title: Adherence and uptake of artemisinin-based combination treatments for uncomplicated malaria: a qualitative study in northern Ghana.
abstract: BACKGROUND
  Based on the recommendations of the World Health Organization in 2004, Ghana changed her antimalarial drug policy from mono-therapy to Artemisinin-based Combination Therapy (ACTs). The country is currently using three first line drugs artesunate-amodiaquine, artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated malaria. Despite this policy, little or no qualitative studies have been conducted to establish the factors influencing adherence to the new treatment for malaria. This study explored factors influencing adherence to the use of ACTs in northern Ghana.
  
  
  METHODS
  This was a qualitative study comprising forty (40) in-depth interviews with patients with malaria who visited selected public and private health facilities and received ACTs. Systematic sampling technique was used to select participants who were given ACTs for the interviews. Nvivo 9 software was used to code the data into themes for further analysis.
  
  
  RESULTS
  The study revealed very important differences in knowledge about ACTs. As expected, the less or illiterates could not mention the type of ACT they would prefer to use for treating their malaria. The educated ones had a good knowledge on ACTs and preferred artemether-lumefantrinee in treating their malaria. The reason was that the drug was good and it had minimal or no side effects. Individual attitudes toward the use of medications and the side effects associated with the use of these ACTs were found to be the main factors affecting adherence to the use of ACTs. Perceived cure of illness after the initial dose greatly affected adherence. Other factors such as forgetfulness and lack of information also influenced patient adherence to ACTs use.
  
  
  CONCLUSIONS
  Individual knowledge, attitudes and behaviors greatly influence patients' adherence to ACTs use. Since ACTs take a number of days to complete, continuous education by health professionals could improve on adherence to ACTs use by patients with malaria.
authors.affiliation: Navrongo Health Research Centre, P.O Box 114, Navrongo, Ghana.
authors.forename: Samuel
authors.initials: S
authors.lastname: Chatio
authors.affiliation: Navrongo Health Research Centre, P.O Box 114, Navrongo, Ghana.
authors.forename: Raymond
authors.initials: R
authors.lastname: Aborigo
authors.affiliation: University of Ghana, School of Public Health, Accra, Ghana.
authors.forename: Philip Baba
authors.initials: PB
authors.lastname: Adongo
authors.affiliation: Navrongo Health Research Centre, P.O Box 114, Navrongo, Ghana.
authors.forename: Thomas
authors.initials: T
authors.lastname: Anyorigiya
authors.affiliation: University of Ghana, School of Public Health, Accra, Ghana.
authors.forename: Patricia
authors.initials: P
authors.lastname: Akweongo
authors.affiliation: Navrongo Health Research Centre, P.O Box 114, Navrongo, Ghana.
authors.forename: Abraham
authors.initials: A
authors.lastname: Oduro
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D037621:Artemisinins / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006268:Health Facilities / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008288:Malaria / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000962:Antimalarials; D037621:Artemisinins; C031327:artemisinin