Poor Knowledge on New Malaria Treatment Guidelines among Drug Dispensers in Private Pharmacies in Tanzania: the Need for Involving the Private Sector in Policy Preparations and Implementation

Objective: To assess the knowledge of dispensers in private pharmacies on new malaria treatment guidelines which involved switching from chloroquine (CQ) to sulfadoxine pyrimethamine (SP) and from SP to artemether-lumefantrine. Methods: A structured questionnaire was used for data collection and the questions focused on whether the subjects were involved in the preparation or implementation of the guidelines or had undertaken any training on how to dispense new antimalarial medicines as recommended in the introduced new treatment guidelines. Results: The study revealed that none of the participants had been involved in the preparation of the treatment guidelines; nor had they undertaken any training on their implementation. As many as 49of the visited private pharmacies were found to continue stocking and selling CQ tablets and injections. Only 30 and 7knew the correct dose regimen of SP and ALU respectively and none of them knew the condition of taking ALU with a fatty meal for improved absorption. Conclusion: Lack of involvement of the pharmaceutical personnel working in the private pharmacies; from the preparation of new malaria treatment guidelines to their implementation; contributed to their poor knowledge and skill on how to correctly dispense the medicines

Validation of Self-Report and Hospital Pill Count using Unannounced Home Pill Count as Methods for Determination of Adherence to Antiretroviral Therapy

Adherence to anti-retroviral therapy (ART) is very crucial for successful treatment outcomes. This study aimed to validate patient-self report (PSR) and hospital based pill count (HoPC) as adherence determination methods by using unannounced home visit pill count (HPC). The study was carried out at Muhimbili National Hospital in Dar es Salaam; Tanzania and 215 patients purposively selected were recruited. On re?ll day; the remaining pills were counted. They were also asked to report on the number of doses they missed during the past 28 days. They were later visited in their homes without appointment where the remaining pills were counted. Ninety-eight percent and 93reported to adhere to ART by PSR method and HoPC; respectively. However; only 58of the same study patients were found to be adherent by = 95using HPC. In conclusion; PSR and HoPC do not always give reliable adherence data in patients undergoing ART. Therefore; we recommend application of combination methods for adherence measuring in patients starting to include patient self report and hospital based pill count in new patients and complementing them with unannounced home based pill count in experienced patients. Wherever possible; drug plasma concentration measurements should also be established