Evidence map›Paper›PMID 30134987›Full record

ArticleMalaria journal2018

Private sector drug shops frequently dispense parenteral anti-malarials in a rural region of Western Uganda.

Lawrence T Wang, Robert Bwambale, Corinna Keeler, Raquel Reyes, Rabbison Muhindo, Michael Matte, Moses Ntaro, Edgar Mulogo, Radhika Sundararajan, Ross M Boyce

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Malaria journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Lawrence T WangSchool of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA. ltwang@ucsd.edu.ORCID http://orcid.org/0000-0002-8026-8044
Robert BwambaleBugoye Level III Health Centre, Uganda Ministry of Health, Bugoye, Kasese District, Western Region, Uganda.
Corinna KeelerDepartment of Geography, University of North Carolina at Chapel Hill, Campus Box 3220, Chapel Hill, NC, 27599, USA.
Raquel ReyesDivision of General Medicine & Clinical Epidemiology, University of North Carolina at Chapel Hill, 5039 Old Clinic Building, CB 7110, Chapel Hill, 27599, USA.
Rabbison MuhindoDepartment of Community Health, Mbarara University of Science & Technology, P.O. Box 1410, Mbarara, Uganda.
Michael MatteDepartment of Community Health, Mbarara University of Science & Technology, P.O. Box 1410, Mbarara, Uganda.
Moses NtaroDepartment of Community Health, Mbarara University of Science & Technology, P.O. Box 1410, Mbarara, Uganda.
Edgar MulogoDepartment of Community Health, Mbarara University of Science & Technology, P.O. Box 1410, Mbarara, Uganda.
Radhika SundararajanDepartment of Emergency Medicine, Weill Cornell Medical College, 525 East 68th Street, New York, NY, 10065, USA.
Ross M BoyceDivision of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Chapel Hill, NC, 27599, USA.
Mbarara University of Science and Technology · UGUniversity of North Carolina at Chapel Hill · USCornell University · USMinistry of Health · UGUniversity of California San Diego · US

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007198 · NIGMS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI CHI, NEIL C, INSEL, PAUL A · 1985 to 2024
$29.3M
INFECTIOUS DISEASE PATHOGENESIS TRAININGT32AI007151 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JULIANO, JONATHAN J · 1985 to 2024
$5.5M
Expanding HIV testing among Ugandan adults who utilize traditional healersK23MH111409 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI SUNDARARAJAN, RADHIKA LU · 2017 to 2021
$778k
National Institutes of Health K23 MH111409National Institutes of Health T32 AI007151NIAID NIH HHS T32 AI007151NIGMS NIH HHS T32 GM007198NIMH NIH HHS K23 MH111409University of California, San Diego Global Health Academic Concentration
6 · The paper itself

Abstract

backgroundMalaria is a leading cause of paediatric morbidity and mortality in Uganda. More than half of febrile children in rural areas initially seek care at private clinics and drug shops. These shops are generally unregulated and the quality of clinical care is variable, with the potential for misdiagnosis and the development of drug resistance. There is thus an urgent need to identify rural drug shops and coordinate their malaria treatment efforts with those of the public sector. The objective of the study was to identify all drug shops in the Bugoye sub-county of Western Uganda and assess their anti-malarial dispensing practices.

methodsThis study is a cross-sectional survey of drug shops in a rural sub-county of Western Uganda. In the first phase, shop locations, licensing and shopkeeper's qualifications, and supply and pricing of anti-malarials were characterized. In the second phase, the proportion of anti-malarials dispensed by private drug shops was compared to public health facilities.

resultsA total of 48 drug shops were identified. Only one drug shop (1 of 48, 2%) was licensed with the sub-county's records office. The drug shops stocked a variety of anti-malarials, including first-line therapies and less effective agents (e.g., sulfadoxine/pyrimethamine). Almost all drug shops (45 of 48, 94%) provided parenteral anti-malarials. Of the 3900 individuals who received anti-malarials during the study, 2080 (53.3%) purchased anti-malarials through the private sector compared to 1820 (46.7%) who obtained anti-malarials through the public sector. Drug shops were the primary source of parenteral anti-malarials. Inadequate dosing of anti-malarials was more common in drug shops.

conclusionsDrug shops are major sources of parenteral anti-malarials, which should be reserved for cases of severe malaria. Strengthening malaria case management and incorporating drug shops in future interventions is necessary to optimize malaria control efforts in the sub-county, and in similarly endemic regions.

Indexed as

PharmacyPrivate SectorAdolescentAdultAgedAged, 80 and overAntimalarialsChildChild, PreschoolCross-Sectional StudiesFemaleHumansInfantInfant, NewbornInjectionsMaleAntimalarialsAnti-malarialsHealth-seeking behaviorsMalariaParenteral drugsPrivate sector

Identifiers

PMID30134987
PMCPMC6106765
OpenAlexW2888019917

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.