Evaluating access to Malaria Rapid Diagnostic Test kit and Artemisinin-based Combination Therapy and the Quality of Treatment Practice among Over-the-Counter Medicine Sellers at the District Level in the Brong Ahafo Region - Ghana

Abstract

Background: Accurate diagnosis and appropriate treatment of malaria with the recommended antimalarials are crucial in the fight against malaria. This study evaluated the availability and sources of ACT and RDT kits among the Over-The-Counter (OTC) medicine sellers in the Pru, Sene and Atebubu-Amantin Districts of Ghana. Method: A cross-sectional descriptive study was conducted using a structured questionnaire. Sixty-two OTC medicine sellers were randomly selected, informed consent sought and interviewed on access to RDT kit, ACT and Training in malaria diagnosis. Data entry, editing and analysis was done using SPSS Ver 22. Results: The study revealed that 26.2% of respondents use the RDT kits to diagnosis and confirm suspected malaria. 94.1% respondents who had malaria RDT kits at their shop purchased them from the NMCP and Pharmacy shops. 95% of respondents had in stock at least one of the 3 recommended ACT - artesunate amodiaquine, artemether lumefantrine, and/or dihydroartemisinin piperaquine.65.6% of respondents often recommend artemether lumefantrine to patients to treat uncomplicated malaria.. The average wholesale and retail prices of the Affordable Medicine Facility malaria (AMFm) branded ACT were higher than the approved suggested retail prices. Conclusion: Most OTC medicine sellers do not comply with the national antimalarial drug treatment policy. 85% of OTC medicine sellers purchase their AMFm branded ACT from second-line buyers at relatively higher price. Recommendation: Regular training of OTC medicine sellers on malaria control and easier access to quality and affordable malaria RDT kits and ACT would help improve malaria control at the community level.