학술논문
Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group
Asia Pacific Malaria Elimination Network
Asia Pacific Malaria Elimination Network
Document Type
Report
Author
Thriemer, Kamala; Bobogare, Albino; Ley, Benedikt; Gudo, Clarice Samo; Alam, Mohammad Shafiul; Anstey, Nick M.; Ashley, Elizabeth; Baird, J. Kevin; Gryseels, Charlotte; Jambert, Elodie; Lacerda, Marcus; Laihad, Ferdinand; Marfurt, Jutta; Pasaribu, Ayodhia Pitaloka; Poespoprodjo, Jeanne Rini; Sutanto, Inge; Taylor, Walter R.; van den Boogaard, Christel; Battle, Katherine E.; Dysoley, Lek; Ghimire, Prakash; Hawley, Bill; Hwang, Jimee; Khan, Wasif Ali; Mudin, Rose Nani Binti; Sumiwi, Maria Endang; Ahmed, Rukhsana; Aktaruzzaman, M. M.; Awasthi, Kiran Raj; Bardaji, Azucena; Bell, David; Boaz, Leonard; Burdam, Faustina Helen; Chandramohan, Daniel; Cheng, Qin; Chindawongsa, Keobouphaphone; Culpepper, Janice; Das, Santasabuj; Deray, Raffy; Desai, Meghna; Domingo, Gonzalo; Duoquan, Wang; Duparc, Stephan; Floranita, Rustini; Gerth-Guyette, Emily; Howes, Rosalind E.; Hugo, Cecilia; Jagoe, George; Sariwati, Elvieda; Jhora, Sanya Tahmina; Jinwei, Wu; Karunajeewa, Harin; Kenangalem, Enny; Lal, Bibek Kumar; Landuwulang, Chandra; Le Perru, Emmanuel; Lee, Sang-Eun; Makita, Leo Sora; McCarthy, James; Mekuria, Asrat; Mishra, Neelima; Naket, Esau; Nambanya, Simone; Nausien, Johnny; Duc, Thang Ngo; Thi, Thuan Nguyen; Noviyanti, Rinitis; Pfeffer, Daniel; Qi, Gao; Rahmalia, Annisa; Rogerson, Stephen; Samad, Iriani; Sattabongkot, Jetsumon; Satyagraha, Ari; Shanks, Dennis; Sharma, Surender Nath; Sibley, Carol Hopkins; Sungkar, Ali; Syafruddin, Din; Talukdar, Arunansu; Tarning, Joel; ter Kuile, Feiko; Thapa, Suman; Theodora, Minerva; Huy, Tho Tran; Waramin, Edward; Waramori, Govert; Woyessa, Adugna; Wongsrichanalai, Chansuda; Xa, Nguyen Xuan; Yeom, Joon Sup; Hermawan, Lukas; Devine, Angela; Nowak, Spike; Jaya, Indra; Supargiyono, Supargiyono; Grietens, Koen Peeters; Price, Ric N.
Source
Malaria Journal. June 20, 2018, Vol. 17 Issue 1
Subject
Language
English
ISSN
1475-2875
Abstract
Author(s): Kamala Thriemer[sup.1] , Albino Bobogare[sup.2] , Benedikt Ley[sup.1] , Clarice Samo Gudo[sup.3] , Mohammad Shafiul Alam[sup.4] , Nick M. Anstey[sup.1] , Elizabeth Ashley[sup.5,6] , J. Kevin Baird[sup.6,7] , Charlotte [...]
The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness. Keywords: Vivax malaria, Plasmodium vivax, Adherence, Effectiveness, Efficacy, Radical cure, Primaquine, APMEN
The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness. Keywords: Vivax malaria, Plasmodium vivax, Adherence, Effectiveness, Efficacy, Radical cure, Primaquine, APMEN