues need to be addressed urgently if the benefits of this new class of antimalarials
are to be extended to the whole population.
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Citation
Hetzel, M.W., Msechu, J.J., Goodman, C., Lengeler, C., Obrist, B., Kachur, S.P., Makemba, A., Nathan, R., Schulze, A. and Mshinda, H., 2006. Decreased availability of antimalarials in the private sector following the policy change from chloroquine to sulphadoxine-pyrimethamine in the Kilombero Valley, Tanzania. Malaria journal, 5(1), p.1.